Rise

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Past Agenda

Monday - January 23, 2023

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Pre-Conference Workshop Registration Desk Open and Networking Breakfast

9:00 AM 7:00 PM

8:00 AM 6:00 PM

7:00 AM 5:00 PM

6:00 AM 4:00 PM

Exhibit Hall Open

10:00 AM 11:35 AM

9:00 AM 10:35 AM

8:00 AM 9:35 AM

7:00 AM 8:35 AM

Pre-Conference Workshop: Orientation to the Bid, Part 1: Understanding Bid Basics and Financials

  • Review key terms, files, and reports crucial to successful bid submission 
  • Discover how base bids, benchmark rates, risk scores, and other bid variables in CMS bid calculation affect health plan revenue 
  • Explore CMS tools and tests that determine pricing  
  • Optimize financial mechanics, base bids and benchmarks, and other bid relationships 
  • Understand how pricing and financial information are incorporated into the bid pricing tool (BPT)

Anant Galande, ASA/ASA, MAAA, Director, Medicare Actuarial
Blue Cross and Blue Shield of Kansas City

Matthew Kridgen, ASA, MAAA, Associate Actuary
Milliman

 

 

11:35 AM 11:50 AM

10:35 AM 10:50 AM

9:35 AM 9:50 AM

8:35 AM 8:50 AM

Networking Break

11:50 AM 1:20 PM

10:50 AM 12:20 PM

9:50 AM 11:20 AM

8:50 AM 10:20 AM

Pre-Conference Workshop: Orientation to the Bid, Part 2: Navigating the Plan Benefit Package (PBP) Data Entry System

  • Get an update on the newly redesigned PBP
  • Walk through and get clear explanations of the many sections, fields, and rules of the PBP data entry system
  • Learn PBP completion strategies that give your health plan a competitive edge

Ana Handshuh, Principal
CAT5 Strategies 

Kylie Severson, Senior Actuarial Analyst
Milliman

 

1:20 PM 2:20 PM

12:20 PM 1:20 PM

11:20 AM 12:20 PM

10:20 AM 11:20 AM

Networking Lunch and Conference Registration

2:20 PM 2:30 PM

1:20 PM 1:30 PM

12:20 PM 12:30 PM

11:20 AM 11:30 AM

Welcome and Chairperson’s Opening Remarks

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

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

CMS Fireside Chat: VBID, Health Equity, and Future Innovations

  • Hear about the various bid and benefit flexibilities available through the value-based insurance design (VBID) model and other special programs 
  • Explore practical implications of addressing health equity priorities via the bid 
  • Consider the ROI of investing in benefits focused on health equity 

 

Sibel Ozcelik, Deputy Director, Division of Health Plan Innovation,
Seamless Care Models Group
CMS Center for Medicare and Medicaid Innovation 

Moderator:
Lauren Driscoll, Founder and CEO
NourishedRx

3:15 PM 4:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

12:15 PM 1:00 PM

Optimize the Bid Cycle: Year-Round Project Management and Process Strategies

  • Understand the players that make up your perfect bid team, how to teach them about the bid, and how to communicate for a smooth process 
  • Learn how to put together a timeline to get the needed input from a multitude of functional areas for the optimal bid that meets internal strategic goals 
  • Create a successful project management structure with C-suite buy-in and a multi-disciplinary review that meets CMS deadlines 

Moderator:
Lawrence Butler, Capture Manager
Google Public Sector

Heather Adams, Senior Product Line Manager 
Blue Cross and Blue Shield of North Carolina 

Nikki Hungate, MS, MHA, Sr. Leader, Medicare Gov’t Programs Product Strategy
MVP Health Care

 

4:00 PM 4:20 PM

3:00 PM 3:20 PM

2:00 PM 2:20 PM

1:00 PM 1:20 PM

Networking Break

4:20 PM 5:10 PM

3:20 PM 4:10 PM

2:20 PM 3:10 PM

1:20 PM 2:10 PM

Define Your Market Strategy to Shape a Successful Bid 

  • Analyze key factors and data about your market to gain an edge on your competition 
  • Learn which key variables drive shopping decisions and how to weigh each in the bid strategy 
  • Evaluate what brings the most value to your target market while staying on budget

Moderator:
Daniel Weaver, Executive Vice President, Product Operations and Stars Strategy
NationsBenefits

Pamela C. Getsie, Plan President
Vermont Blue Advantage

Pritpal Virdee, President
Emergient/BCBS of Michigan

 

5:10 PM 6:00 PM

4:10 PM 5:00 PM

3:10 PM 4:00 PM

2:10 PM 3:00 PM

Future-Proof Your Bid

  • Learn the value of developing a three-year bid strategy
  • Project future CMS payments to increase benefit offering stability
  • Explore ways to design benefits for member cohorts to improve medical loss ratio (MLR), address social determinants of health, and boost member loyalty
  • Consider rewards and incentive packages that can be submitted via the Value-Based Insurance Design (VBID) framework

Melissa Smith, EVP, Consulting and Professional Services
Healthmine

Sion Hughes, Senior Consultant
Wakely Consulting Group, an HMA Company

Ana Handshuh, Principal
CAT5 Strategies 

 

6:00 PM 7:00 PM

5:00 PM 6:00 PM

4:00 PM 5:00 PM

3:00 PM 4:00 PM

Networking Cocktail Reception

Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.

Tuesday - January 24, 2023

9:00 AM 10:00 AM

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

Registration Desk Open and Networking Breakfast 

9:00 AM 4:00 PM

8:00 AM 3:00 PM

7:00 AM 2:00 PM

6:00 AM 1:00 PM

Exhibit Hall Open

10:00 AM 10:15 AM

9:00 AM 9:15 AM

8:00 AM 8:15 AM

7:00 AM 7:15 AM

Welcome and Day One Takeaways from Chairperson

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

10:15 AM 11:00 AM

9:15 AM 10:00 AM

8:15 AM 9:00 AM

7:15 AM 8:00 AM

How Risk Adjustment Drives Revenue Projections

  • Get insight into how risk score assumptions figure into revenue modeling for the bid
  • Learn how to build up a risk profile based on current members 
  • Understand how ongoing retrospective and prospective risk adjustment activities contribute to revenue projections

 

Moderator:
Laura Sheriff, RN, MSN, CPC, CRC, Vice President Operations, Risk Adjustment 
Southwestern Health Resources

Thomas B. Glasner, Managing Actuary
Health First Health Plans

Shannon Decker, M.Ed, MBA, PhD, Principal 
VBC One 

 

11:00 AM 11:45 AM

10:00 AM 10:45 AM

9:00 AM 9:45 AM

8:00 AM 8:45 AM

Develop a Bid that Boosts Star Ratings

  • Ensure all bid strategy team members understand the bid’s impact on Star ratings  
  • Explore bid strategies to improve Star ratings, including the heaviest-weighted member experience measures 
  • Understand how bid changes impact different members and how to mitigate potential dissatisfaction 

Rex Wallace, Founder and Principal
Rex Wallace Consulting

Jenn Kerfoot, Chief Experience Officer
FarmboxRx

11:45 AM 12:05 PM

10:45 AM 11:05 AM

9:45 AM 10:05 AM

8:45 AM 9:05 AM

Networking Break

12:05 PM 12:55 PM

11:05 AM 11:55 AM

10:05 AM 10:55 AM

9:05 AM 9:55 AM

The Ins and Outs of Supplemental Benefits

  • Discover supplemental benefit trends and explore unique offerings
  • Learn techniques for determining what supplemental benefits to offer, how to include them in your bid, and how they can help address social determinants of health 
  • Assess the pros and cons of participating in Special Supplemental Benefits for the Chronically Ill (SSBCI), Value-Based Insurance Design (VBID), and other special programs 

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

Vincent Giglierano, Senior Manager, Health Services Research
Faegre Drinker

Mike Spicer, Vice President, Product
Capital District Physicians’ Health Plan

 

  •  

12:55 PM 1:55 PM

11:55 AM 12:55 PM

10:55 AM 11:55 AM

9:55 AM 10:55 AM

Networking Lunch

1:55 PM 2:45 PM

12:55 PM 1:45 PM

11:55 AM 12:45 PM

10:55 AM 11:45 AM

The CMS Desk Review: What to Expect and How to Prepare

  • Find out what to expect from the desk review and what bid reviewers are likely to scrutinize 
  • Learn best practices to limit mistakes and bid reuploads 
  • Prepare for CMS’ announcement on Part D National Average Bid Amount (NABA) and its impact on your bid planning 

Danica (Dani) Holliston, Medicare Product Manager III
Regence BCBS

Michael O'Malley, Plan Administrator
AIDS Healthcare Foundation

2:45 PM 3:45 PM

1:45 PM 2:45 PM

12:45 PM 1:45 PM

11:45 AM 12:45 PM

Regulatory Update: Responding to Part D Changes and More

  • Find out how Part D changes in the Inflation Reduction Act — including Medicare negotiation of drug prices and a cap on insulin cost — will affect your bid 
  • Learn strategies for dealing with new pharmacy Direct and Indirect Remuneration (DIR) rules 
  • Understand the bid-related implications of the end of the COVID public health emergency 

Omar Daoud, Director of Pharmacy 
Community Health Plan of Washington 

Adam Feller, Consulting Actuary
Milliman

  •  

     

3:45 PM 4:00 PM

2:45 PM 3:00 PM

1:45 PM 2:00 PM

12:45 PM 1:00 PM

Chairperson’s Closing Remarks and Conference Concludes

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

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