2022 Agenda

Second Day Opening Remarks

Ana Handshuh, Principal 
CAT5 Strategies 

Chair 

The RISE Association, Quality & Revenue Community 

Member Retention Through Part D: Optimize Your Formulary Design

• Understand the components and how the rebate allocations work  
• Learn what can optimize your Part D formulary tier structure to boost member retention and Star ratings 
• Discuss CMMI’s Part D Senior Savings Model and strategies for plan revenue 

Andy Wheaton, Pharmacy Department Manager  

Network Health 

Managing the Part B Professionally Administered Drugs Effectively

• Capitalize on Part B drug rebates and select the right vendor
• Discover strategies to manageyour drug expenditure while maintaining outcomes 
• Drug trends and how to prepare for the future
• CMS guidance on Part B step therapy programs 

Omar Daoud, Director of Pharmacy 

Community Health Plan of Washington 

Deep Dive into Flex, Special Supplemental Benefits for the Chronically Ill (SSBCI), and Value Based Insurance Design (VBID): Analysis and Benchmarking

• Get a clear roadmap and framework to the seemingly endless benefit possibilities, from companion providers to pet sitting to transportation 
• Learn what plans are offering and where in the bid benefits were placed 
• Compare what was filed and what CMS accepted 
• Discuss how COVID impacted benefit selection and financials 

Mike Spicer, Director, Product Innovation & Research

Capital District Physicians' Health Plan

Tom Pelegrin, Senior Vice President & Chief Revenue Officer  

Convey Health Solutions 

Case Study Learnings to Clear the Confusion Around Meal and Grocery Benefits

• Get the step by step, how one plan successfully incorporated grocery benefits for better member outcomes 
• Parse the options, from prepared meals to a la carte, nonperishable groceries, fruit and veg to best serve the communities within your membership 
• Gain assessment frameworks to determine the best food benefit application, whether OTC dollars, SSBCI, or other options 

Ashley Tyrner, Founder and CEO

FarmboxRx

Ana Handshuh, Principal
CAT5 Strategies

Chair
The RISE Association, Quality & Revenue Community

Lunch Break

Optimize Vendor Selection, Timing and Strategies to Ensure You Delight Your Members

• Gain methodologies and best practices for researching and vetting benefit providers to ensure you partner with the best choice 
• Discuss timetables for vendor research, selection, and involvement relative to bid development and submission 
• Get a blueprint of essentials to assess and of what to avoid, to make selections efficiently and confidently 

Hannah Neylon, Manager, Government Products and Relations

Network Health

Dan Weaver, EVP Product Operations and Stars Strategy 

NationsBenefits 

Differentiate Your Plan Through Competitive Benefit Design for Vulnerable Populations

• Discuss challenges of the CHRONIC Care Act and how health plans are responding through innovative benefit offerings 
• Create frameworks for determining the special needs to address with an appropriate SNP  
• Learn how to build product designs, case management, pick benefits, and select and onboard the best providers for the SNP 

Puneet Budhiraja, Senior Vice President, Value Based Analytics, and Chief Actuary
Capital District Physicians’ Health Plan (CDPHP)

Donna Doebler, AVP, Medicare SNP Product & Analytics
UPMC Health Plan

Desk Review, Audits and Required Changes After Bid Submission

• Survey recent health plans’ experiences with bid desk review and audits, to get advance knowledge on what bid reviewers scrutinize 
• Learn how best to analyze your performance post-bid to measure attractiveness to beneficiaries, to assess competitiveness, and to evaluate the accuracy of bid pricing assumptions 
• Gain best practices to limit mistakes and bid reuploads 
• Prepare for CMS’ announcement on Part D National Average Bid Amount (NABA) and its impact to your bid planning 

Ana Handshuh, Principal 
CAT5 Strategies 

Chair 

The RISE Association, Quality & Revenue Community 

Thomas Grivakis, Senior Consulting Actuary 

Wakely Consulting Group  

Build Back Better: How the Reconciliation Bill Would Impact MCOs

• Get up to speed on the status and trajectory of Biden Administration proposals and legislative reform to Medicare Advantage and Part D 
• Assess the continuing impact of COVID-19 tumult on bids and how that informs bid strategy for 2023 
• Prepare for rulemaking changes and their downstream impacts to 2023 bids 

Alex Cires, Consulting Actuary   

Milliman 

Closing Remarks and Conference Concludes

Ana Handshuh, Principal 
CAT5 Strategies 

Chair 

The RISE Association, Quality & Revenue Community