Is the Industry Ready for Open Payments?
For those who plan meetings for health-care professionals, March 31 looms large. That's the reporting submission deadline for Open Payments, previously known as the Physician Payments Sunshine Act. All of the data concerning physician payments from Aug. 1 through Dec. 31, 2013, must be filed with the federal government, including speaker and consultation fees, meals, travel costs and the like. And every company that conducts sessions or events for health-care professionals must file by that same deadline.
With that in mind - and with the recent health-insurance open-enrollment technical fiasco still fresh - the Centers for Medicare and Medicaid Services held nine hours worth of webinars this past December to aid in training those responsible on how the data must be collected and filed. If the current government timeline sticks, all of that payment information will be made public by late 2014.
Pat Schaumann, CMP, CSEP, DMCP, the president of St. Louis-based Meeting Compliance IQ and the founder of the International Medical Meeting Professionals Association, has been teaching courses on preparing for and adhering to the payments provision. By the end of 2013, she says, about 100 meeting professionals had taken the Healthcare Compliance Certificate Program, which is all based on the new law. "The response has been incredible," she says.
As for levels of preparedness, it's a decidedly mixed bag for pharma and life-sciences companies, according to Nicole Davis-Ellison, CMP, vice president of strategic account management for the Durham, N.C.-based Plannernet, which supports about 13,000 health-care meetings annually.
She says that many of the larger pharma companies have been quite diligent in collecting and saving the data required for reporting, "but we're definitely seeing the crunch in the mid and small life-sciences companies that don't have that infrastructure." Many of those clients, she notes, are striving to balance the demands for data with maintaining a positive attendee experience at the registration desks.
The effects wrought on some medical meetings by sequestration, government budget reductions and federal travel restrictions have been massive. Take, for example, the annual meeting of the Chicago-based American Academy of Medical Administrators.
About half of the organization's members work for the federal government. In large part, they represent the U.S. armed services or National Guard and, traditionally, make up more than half of the attendees at the AAMA meeting. That won't be the case when the academy convenes for the 2014 gathering later this month. "This is a conference that typically has attracted about 400 people," says SmithBucklin's Kevin Baliozian, the show's executive director. "We will be ecstatic if this year we attract, say, 200 to 250 people face-to-face."
Due in large part to the travel policy restrictions that grew out of the GSA conference scandal of 2012, Baliozian says, armed-forces representatives have to pay their own way to this year's AAMA meeting -- the government won't pick up the tab for either registration or travel. And that applies to every federal-sector attendee of the conference (except for the National Guard, notes Baliozian, because that agency has a different budget). This isn't necessarily the case long-term, nor is it true for every conference. But for this particular meeting, that's what Baliozian has to deal with.
The AAMA meeting has been hit particularly hard due to the notably high percentage of federal-sector attendees, but other health-care organizations likewise are feeling the effects. At the American College of Healthcare Executives, also based in Chicago, attendance from government agencies has similarly taken a dive. While federal attendees -- most from the armed services and the Veterans Administration -- comprise only about 8 percent of the organization's membership, those members traditionally have made up a disproportionately large percentage of attendees at the annual meeting, says ACHE president and CEO Deborah Bowen.
"We normally get about 800 of them at the annual meeting," notes Bowen, "out of approximately 4,300 total attendees. Last year we only had 100. They haven't been able to get the funding to come."
This is likely to be a long-range issue for the marketplace. On Jan. 14, the Senate Committee on Homeland Security and Governmental Affairs held a hearing on "Examining Conference and Travel Spending Across the Federal Government." As indicated in M&C's coverage of the meeting (see Newsline, page 20, and expanded coverage of the hearing at bit.ly/KnRRBt), policymakers are investigating legislation that would restrict such government spending in the long term.
In the face of such challenges, medical and health-care meeting planners have had to adapt.
Upping the Ante on Education
"When you're fighting for a smaller pie of education dollars, you have to make sure the education you offer is very compelling and very relevant," points out Kevin Baliozian. For the AAMA, that has meant working individually with each branch of the armed forces to determine their needs, and to offer both highly specialized sessions as well as those that touch on health-care topics of interest to the total attendee population.
But the challenge here is also about convincing the federal government that such education has value in the first place, that meetings are not boondoggles or a waste of public funds. The ACHE's Deborah Bowen believes that some progress already is being made in that direction.
"This year we're going to have some pick-up in attendance," Bowen says, estimating that the federal-sector representation could be as high as 300 attendees at the March meeting, up from last year's 100. "I think people are realizing, on some level, that they do need the education. Some agencies are getting special dispensation to send groups of people." Plus, she adds, it seems that some of the confusion around the new travel policies has been worked out. "Last year, people didn't know until the eleventh hour whether they were coming to our meeting or not. I think a lot about the policy has since been clarified -- in some cases to our favor." Adding Civilians
Members of the military have traditionally comprised about 30 percent of attendees at the annual meeting for the Pitman, N.J.-based American Academy of Ambulatory Care Nursing. "We've definitely seen a decline over the past few years," admits conference manager Laura Kensil, "with 2013 having the lowest military presence." Such attendance was extremely sparse at last April's conference -- "no more than 20 people," says Kensil. At least some of those who did attend, she adds, wound up paying their own travel and meeting costs.
And yet, that meeting drew about 700 attendees, on par with past conferences. "We were very worried leading into 2013, knowing what was going on with the federal cuts," according to Kensil. "But luckily, we were in Las Vegas last year, and our other attendees happened to make up for it. Had we been in another location, I'm not sure we would have been able to meet the budget we had set." Based on the past history of shows managed by Kensil's employer, the Anthony J. Jannetti association management company, Las Vegas usually draws at least 10 percent more attendees than any other city, notes Kensil.
But the AAMA's Kevin Baliozian, whose organization relies more heavily on federal-sector attendance, is not as optimistic about his annual meeting this month, which also happens to be in Las Vegas. For his crowd, he says, the location currently represents an added challenge.
"It's incredibly cost-effective," he says, "and everyone is taking this seriously, but it's in Las Vegas and that's a perception issue. There's no rule [for federal-sector employees] against Las Vegas, but it just doesn't help."
So Baliozian and his team have developed additional conference content and marketing with the association's nonmilitary members in mind. "We're hoping to partially compensate for the drop in military attendance that way," he explains.
Virtual Education
Conceding that in many cases it might just be impossible for the federal-sector crowd to attend in person, these conferences increasingly are offering incentives for members to attend virtually. The AAACN, for example, has offered an on-demand online library of courses for the past five years. Last year, however, was the first time the organization offered a steep discount to the military members to access those courses.
The AAMA, meanwhile, is offering a complete virtual track for this month's conference, simulcasting many of the sessions of interest to the federal sector live via GoToMeeting. "It's the first time we're doing this," notes Baliozian, who adds that it's something the federal attendees have requested, and the initial response has been quite good. "From a marketing standpoint, it's excellent because it means we're really listening to the constituency," he says. "We did focus groups and interviewed a lot of people, so hopefully this has a direct impact on bringing in more revenue, reaching more people, and showing that we're listening and reacting accordingly."
The organization is charging roughly two-thirds of the registration fee to attend virtually; in a stroke of good fortune for both the show and attendees, the armed services education budget has been covering the cost of virtual attendance, even though in-person registration and travel costs are the responsibility of the attendees.
At press time, the AAMA had only just launched virtual registration. "It would be great if we get 100 to 200 attendees virtually," says Baliozian. "But we really don't have a very good grasp yet of what that's going to be. Our break-even point is having 30 people attend virtually. That would be fine."
If successful, the virtual component could become an essential part of future meetings. "Eventually," says Baliozian, "we may be dealing with having to have the same size conference, but smaller in person and larger virtually. I wouldn't be surprised if we get to a 50-50 type of mix; probably not this year, but who knows?"
Home Delivery
With federal travel budgets under ever-increasing scrutiny, some shows have seen more demand from the armed services to have the education brought to them, say sources. For instance, the military branches increasingly are taking advantage of ACHE's on-location programs, says Deborah Bowen, through whatever ACHE faculty can be brought on-site to deliver accredited sessions wherever they are required.
Similarly, AAMA is currently in discussions with the National Guard to take some existing content and speakers from the annual meeting and repackage it for a National Guard-hosted event. And such services may become part of deals with other federal-sector branches, each of which has different requirements.
"We have to be much more nimble," says Baliozian. "The thing where you just have a program and people show up? That's over. Some people do show up live, and some of the content we have to repackage, whether it's for an ancillary meeting or a post-conference wrap-up at a military-hosted gathering. So we're more creative."
"The trick with all of this," adds Bowen, "is to have enough flexibility in your systems, and enough types of other opportunities to properly serve the community."
On the Horizon
At this point, no one knows with any certainty what, if any, legislation might be introduced to curtail government meetings and travel. However, some trends probably won't change.
"They will solve the regulatory aspect, in terms of travel and meeting policies, for sure," says Baliozian. "These things are cyclical. But the budget constraints? While they technically ended the sequester and are smoothing out cuts over the next two years, ultimately their budgets are getting reduced long-term. There's a shift of money, favoring deployment, that's going to come from other places, including education. So we've got to provide them with better ROI for their education dollars."