Rise

Welcome Remarks: Conference Chairperson

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

Keynote and Q&A: CMS Policy Update

Ashby Wolfe

Chief Medical Officer, Regions VIII, IX & X         

Centers for Medicare & Medicaid Services (CMS)

Break

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 

Break

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

Networking Lunch Break in the Virtual Lobby

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

Break

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 

Break

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

Break

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 

Closing Remarks: Conference Chairperson

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

Networking Reception in the Virtual Lobby