Event Schedule
Registration & Networking Continental Breakfast
Chairperson’s Opening Remarks
Abby Katabaro,
Managing Director, Medicare Product,
Blue Cross Blue Shield of Michigan
Growing & Competing Amidst Dramatic Market Changes
Panel Discussion: Pivoting Post-Election
Moderator:
Henry W. Osowski,
Managing Partner,
Strategic Health Group
Panelists:
Abby Katabaro,
Managing Director, Medicare Product,
Blue Cross Blue Shield of Michigan
Max Sungurov, MD, MBA,
Chief Medical Officer, Medicare Advantage Plans,
BlueCross BlueShield of South Carolina
What's in Store for MA Regulation & Why Government Affairs is Critical
Over the past few years, MA had faced significant downward policy and operational pressure from CMS and Congress. With a new presidential administration and Congress, come find out what policymakers in Washington, DC are thinking about and how health plans can engage.
Andrew Schwab,
Founder,
Platform Government Strategies
Medical Loss Ratio and its Impact on the Future Growth of Medicare Advantage Plans
Explore the basics of MLR and MLR based Population Health management. Discover opportunities in benefit design based on data insight and population segmentation. Understand cost containment and revenue building opportunities in the competitive environment of Medicare Advantage plans.
Max Sungurov, MD, MBA,
Chief Medical Officer, Medicare Advantage Plans,
BlueCross BlueShield of South Carolina
Quality & Service Innovations on a Budget
Exceptional Hearing Care Through Transparent Analytics
- Increase engagement and positive member outcomes for the hearing care of your
- members through personalized care plans
- Proactively address hearing health among your patients
- Long term effects of reducing the risk of comorbidities
- Improving impact of overall cost of care and improve MLR
Eddie Maria,
Head of Sales,
Birdsong Hearing Benefits
Networking Refreshment Break
Addressing 3 Predictable & Preventable High-Cost Conditions Affecting MA Patients
Diabetes, heart failure, and falls collectively cost MA plans billions of dollars - and poor brain health is a key driver of expenses in each. This session will address how a brain health CCIP can lower your costs, improve outcomes, and delight members.
Henry W. Mahncke,
Ph.D., CEO,
BrainHQ
Panel Discussion: Real World Product, Service & Technology Innovations to Streamline Operations, Reduce Costs & Improve Quality
Moderator:
Henry W. Osowski,
Managing Partner,
Strategic Health Group
Panelists:
Bent Christiansen, SVP,
Payer Partnerships,
Better Health
Tim Buxton, AVP,
Risk Adjustment and Coding Services,
Annova Solutions
Victoria Andrews, FNP,
Sr. Director, Solutions Consulting,
Hello Heart
Feature Presentation
Networking Lunch Sponsored by
Concurrent Roundtable Discussion Groups – Addressing Challenges & Solutions in a 1:1 Small Group, Interactive Format
Join one of these small group, highly interactive discussions to get your questions answered on the spot, generate innovative ideas and hear from your industry colleagues.
- AI Modernization & Other Digital Tools – Practical Applications to Streamline Operations, Enhance Service & Boost Quality
- Star Power: What’s Working and What’s Not – Lessons Learned and Innovative Approaches
- Building and Managing Special Needs Plans
- Identifying and Addressing Access Barriers in a Time of Resource Constraints
- Demographic data challenges
- Developing trusted relationships with community partners
- Working with unique Community-Based Organizations
- Demonstrating Value
- Funding constraints
Group Leader:
Melissa Smith,
Founder & Senior Advisor,
Newton Smith Group
Group Leader:
Gregory A. Hanley, MBA, FACHE, CPHQ, VP,
Health Services Quality & Operations,
UCare
Allison Hess,
Vice President, Innovation,
Geisinger
Health Equity, Diversity & Inclusion – Moving Beyond Data to Effective Population Management
Case Study: Addressing Health Equity & Social Determinants of Health Across All Plan Operations to Help Members Access Services
- Identifying populations who are not accessing health plan services and support.
- Conducting root cause analysis to identify barriers across communities.
- Developing interventions and measuring increased access.
Gregory A. Hanley, MBA, FACHE, CPHQ, VP,
Health Services Quality & Operations,
UCare
Networking Refreshment Break
Partnering with Community Based Organizations (CBOs) to Address Social Isolation, Social Needs & Provide Care Closer to Home in Rural Communities
- How to effectively engage and build trust with CBO partners to drive impact leveraging data
- Breaking down barriers, considerations and lessons learned when forming a partnership
- Case studies/examples effectively connecting healthcare to social care with demonstrated impact
Allison Hess,
Vice President, Innovation,
Geisinger
Addressing Health Equity in Medicare Advantage: A Holistic Approach to Care to Reduce Disparities
Join Keslie Crichton, BeneLynk and Jennifer Callahan, COO ATRIO Health Plans to explore how Medicare Advantage plans can play a pivotal role in reducing health disparities and ensuring equitable access to care. Attendees will learn about the impact of social risk factors, including Veteran status, on health outcomes and strategies for reducing disparities in underserved populations. The session will also cover how Medicare Advantage plans can use both their supplemental benefits along with community programs to address health-related social needs (HRSN) and promote health equity.
- Focus: The role of Medicare Advantage plans in addressing health disparities and ensuring equitable access to healthcare.
- Key Points:
- Identifying members with health-related social risk factors and how human to human engagement can impact retention and health outcomes.
- Strategies for reducing disparities among underserved populations.
- How Medicare Advantage plans can use tailored benefits and community partnerships to address inequities.
Keslie Crichton,
Chief Sales Officer,
Benelynk
Jennifer Callahan,
Chief Operating Officer,
ATRIO Health Plans
Panel Discussion: Increasing Member Satisfaction and Retention – Balancing Cost and Quality
Bridging Gaps: Collaborative Approaches for Health Plans and Providers to Advance Social Determinants of Health and Health Equity Programs
In an increasingly complex healthcare landscape, health plans and providers are uniquely positioned to address social determinants of health (SDOH) and advance health equity. This session will explore a structured approach to implementing SDOH and health equity programs through successful partnerships between health plans and providers. We will share insights from a recent program highlighting best practices in coordination, role definition, and data tracking to improve patient well-being and address health disparities. Participants will gain actionable strategies for defining partner roles, establishing clear workflows, and leveraging data to monitor and evaluate outcomes effectively. Join us to learn how collaborative efforts can close gaps in care, improve quality, and create a more equitable healthcare experience for all.
Lynn Deguzman,
PharmD, Regional Director, Strategy & Programs, Social Health Impact Programs, Primary Care, Permanente Medicine,
The Permanente Medical Group
Boosting Performance Measures in a Zero Budget Environment
Strategies to Elevate Quality Performance Scores Amidst Seismic Change
Melissa Smith,
Founder & Senior Advisor,
Newton Smith Group
Networking Reception
Sponsored By:
Networking Continental Breakfast
Chairperson’s Remarks
Abby Katabaro,
Managing Director, Medicare Product,
Blue Cross Blue Shield of Michigan
Integrating Stars, HEDIS®, Quality & Risk Adjustment to Drive Significant Improvements in Health Care Outcomes
- Increase return on investment with collaborative interventions
- Boost innovation for interventions by capitalizing on strengths
- Reduce member and provider abrasion with aligned outreach
- Improve staff engagement and stewardship
- Better prepared new and changing measures
Kim Barrus, MSN, BSCIS, RN, PMP,
Director, Clinical Outcomes Management,
SelectHealth
Panel Discussion: Supplemental Benefits – Innovations on Budget, Tracking Utilization & Linking ROI to Cost of Care
Moderator:
Chester Brown Jr, (CJ), DM, MHA,
Director, Medicare Provider Performance & Network Strategy,
Blue Shield of California
Panelists:
Christine Leo,
Vice President, Senior Products,
Cigna
Zach Dennett,
VP, MM Consumer Healthcare,
CVS Health
Andrew Parker,
Founder & CEO,
Papa
Marketing, Sales & Distribution: Competing with Market Disruptors and Adapting to New Member Demographics While Ensuring Compliance
Marketing & Distribution Strategies to Ensure Compliance and Harness the Latest Technology Tools to Control Costs and Improve Member Experience
- Why you should Simplify, standardize, and automate
- Optimizing your operating model
- Improving member experience across channels while remaining compliant
Kim Leible,
Associate Vice President, Marketing, Regulatory and Operational Communications,
Humana
Health Plan Case Study
Boosting Member Engagement & Satisfaction – Meeting Members Where They Are
Networking Refreshment Break
Managing Member Expectations as Benefits Change or Decrease
- Valuing the volume of benefit degradations in member materials and messaging
- Marketing and selling products in a new environment
- Creating communications plans across the health plan with internal and external partners
- Developing innovative benefits with reduced funding
- Balancing member needs with member desires – what does the data tell us?
Abby Katabaro,
Managing Director, Medicare Product,
Blue Cross Blue Shield of Michigan
Leveraging Data-Driven Personalization to Enhance Customer Retention
In this session we will cover strategies and tools for using data analytics to create personalized customer experiences, which in turn drive long-term engagement and retention. Specific areas we will cover are:
- Why Retention is a relationship metric vs a transaction metric.
- The role of machine learning and AI in personalizing user experiences.
- Identifying key data points for understanding customer behavior and preferences.
- Implementing data-driven customer segmentation for targeted retention strategies.
Archie Dey,
Senior Director, Consumer Experience and Insights,
SCAN Health Plan
Integrated In Home Care -- Meeting Member Where They Are
Lauren Easton,
Senior Vice President, Clinical Innovation,
Commonwealth Care Alliance
Health Risk Assessments (HRA) - Improve Completion Rates and Utilize the Responses for Improved Health Outcomes Versus Just Checking the Box
- HRAs are essential to identify beneficiary's health status and needs to ensure they are receiving the right care at the right time in the right setting to holistically improve their health and wellbeing.
- Explore techniques and methods on how to reach and engage enrollees to improve rate of completion especially with difficult to reach enrollees.
- Successfully capture the HRA through effective outreach efforts from the initial enrollment stage and during follow up outreach as the care team monitors and manages an enrollee's health status or change in condition.
- Utilize the responses in the comprehensive questionnaire to deliver an impactful personalized and patient-centered care model.
Messina Martinez,
Director of Strategy & Operations,
Wellcare -- Centene
Networking Lunch
Artificial Intelligence & Other Advanced Technology Tools to Streamline Operations, Improve Quality & Member Experience & Reduce Costs
Managing Implementation, Usage & Governance of AI for Specific Applications
- Member Management
- Revenue Cycle Management
- Operational Efficiency
Benjamin Vicidomina, VP,
Analytics and Quality Improvement,
Blue Cross Blue Shield of Louisiana
Health Plan Case Study
Product/Benefit Design Meets Clinical and Quality Care – Managing Regulations and Costs
Benefits vs Clinical Programs ---– Navigating the Gray Areas While Meeting Quality Standards & Regulations
Want to offer a program or innovation in your plan? Learn how to determine if you need to file a new innovation or program as a benefit or not. Understand when it is best to implement following the plan year cycle and when you can implement mid-year. Know what constitutes a pilot and what does not and when to use pilots and how to measure success, all while remaining compliant and not compromising quality.
Christine Leo,
Vice President, Senior Products,
Cigna
Adapting to Part D Regulatory Changes and Evolving Product Needs
This session will provide an overview on regulatory updates that have transformed Medicare's prescription drug benefit landscape in recent years. This session will focus on how health plans have adapted to these changes, particularly in light of rising drug costs and evolving member demographics. The discussion will include insights from teams responsible for designing and implementing new strategies, ensuring compliance, and managing member communications to navigate these transitions. Attendees will learn how one organization has leveraged cross-functional collaboration, including input from marketing and operations, to effectively address shifting regulatory requirements. With upcoming policy changes on the horizon, the session will also explore how health plans can continue to evolve their benefit designs to meet both regulatory standards and member needs. Case studies will be presented to showcase how successful approaches have been enacted to maintain competitiveness and compliance in the Medicare Advantage market
Michael Spicer,
Vice President Product,
Capital District Physicians’ Health Plan