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2020 Agenda

Monday - December 14, 2020

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Welcome Remarks: Conference Chairperson

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

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Keynote and Q&A: CMS Policy Update

Ashby Wolfe

Chief Medical Officer, Regions VIII, IX & X         

Centers for Medicare & Medicaid Services (CMS)

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Break

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Industry Roundtable: Staying Abreast of Regulatory Changes Amid a Pandemic and Looking into the Future

  • Join your peers to analyze all recent interim rulesand understand the impact of the adjustments made by CMS  
  • Explore the expansion and implications of Telehealth services
  • Prognosticate what Star ratings and reporting will look like moving forward and discuss cut point trends

 

Moderator: 

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

 

Presenters: 

Daniel Weaver

VP Medicare & Medicaid Quality Programs

Gateway Health Plan

 

Ryan Davis

Manager, Pharmacy Medicare Programs

Kaiser Permanente

 

David Dodge  

Medicare Stars Program Director, Government Programs

Cambia Health Solutions 

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Break

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From 2x to 4x: Cracking the Code of Member Experience to Maximize Results

  • Understand how to prioritize and operationalize customer experience/CAHPS to increase scores
  • Hear best practices from industry leaders on how to approach member experience holistically for better health outcomes
  • Analyze interoperability strategies to ensure focus of care is shifted towards member experience and member satisfaction

 

Moderator:

Rodolfo G. Velasco, MBA 

Healthcare Solutions Manager

Nagnoi 

 

Rex Wallace

Principal

Rex Wallace Consulting

 

Michelle D. Chang

Director, Network Quality

SCAN Health Plan

 

Ana Handshuh

RISE Revenue & Quality Community Chair

Principal

CAT5 Strategies

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Networking Lunch Break in the Virtual Lobby

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Keeping Momentum: Best Practices to Maintain or Improve Star Ratings

  • Understand how to focus efforts on clinical quality such as preventive care screenings and condition management
  • Learn how to maximize each visit and interaction with members for meaningful and streamlined engagement
  • Hear best practices to boost medication adherence 
  • Understand how to approach the tripling of health care: cost, quality, and access

 

Tejaswita Karve, Ph.D.

Director, Quality Improvement

Johns Hopkins HealthCare

 

Reva Sheehan 

Government Programs Strategic Market Executive

mPulse Mobile

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Break

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Aligning Risk Adjustment and Quality Efforts to Improve Star Ratings

  • Discuss lessons learned from interoperability winsand how RA fits in the broader spectrum
  • Learn how to streamline information from RA and Qualityand navigate innovative ways to collect data 
  • Closing the loop with providers and preventing provider abrasion

 

Sara Hansen

Director of Quality & Clinical Risk Services

 Avera Health Plans & DAKOTACARE

 

Margaret Ciancetta 

Senior Quality Business Analyst

Pulse8 

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Break

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Part D Focus: Getting it Right and Achieving Outcomes

  • Evaluate & analyze 2020 metrics surrounding medication adherence
  • Review pharmacy utilization trends and specific benefit enhancements addressing COVID-19
  • Demonstrate the design and initial outcomes of a high-value pharmacy service designed to improve quality performance and lower costs among medically-complex MAPD members

 

Matthew Dinh, PharmD

Director, Pharmacy Quality & 5 Star

SCAN Health Plan

 

Josh Benner

President and CEO

RxAnte

 

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Break

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Maintaining and Leveraging Telehealth Visits to Close Gaps and Maximize Results

  • Hear how plans have pivoted their strategy to be more digital in nature and discuss impact on star ratings
  • Understand how to continue to utilize telehealth to integrate quality and make the best use of it
  • Navigate the future of delivery of care via telehealth

 

Michelle Duran, CPC, CRC, CDEO 

Practice Transformation Facilitator

Hill Physicians Medical Group 

 

Ryan Dodson 

Regional Manager, Risk Adjustment

Molina Healthcare 

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Closing Remarks: Conference Chairperson

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

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Networking Reception in the Virtual Lobby

Tuesday - December 15, 2020

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Opening Remarks: Conference Chairperson

Jay Scholes

Director of Sales

Pulse9

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NCQA Fireside Chat: Where Do We Go from Here? A Look into the Current Star Ratings Landscape

  • Explore lessons learned from COVID-19 era and how they can be applied to other outbreaks such as the flu season
  • Discuss insights on whether 20-21 will be used by CMS and how to proactively plan to get in line with changes
  • Hear what NCQA has to say about the future of Stars

 

Paul Cotton

Director, Federal Affairs

NCQA

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Break

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So COVID happened! What's next for your Medicare Part D 5-star Strategy?

  • Discuss if your organization should give additional consideration to metrics that are lower in weighting 
  • ​Hear how to ensure a positive member experience outside of traditional surveys while improving your quality scores
  • ​Understand how to leverage cross-functional relationships to get the job done.  

 

Ryan Davis

Manager, Pharmacy Medicare Programs

Kaiser Permanente

 

Kate Rollins

Senior Vice President, Population Health and Clinical Innovations

Gorman Health Group

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Break

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2021 Star Ratings Industry Update: Where We Are Now & What’s on The Horizon

  • Explore an overview of the 2021 Star Ratings for Medicare Advantage plans
  • Gain insights on current market trends, proposed policy changes, and the impact on future Star Ratings
  • Learn how to leverage technology to build successful quality improvement strategies for 2021 and beyond

 

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine  

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Break

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SNPs Highlight: Increasing Star Ratings for Special Need Plans

  • Understand nuances between a SNP plan and the average MA plan’s roadmap to successful ratings
  • Discuss med adherence best practices for the SNP population
  • Explore coordination of services and benefits for dual eligibles during and after the pandemic
  • Hear engagement strategies for SNPs popluations

 

Daniel Weaver

VP Medicare & Medicaid Quality Programs

Gateway Health Plan

 

Kurt Cegielski 

Senior Vice President, Client Success

Revel-Health 

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Networking Lunch Break in the Virtual Lobby

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Roundtable Discussion: Gathering of the Minds (lively discussion of topics in a roundtable/debate setting)

  1. Why strive for 5 stars? Is there a drawback?
  2. RBRVS paying method for providers: is it working? What could other possibilities be?
  3. Are we really on a path to a healthy population?

 

Moderator:

Ana Handshuh

RISE Revenue & Quality Community Chair

Principal

CAT5 Strategies

 

Presenters:

Kathleen Faulk

General Manager, Government Programs

Regence

 

Tejaswita Karve, Ph.D.

Director, Quality Improvement

Johns Hopkins HealthCare

 

John Suarez 

CEO and Founder

iCare Intelligence 

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Break

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Closing Gaps in Care during a Pandemic through Member Engagement

  • Learn how to communicate effectively to motivate members back to care
  • Understand how to tackle the barriers that are keeping members from getting needed screenings
  • Hear how Blue Cross and Blue Shield of Minnesota is leveraging innovative tactics to engage their members
  • Learn examples of how collaboration with providers is driving action  
  • Hear thoughts on how to educate and prepare members for a future vaccine roll out  

 

Kathleen Ellmore 

Managing Director

Engagys 

 

Kimberly Switlick Prose

Vice President, Star & Risk Adjustment Center of Excellence

Blue Cross and Blue Shield Minnesota

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Closing Remarks: Conference Chairperson

Jay Scholes

Director of Sales

Pulse9