Tuesday, January 24, 2023
7:00 |
Networking Continental Breakfast
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8:00 |
Co-Chairpersons’ Welcome & Opening Remarks
Elizabeth BenzVice President Quality and Clinical Integration,Network Health Allison HessVice President, Health Innovation,Geisinger |
8:10 |
Follow Thy Members, Stars Follow YOU
Priyanka Jain,Vice President, Medicare Quality and Member Experience,Point32Health, Harvard Pilgrim Health Care & Tufts Health Plan |
8:40 |
Rapid Performance Improvement and Value-Based Contracting
Dr. Douglas Allen, MD., MMM,Senior Medical Director Government Programs,Blue Shield of California |
9:10 |
The New Value Proposition- Cost Avoidance: Using Data to Go Upstream to Address Chronic Disease PreventionWe now have access to multiple sources of data that informs the programs we develop to address chronic conditions. We also have data to identify and intervene with members who have a higher risk of developing chronic conditions. We are able to move into the new value proposition of cost avoidance. In this session we will discuss:
Reggie Wardoku, Health Services Analytics Manager,UCare |
9:40 |
Networking Refreshment Break
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10:10 |
Panel Discussion: Enhancing Member Experience: Tools and Strategies
Moderator:Henry W. Osowski,Managing Partner,Strategic Health Group Panelists:Mark Fleming,Vice President, Service Innovations,SCAN Ellen Rudy, PhD,Vice President of Health and Social Impact,Papa Jenn Roberts,VP Employer Health Strategy, Hello Heart Carissa Stajnrajh, Vice President, Customer Experience, Insightin Health |
10:55 |
Building Better Brains: What Medicare Advantage Members Want from Memory Fitness Benefits - and How to Provide It to ThemNew results from the first ever survey of Medicare Advantage members and memory fitness benefits. Evidence-based brain training programs (memory fitness programs) are one of the newest supplemental health benefits, and are the fastest growing type of fitness-related benefit. Seniors have enormous interest in maintaining brain health and cognitive function - and delivering a memory fitness benefit can be a winning growth strategy. Learn the latest from this fast-moving field and understand how to make it work for your plan and your members. Tim Brousseau, SVP of Client Services,Deft Research Henry Mahncke, PhD,CEO, Posit Science |
11:25 |
Case Study: How to Use Data to Inform Your Business: Sorting Through the Noise
Christine Leo, Vice President, Senior Products,Cigna |
11:55 |
Choose Your Own Adventure: Combined Benefit Package TrendsThe 2023 benefit landscape in the MA market includes an increase in combined benefit offerings. This benefit design allows a health plan to offer multiple supplemental benefits to beneficiaries under a combined limit, or multiple benefit selections from a menu of benefits, or both. There are multiple ways to structure a combined limit package and from product design, to marketing, to actuarial, there are complex issues to consider. This presentation will focus on the growth of combined benefits in the 2023 MA market and trends in combined benefit offerings, as well as what to expect for the future. Julia Friedman, FSA, MAAA Senior Consulting Actuary Milliman, Inc Mary Yeh, FSA, MAAA Consulting Actuary Milliman, Inc Ivan Yen, ASA, CERA, MAAASenior Actuarial Analyst Milliman, Inc |
12:30 |
Networking Lunch
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1:30 |
Panel Discussion: Integrating Data from Population Health, Behavioral Health, SDOH into Care Coordination and other Clinical Teams – Breaking Down SilosModerator:Amy Wickman, VP, Clinical Services,UCare Panelists:Sean Libby,President,BeneLynk Michelle Werr, Managing Director, HealthScape Advisors Mindi Knebel, Founder & CEO, Kaizen Health Luke Knutson, Vice President of Health Plans and Provider NetworksVida |
2:15 |
Activating Family Caregivers to Reduce Hospitalizations for Frail Elderly MembersThe key to reducing any hospitalization is to detect and address a change in condition, before it worsens. Who better to detect a change in condition in the member than a family caregiver who has regular -- often 24/7 -- visibility into their loved one’s health? Learn how activated family caregivers break the cycle of costly deterioration that accompanies hospitalizations, avoiding downstream costs. Outcomes and insights from a clinical study of Ceresti’s Digital Caregiver Activation Program will be presented. Dirk Soenksen, CEO,Ceresti Health |
2:45 |
Panel Discussion: Embracing Digital Transformation Across All Departments/Functional Areas to Support Aging in Place
Moderator:Henry W. Osowski,Managing Partner,Strategic Health Group Panelists:Andy Friedell, Founder and CEO,healthAlign Kevin M. Healy,Chief Executive Officer,Allymar Health Solutions Kristen Antunes, Director of Clinical Outcomes,Custom Health |
3:20 |
Networking Refreshment Break
Sponsored by:![]() |
3:50 |
Addressing Interoperability: A Multi-Pronged Approach to Close Gaps in Care and Drive ValueBuilding a real-time health data exchange can address gaps in care, improve patient outcomes, and reduce costs. The purpose of this session is to highlight a multi-pronged approach for data integration across disparate platforms. This session will go into a health plan’s journey for building a portfolio of capabilities to electronically exchange health information and insights between disparate health care systems at provider, patient, and payer settings. Nazanin Salehitezangi,Manager, Health Data Exchange Adoption and Analytics Consulting Health Care Service Corporation |
4:20 |
Older + Wiser: Engaging Medicare Members in Digital HealthBest practices, key takeaways and insights about how a Medicare population engages with a digital health program. In this session, hear from Hinge Health’s Vice President of Medicare Austin Weaver as he debunks myths about the Medicare population’s relationship with digital health technologies. Austin WeaverVice President of MedicareHinge Health |
4:50 |
Leveraging Data and Digital Solutions to Target SDOH Needs of Medicare MembersFramework for collecting data, reviewing and developing programs and solutions based on the needs of your members is important for implementing a whole person care approach and creating a longitudinal health record. Levering relationships with community based organizations and digital solutions allows you to expand your reach, scale your efforts and provide care closer to home. Social needs screenings allow you to identify areas of opportunity and social care needs based on individuals and communities, and when paired with a referral option, it allows for a closed-loop referral process to support your population health efforts. Allison HessVice President, Health Innovation Geisinger |
5:20 – 6:20 |
Networking Reception
Sponsored by:![]() |
Wednesday, January 25, 2023
7:00 |
Networking Continental Breakfast
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8:00 |
Co-Chairpersons’ Remarks
Elizabeth BenzVice President Quality and Clinical Integration,Network Health Allison HessVice President, Health Innovation,Geisinger |
8:05 |
Integrating Health Equity Data into all Plan Operations – Setting Up the Infrastructure to Support SuccessElizabeth will discuss how Network Health is integrating health equity data throughout the plan to drive better member experiences and quality outcomes.
Elizabeth Benz,Vice President Quality and Clinical Integration, Network Health |
8:35 |
Innovative Products, Benefits, and Engagement Programs Designed to Boost Quality Outcomes, Attract & Retain Members, and Control CostsAnother AEP season is behind us, 2024 design planning is already underway, and the impacts of 2024 Star Ratings are rippling across the nation. This session will explore emerging trends in product and benefit designs including one plan’s approach to growth and retention in a competitive landscape; evolving engagement programs that boost participation and outcomes including ways MVP Health has bolstered member engagement; and operational integration strategies to align growth, quality, and medical expense cost control. Nikki Hungate, MS, MHA, Senior Leader, Medicare Government Programs Product Strategy, MVP Health Care Daniel Weaver,Executive Vice President of Product Operations and Stars Strategy,NationsBenefits |
9:05 |
Partnering Up to Empower Members to Revolutionize HEDIS Care Gap Closures and Member Experience
Julianne Eckert, RN BSN, CCM, CMCN, ACMP,Senior Director of Clinical Quality Programs, Clover Health Archana Mahimkar,Senior Director Clinical Quality Improvement & Safety, Walgreens Health Katharine Iskrant, President, Healthy People |
9:40 |
Organizational Alignment: The Foundation of Executing a Successful Star Ratings Strategy
Jessica Assefa, Chief Quality Officer, ATRIO Health Plans |
10:15 |
Networking Refreshment Break
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10:45 |
Win MA markets with Innovative Benefits Platform in 2024
By 2025, Medicare Advantage (MA) enrollments are expected to reach 38 million, a penetration of 47% in the Medicare market, and very likely to grow higher each year. Every Payor wants to capture a share of this fast-growing market. The question is, how?
Nirnay PatelExecutive Vice President & General Manager,Simplify Healthcare Quinton Skilling Business Analyst,Simplify Healthcare |
11:15 |
Panel Discussion: Innovative Products & Benefits Designed to Attract & Retain Members, Boost Outcomes, Control CostsModerator:Mari Findley, MPA, RN, CCM Director Case Management, Clinical Services,UCare Panelist:Frank D. Dumont, MD, FACP, Commercial Medical Director,Virta Health James Egan, WEX |
11:50 |
Product Design & the Member Experience: How to Take a First Date and Make it a Long-Lasting “Marriage"Explore bid strategies to improve Star ratings and understand how bid changes impact different members and how to mitigate potential dissatisfaction. As we collectively look ahead to the upcoming possible changes featured in the proposed rule learn how to align your organization for sustainable and scalable success. See how plans are leveraging flexibilities within benefit design to address health equity and boost Star Ratings. Jenn Kerfoot,Chief Experience Officer, FarmboxRx |
12:20 |
Networking Lunch
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1:20 |
Supporting Specialists at the Point of Care to Ensure Compliance and Optimize Care Management & Coordination Through Integrated TechnologyComprehensive patient care requires collaboration with a delivery team comprising primary care, specialists, and care management coordinators. UPMC Health Plan has historically collaborated with primary care providers regarding documentation for risk adjustment as well as identification of patients who could benefit from care management. Patient care has become increasingly complex, and many patients see specialists as their primary care providers. See how UPMC, an Integrated Delivery Finance System, has leveraged NLP and care coordination technology to primary care and specialists to improve documentation and care opportunities. Kimberly L. Geidel, BS, MPM, CPC,AVP of Government Revenue,UPMC Health Plan Adele Towers, MD, MPH, FACP, CRC, Director, Risk Adjustment,UPMC Enterprises |
1:50 |
How to Get EMR Data from Providers and Sharing Health Plan Data with Providers
Wynda Clayton, MS, RHIT, Director Risk Adjustment,Providence Health Plan |
2:20 |
Ensure Compliance When Utilizing Electronic Queries – Protect Your Plan’s Reputation & Financial Security
With the ever-increasing scrutiny on accurate reimbursement for coding and documentation it is more
important now than ever to ensure your electronic query process/solutions meet established guidelines.
Join us for an interactive discussion on what the OIG and DOJ are targeting. We will review the elements
of a compliant query that are required regardless of the method used. This is a discussion you cannot
miss if you want to ensure that your organization’s reputation and financial security is protected!
Colleen Gianatasio, Director, Clinical Documentation Integrity and Coding Compliance,Capital District Physicians’ Health Plan |
2:50 |
Leverage Comprehensive Health Screening Programs for Early Detection of Comorbidities to Help Improve Overall Quality, Cost, and Patient Outcomes
Bryan Gregory,Sr. Manager of Practice Performance, Prominence Health Plan Angi Jennings, Vice President, Practice Transformation, Wellvana Health |
3:20 |
Chairperson’s Closing Remarks
Elizabeth Benz,Vice President Quality and Clinical Integration, Network Health |
3:30 |
Close of Main Conference
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