Agenda

January 21, 2021

10:00AM - 10:10AM ET

Welcome and Chairperson’s Opening Remarks

Patrick Coulson, Chief Growth Officer
Advantasure

Ana Handshuh, Principal
CAT5 Strategies
Chair
The RISE Association, Quality & Revenue Community

10:10AM - 11:00AM ET

Changes and Unknowns in 2022: Regulatory and Legislative Actions to the Medicare Program During a Pandemic

  •  Understand the impact of COVID-19 fallout on bids and how it can inform bid strategy for 2022

  • Prepare for rulemaking changes and their downstream impacts on 2022 bids

  • Get up to speed on legislative proposals to reform Medicare Advantage and Part D and the new Administration goals

Kathryn Qin, FSA, MAAA, Vice President of Pricing 
Blue Shield of California

Deana Bell, FSA, MAAA, Principal and Consulting Actuary
Milliman

11:00AM - 11:15AM ET
Break

11:15AM - 12:00PM ET

A Bird’s Eye View of the Bid Cycle and Requisite Project Management

  • Discover how various health plans construct their timelines to coordinate inputs from a multitude of functional areas for optimal bid build 
  • Create a successful project management structure with C-suite buy-in, a multi-disciplinary review, and CMS deadline-driven project schedule for a smooth annual bid process 

Moderator:
Ana Handshuh, Principal
CAT5 Strategies
Chair
The RISE Association, Quality & Revenue Community

Sara Wedlock, Senior Product Manager
Harvard Pilgrim Health Care

Monica Pagels, Senior Product Manager Medicare Product Oversight
Health Alliance Plan

Donna Doebler, AVP Medicare Product & Analytics
UPMC

12:00PM - 12:15PM ET
Break

12:15PM - 1:00PM ET

Expanding Medicare Advantage Market Share

  • Understand marketing and operational requirements for successful implementation in a new-to-you region

  • Assess models that optimize the creation of a Medicare Advantage plan with financial and operational efficiency

  • Review startup experiences with product, price, channels, advertising and how these wove into the bid planning process

     

Pamela Getsie, President
Vermont Blue Advantage

Patrick Coulson, Chief Growth Officer
Advantasure

1:00PM - 1:45 PM ET
Networking Luncheon

Don’t Miss Out! Turn on your camera and join us in the Virtual Lobby for that face-to-face networking experience we’ve all been missing. Connecting with your peers and vendors in product development has never been easier - click on an open seat, say hello to familiar faces, and take part in CMS bid discussions. We’ll see you in the lobby! 

1:45PM – 2:30PM ET

Master Plan Revenue: Part 1 - CMS Bid Variables 101

  • Discover how base bids, benchmark rates, risk scores and other bid variables in CMS bid calculation affect health plan revenue
  • Compare CMS tools and tests – and their dependencies – that determine pricing  
  • Optimize the financial mechanics behind lower rebates and higher provider group payouts, rebates versus adjusting your product offering, base bids and benchmarks, and other bid relationships
  • Understand the importance of risk scores on your plan revenue 


Lucretia Hydell, Principal, Growth & Partner Analytics 
CityBlock

Ryan Swenson, FSA, MAAA, Principal and Consulting Actuary
Milliman

2:30PM – 2:45PM ET
Break

2:45PM - 3:30PM ET

Master Plan Revenue: Part 2 - Risk Score Mechanics for Accurate Modeling

  • Gain best practices for building up a risk profile for your bid, based on current members
  • Learn how risk adjustment assumptions dial into your revenue modeling for the CMS bid
  • Discover how ongoing retrospective and prospective risk adjustment activities contribute to revenue projections
  • Understand the calendar of CMS mid-year adjustments, “sweeps” activities, and assumptions that factor into your bid cycle milestones

Benjamin Nadler, Director, Actuarial Services
Independent Health

 

3:30PM – 3:45PM ET
Break

3:45PM - 4:30PM ET

Competitive Analysis: Define Your Strategy for Your Most Impactful Bid

  • Explore the key factors you should know about your market and where to find the data to strategically gain an edge on your competition
  • Learn which key variables drive shopping decisions and how to weigh each in the bid strategy

Paul Cain, AVP Medicare Product
Cigna

Donna Doebler, AVP, Medicare SNP Product & Analytics
UPMC

4:30PM - 4:45PM ET

Day One Summary Remarks

Patrick Coulson, Chief Growth Officer
Advantasure

Ana Handshuh, Principal
CAT5 Strategies
Chair 
The RISE Association, Quality & Revenue Community

4:45PM - 5:30PM ET

"Choose Your Own Adventure" Facilitated Group Discussion

Zoom Room 1

Improvements and Challenges to Medicare-Medicaid Coordination

  • Learn how various states are managing integration requirements 
  • Understand what’s driving recent CMS updates 
  • Discuss the opportunities and considerations with regards to your plan and CMS bid submission 

Bill Jensen, Vice President
Independent Care Health Plan (iCare)

Zoom Room 2

Avoid the NOID

Sara Wedlock, Senior Product Manager
Harvard Pilgrim Health Care

Zoom Room 3

Processes for Completing the ANOC and EOC Submission

Monica Pagels, Senior Product Manager Medicare Product Oversight
Health Alliance Plan

Zoom Room 4

Tactics to Financially Manage a Product After It’s Released

  • Learn what key member-level data to collect after your Medicare Advantage product is launched
  • Understand which cross-functional departments need to be involved in managing the financial impact
  • Discuss tactics to engage other departments to help build dashboards, analyze the data, and develop action plans to financially manage your Medicare Advantage product

Lisa Franklin, Market Portfolio Manager
CareFirst BlueCross BlueShield

Zoom Room 5

Trends to consider for 2022 In Supplemental Benefits

Tom Pelegrin, Senior Vice President & Chief Revenue Officer
Convey Health Solutions

Brian Goetsch, Managing Director
HealthScape Advisors

January 22, 2022

10:00AM - 10:10AM ET

Day Two Opening Remarks

Patrick Coulson, Chief Growth Officer
Advantasure

Ana Handshuh, Principal
CAT5 Strategies
Chair 
The RISE Association, Quality & Revenue Community

10:10AM - 11:00AM ET

Design Benefits for Our Changing Times

  • Understand the important drivers of change within the healthcare ecosystem
  • Respond to CMS Star Rating shifts in experience and access measure importance by adapting your benefits and your bid
  • Include the right stakeholders at your benefit design table
  • Leverage vendors and providers to deliver value in benefit design, implementation and final delivery
  • Design data collection and reports to measure performance and evolve your new benefit offerings year over year


Ana Handshuh, Principal
CAT5 Strategies
Chair
The RISE Association, Quality & Revenue Community

11:00AM - 11:15AM ET
Break

11:15AM - 12:00PM ET

Effectively Forecast Star Measures for Your Plan

  • Manage real time operations for better long-term outcomes 
  • Understand the future financial impact of health plan operations on the Medicare Star Program 
  • Discuss bid strategies that support and improve Star ratings 

Christina Latterell-Loganimoce, Healthcare Change Agent 

Rex Wallace, Founder and Principal
Rex Wallace Consulting

12:00PM - 12:15PM ET
Break

12:15PM - 12:45PM ET

COVID-19-Driven MA Benefit Innovations

  • Special Supplemental Benefits for the Chronically Ill (SSBCI) two cycles in:  delve into plans’ quality of care and cost results from introducing health-related supplemental benefits and what constitutes an SSBCI benefit 
  • Discuss what telemedicine will look like in 2021 and how cost share will factor in 
  • Assess whether and how the uniformity requirements flexibility impacted quality of care, members’ plan selection, and plan revenue

Puneet Budhiraja, Chief Actuary and Senior Vice President
Capital District Physicians Health Plan

 

12:45PM - 1:30PM ET
Networking Luncheon

Don’t Miss Out! Turn on your camera and join us in the Virtual Lobby for that face-to-face networking experience we’ve all been missing. Connecting with your peers and vendors in product development has never been easier - click on an open seat, say hello to familiar faces, and take part in CMS bid discussions. We’ll see you in the lobby! 

1:30PM - 2:15PM ET

Part D: Financing and Design Considerations That Draw a Crowd

  • MLR considerations:  assess the pandemic’s impact on drug spend, and whether these trends will continue in a post-COVID-19 world 
  • Analyze CMMI’s Part D Senior Savings Model and potential strategies for plan revenue 
  • Understand the levers that optimize your formulary tier structure to boost member retention and star ratings 

Matthew Hayes, FSA, MAAA, Principal and Consulting Actuary
Milliman

David Mike, FSA, MAAA, Principal and Consulting Actuary
Milliman

2:15PM - 2:30PM ET
Break

2:30PM - 3:00PM ET

Bid Strategy from an Actuarial Perspective

  • Understand the basic applications of actuarial analysis 
  • Learn how to use rate information to build your bid 
  • Examine the impacts on revenue projections that should be factored into the bid 

Lucretia Hydell, Principal, Growth & Partner Analytics
CityBlock

3:00PM - 3:15PM ET
Break

3:15PM - 4:00PM ET

Desk Review, Audits and Required Changes After Bid Submission

  • Gain best practices to analyze your performance post-bid: measure attractiveness to beneficiaries; assess competitiveness; and compare your performance against your bid submitted to explain the differences 
  • Survey recent health plans’ experiences with bid audits, RADV, data validation and other audits that keep us up at night 
  • Gain best practices to limit mistakes and bid reuploads 
  • To avoid road bumps in the bid process, get advance knowledge on what bid auditors scrutinize 
  • Leverage your supplemental benefit vendors to support your bid submission and your post bid performance

Sara Wedlock, Senior Product Manager
Harvard Pilgrim Health Care

Tom Pelegrin, Senior Vice President & Chief Revenue Officer
Convey Health Solutions

Pat Petty, Senior Consultant, Risk Adjustment
Gorman Health Group

4:00PM - 4:15PM ET

Closing Remarks and Conference Concludes

Patrick Coulson, Chief Growth Officer
Advantasure

Ana Handshuh, Principal
CAT5 Strategies
Chair
The RISE Association, Quality & Revenue Community