The 8th Annual
Medicare Advantage Leadership Innovations

Strategic Initiatives & Targeted Interventions to Boost Competitiveness as Dramatic Changes in Demographics, Member Preferences, & Regulations Sweep the MA Market in 2025

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


OTC health Logo

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.

  1. AI Modernization & Other Digital Tools – Practical Applications to Streamline Operations, Enhance Service & Boost Quality
  2. Star Power: What’s Working and What’s Not – Lessons Learned and Innovative Approaches

  3. Group Leader:

    Melissa Smith,

    Founder & Senior Advisor,

    Newton Smith Group


  4. Building and Managing Special Needs Plans
  5. 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:


    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:

Sponsors Logo

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

Close of Conference