Wednesday, January 27, 2021: 10 a.m. ET – 12:45 p.m. ET
Pivoting Amidst the Pandemic and Political Change: Balancing Compliance, Quality, Cost & Outcomes |
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10:00 |
Welcome & IntroductionRoz Applebaum,VP, Virtual Events,Strategic Solutions Network |
10:05 |
Panel Discussion: Impact of the Pandemic & the Election on Medicare Advantage – How Plans are Reacting and Changing
Moderator:Lisa Holden,Vice President, Accountable Care,iCare Panelists:Christine Leo,Vice President, Senior Products,Cigna Rob Gibbs,SVP of Sales and Account Management,TruHearing Catherine Macpherson,Vice President, Product Strategy and Development and Chief Nutrition Officer,Mom’s Meals |
10:35 |
Advancements in Interoperability to Drive Value-Based CareThere has been a long-standing challenge of accessing medical record data in a timely fashion. Join Apixio’s Vice President of Solutions, Bryan Lee, as he discusses how Interoperability is key to improving collaboration among payer and provider to drive real-time bi-directional data exchange. In this presentation, Bryan will address the challenges that payers and providers face and provide considerations to mitigate these challenges in an informed and deliberate manner. Bryan Lee,VP, Solutions,Apixio |
10:55 |
2021 Stars & HEDIS/Quality
Melissa Smith,Executive Vice President, Consulting and Professional Services,HealthMine |
11:15 |
Clover Health/Walmart Partnership – Together, Insurance and Retail Lower Barriers to CareA key component to helping people stay healthier is providing them with the ability to access basic healthcare in places that are convenient to them. In this presentation, Clover Health Chief of Staff, Theresa Safe, discusses the importance of insurance companies and brick & mortar retailers working together to "decentralize care" through innovative and mutually beneficial partnerships. The talk will include a case study on Clover's work with Walmart as well as one other (currently unannounced!) national retail chain. Attendees will learn how to think outside the current constructs of the healthcare system to better address the unique needs of different communities. Theresa Safe, Chief of Staff,Clover Health |
11:35 |
Break
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11:45 |
Cross-Functional Performance Transformation Methodologies
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12:05 |
Supplemental Benefits – Key Drivers to Plan SuccessToday's Medicare beneficiaries have a lot of choice. In fact, 90% of Medicare enrollees have access at least ten Medicare Advantage Plans. What can you do to make your plan stand out? In this session, Dave Olson, Senior Vice President of Network and Medicare Advantage for DentaQuest will cover how strategically leveraging supplemental benefits like Dental and Vision can give your Medicare Advantage plan an edge in this crowded market. Specifically, you will learn:
David J. Olson, Senior Vice President, Network & Medicare Advantage,DentaQuest |
12:25 |
Rapidly Changing Digital Landscape for Medicare Advantage Members: Marketing, Engagement, TelehealthThe COVID-19 public health emergency has disrupted the lives of the people we love and care for in countless ways. That disruption has accelerated changes in how, when, and where people access health care services—changes that are here to stay. The perception that seniors will not engage in digital health has been replaced with high engagement and broad adoption as the new normal. How these seniors take part in their health has never been more important as telehealth adoption soars and policymakers, health plans, and providers shift from reactive to cohesive digital strategies. Hear our observations on the innovative approaches that are driving enrollment, engagement, and results.
Hunter Sinclair, Vice President Medicare Market,Teladoc Health Melissa Ritz, Vice President Government Market,Teladoc Health |
12:45 |
CAHPS: Approaches to Taking Action on the New King of Star
Saeed Aminzadeh,CEO,Decision Point Healthcare Solutions |
1:05 |
Close of Module
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Wednesday, January 27, 2021: 2:00 p.m. ET – 5:45 p.m. ET
2:00 |
Opening Remarks
Kent Holdcroft, Vice President, Growth,HealthMine |
2:05 |
Maintaining Compliance in a Fluid Medicare Advantage World
Keri Steege, Medicare Compliance Officer/Director of Medicare Compliance,Providence Health Assurance Brandy Hilgefort, Medicare Operational Compliance Program Manager,Providence Health Assurance |
Tools & Strategies to Boost Member Experience & Engagement |
2:25 |
Case Study: Creating a Seamless Member Experience from Sales to RetentionOptima Health recognizes continued success on its growth trajectory and is expected to double the number of Medicare Advantage Members by the end of 2021. One of our top priorities is a seamless member experience. A member centric approach to sales and marketing, education, and member retention are the keys to propelling our revitalized Medicare Advantage Program forward into the future. Catherine Brisland, DO, MBA, FCCP,Medical Director,Sentara Health Plans |
2:45 |
Panel Discussion: Member Engagement Innovations -- New Opportunities to Retain Members, Maximize Outcomes & Improve Satisfaction
Moderator:Josh Edwards Medicare Stars Programs Manager Martin’s Point Health Care Panelists:Carolyn Langer, MD, JD, MPH SVP and Chief Medical Officer fallonhealth Jan Smith Reed Director of U.S. HealthcareT-Base Communications Reva SheehanGovernment Programs Strategic Market ExecutivemPulse Mobile Kent HoldcroftVice President, GrowthHealthMine |
Product Innovation: Moving Towards Whole Person Care -- Focus on Value-based Care, SDoH & Population Health |
3:25 |
Hidden Access: Make Access Measures Your Key to Star Ratings Success
When CMS announced the weight increase for patient experience, complaints, and access measures a shockwave tore through our industry. Since then much of the commotion (and resource allocation) has focused on member experience through the CAHPS survey, while the four measures capturing access have received little attention. Why don't we focus on access for a bit?
Josh Edwards,Medicare Stars Programs Manager,Martin’s Point Health Care |
3:45 |
Break
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3:55 |
Panel Discussion: Innovative Products & Benefits Designed to
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4:25 |
Focusing on Social Factors that Impact Health and Quality of LifeThe World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” In developing approaches to enhance the lives of older adults, it is important to understand and address social factors that impact their health outcomes and quality of life. This session will discuss on these factors and approaches to addressing them. Donna Almario Doebler, DrPH, AVP, Medicare SNP Product & Analytics,UPMC Health Plan |
4:45 |
Panel Discussion: Be More Generous to Save Money: A Discussion of Benefits that Demonstrate Cost SavingsThere’s a lot of conversation about supplemental benefits that, in theory, should produce savings for MA plans by improving the lives of members. But how many of these benefits have actuarially modeled savings or demonstrated savings with other plans? On this panel, innovative benefit vendors and actuaries will present documentation of the cost offsets that they can deliver MA plans through actuarial modeling and client case studies Moderator:Michael S. Adelberg,Principal, Lead, Healthcare Strategy Practice, Faegre Drinker Consulting,Formerly, Director of Medicare Advantage Operations, CMS Panelists:Dr. Elizabeth Klodas,Founder,Step One Foods Henry W. Mahncke, Ph.D.,CEO,Posit Science Rich Waldron, PT,VP Medical Affairs,Joint Academy Michael Rea, PharmD,Chief Executive Officer, Rx Savings Solutions |
5:45 |
Close of Module #2 |
Thursday, January 28, 2021: 10 a.m. ET – 12:30 p.m. ET
10:00 |
Preparing for “Table Stakes Benefits 3.0” – Tailored Benefit Innovations to Overcome Barriers to CareTo date, there have been two large waves of Medicare Advantage benefit innovations. In the first wave, plans offered dental, vision, hearing and gym benefits that formed the basis of “Table Stakes Benefits 1.0.” Since 2018, plans have taken advantage of liberalized CMS guidance to offer a new wave of benefits, the most popular of which—including OTC, transportation and meals—are emerging in competitive markets as “Table Stakes 2.0.” In this session, participants will be re-exposed to the first waves of benefit innovations, but the focus will be on the emerging third wave of benefit innovations which will be focused on specific chronic conditions and the social determinants of health. Join the presenter for a norm-challenging discussion about tailored benefits, and what innovation will look like in Plan Year 2022 and beyond. Michael S. Adelberg,Principal, Lead, Healthcare Strategy Practice, Faegre Drinker Consulting,Formerly, Director of Medicare Advantage Operations, CMS |
10:20 |
Integration of Behavioral Health in Vulnerable Populations
Lauren Easton Vice President of Innovations Commonwealth Care Alliance |
10:40 |
Integrating Community Health Assistants into the Care Team
Joann P. Sciandra, MHA, BSN, RN, CCM Vice President of Care Coordination and IntegrationGeisinger Stacey Staudenmeier, MSW, LSW, MHA. Associate Vice President of Behavioral Health and Health ChoicesGeisinger |
11:10 |
Population Health: Integrating Social Factor Data to Improve Health and Address Health DisparitiesHow can we use more data sources to identify and address the factors that contribute to poor health and negative outcomes? Through the incorporation data beyond claims, we can identify the social factors that create barriers to better health. Additionally, we are able to begin to address health disparities within sub-populations. This presentation will discuss the journey we are on to move upstream in the implementation of interventions to help our members achieve their best health. Gregory A. Hanley, FACHE, CPHQ, Vice President, Quality Management & Pharmacy,UCare |
11:30 |
Case Study: Value-based Contracting to Optimize Revenue Streams Through Real-time, Concurrent Code Review -- A Win-Win Partnership Between a Payer and their PCPsValue based contracting is becoming increasingly prevalent in the health care industry. This session will focus on risk adjustment based contracting between payer and PCP in a network model. Hear progress, challenges and lessons learned from CDPHP’s innovative partnership with their primary care providers and learn how these win-win arrangements can be operationalized. Gain insights in how real-time, concurrent code review can optimize revenue streams for both parties and reduce RADV audit risk. Tom Nasadoski, MBA, Director, Risk Adjustment and Recovery,Capital District Physicians’ Health Plan |
Harnessing Technology Innovations in the New Era of Telehealth & Enhanced Analytics |
11:50 |
2021 -- An Opportunity to Expand Chronic Care Management through Expanded Use of Telemedicine
Jonathan Harding,Senior Medical Director for Senior Products, Tufts Health Plan |
12:10 |
NLP and AI technology – How it Works, What it’s Used for, and Why it’s Better Today
Andy Kumar,VP Product Management & Strategy, Ciox Health |
12:30 |
Close of Module #3 |
Thursday, January 28, 2021: 2:00 p.m. ET – 3:50 p.m. ET
2:00 |
Real Time Risk Adjustment – Data and Program Designs to Optimize Point of Care Risk AdjustmentWith a market shift towards EMR integrated and technology enabled risk adjustment solutions, we need to reconsider how data and processes are handled in order to stay nimble while still maintaining robust analytics and reporting. This session will discuss best practices for designing programs in parallel with data infrastructure to support real-time integration, identify key pieces of information that are needed for governance, reporting, and valuation, and explore how this framework can be extrapolated for more generalized interoperability in the future. Lars Johnson, FSA MAAA, |
Quality of Care Innovations: Improving Outcomes & Controlling Costs |
2:20 |
Innovative Tools & Interventions for Transitions of Care Before and During the Pandemic: Lessons Learned
Carolyn Langer, MD, JD, MPH,SVP and Chief Medical Officer, fallonhealth |
2:40 |
Case Study: Value-based Purchasing for Home Health Care to Reduce ReadmissionsThis session will focus on an innovative Readmission Prevention Program using a Value-Based Purchasing agreement for member-centered case management provided by community Home Health Agencies following a hospitalization.
Lisa Holden Vice President, Accountable Care, iCare |
3:00 |
Break
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3:10 |
End Stage Renal Disease: What Happened During AEP? What are You Doing to Improve Outcomes and Manage This New Population?
Christine Leo Vice President, Senior Products, Cigna |
3:30 |
Medicare Senior Savings Model Insulin Copay Caps: Plan Considerations for ParticipationBrian Smolich, Vice President of Pharmacy Services for Health Alliance Medical Plans, will discuss his plan’s decision to participate in the Senior Savings Model for 2021. This discussion will cover the thought process in deciding to participate as well as given background information to how the program is structured. The Senior Savings Model caps Part D expenses for members that require insulin for management of Diabetes. Brian Smolich Vice President of Pharmacy Services, Health Alliance Medical Plans |
3:50 |
Close of Conference
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