2019 Agenda

June 27, 2019

8:00AM
Registration and Networking Breakfast

8:45AM

Chairperson’s Welcome Remarks

RaeAnn Grossman, Chief Growth Officer 

DataLink 

9:00AM

Keynote Address: 2019-2020 CMS Quality Measures Update

  • An in-depth analysis of the overall CMS expectations for quality ratings in 2019/20 
  • Examine the new Stars measures that will be introduced by CMS 
  • Understand operational changes needed due to new measures 
  • Recognize the Stars measures that have been removed and understand if you are required to collect and report data 

 

David S. Nilasena MD, MSPH, MS, Chief Medical Officer, Region VI 
Centers
 for Medicare & Medicaid Services  

 

9:45AM

Improving Quality Scores by Addressing Disparities

  • Examine tools on the market that can bridge the gap 
  • Assess how supplemental benefits can help your members 
  • Collaborate with community-based organizations 
  • Maximize quality with patient centered homes 

 

Paul Cotton, Director, Federal Affairs

National Committee for Quality Assurance (NCQA)

10:30AM
Networking Break

11:00AM

5-Star Can’t be Achieved Alone

  • Attain key strategic input to formulate a Star’s plan across all touch point teams 
  • Hear best practices to ensure cohesive and patient-centric quality of care  
  • Obtain buy in from all teams to achieve stars quality and HEDIS scores 

 

Michael Clift, Director of Stars Strategy and Analytics

Cigna

 

Cynthia Aguglia, Medicare Stars Administrator, Quality Enhancement

CDPHP

 

11:45AM
Networking Lunch

1:00PM

Concurrent Sessions

1:00PM

Track A: The Quality Paradox: Improving Performance by Motivating the Unengaged

Historically non-compliant members are the most difficult to engage, but they’re also the most critical to motivate due to their potential impact on Star ratings and the disproportionate amount of care costs they represent.

  • Learn why one-size-fits-all member engagement doesn’t work and why successful programs focus where it counts
  • Discover 5 proven strategies for motivating the unengaged to participate in their own care
  • Hear from a health plan currently running a successful multi-year member engagement program on what works, what doesn’t and what they’ve learned in the process


Christine Gage, Sr. Program Performance Strategist

NovuHealth

 

Cynthia Weiss, Director of Quality, Accreditation and Wellness

AvMed Health Plans

 

 

1:00PM

Track B: Provider Engagement Strategies to Improve HEDIS Quality Measure Performance and Risk Adjustment

  • Recognize how a combined engagement approach increases performance while reducing abrasion.
  • Examine different levels and types of communication to engage with providers
  • Hear how to implement workflows to create optimal efficiency

 

Colleen GianatasioRisk Adjustment Quality and Education Program Manager

CDPHP

 

Frances Johnson, Director, Quality Management

Blue Cross and Blue Shield of North Carolina

1:45PM

Concurrent Sessions

1:45PM

Track A: Enhancing Engagement Strategies to Bridge Gaps in Care

  • Understand how analytics and algorithms help predict member preference as it relates to how, where and when they receive care.
  • Learn how unique venues like mobile health clinics can offer members greater choice and convenience in accessing important care and preventive services.
  • Hear case study data that supports the strategic objectives of bridging key care gaps

 

Daniel Castillo, MD, MBA, Chief Medical Officer

Matrix Medical Network

 

Nadia Ince-Lovelace, Director, Enterprise Quality – STARS Program 

CareSource 

  

Vicki Schwab, Enterprise Quality Business Operations Manager 

CareSource 

 

1:45PM

Track B:How Value-Based Care is Transforming the Quality Landscape for Plans and Providers

  • Understand how value-based care is changing the landscape for health care providers and health payers
  • Make It Real: Learn how plans and providers can work together to improve quality ratings
  • Hear how Providers and Plans are aligning incentives to manage the critical elements of successfully managing the shift

Kari Hadley, Senior Director, Quality Product Solutions

Pulse8

 

Frances Johnson, Director, Quality Management

Blue Cross and Blue Shield of North Carolina

 

2:30PM
Networking Break

3:00PM

Concurrent Sessions

3:00PM

Track A: Expert Panel: Strategies to Achieve and Maintain a 4-Star+ Rating- Improvement Strategies

  • How to establish areas of your current quality program that can be improved in a changing landscape, regardless of plan size
  • Maximize the financial loss data to increase awareness and support from higher up administration and quality team
  • Tactics to establish an advanced workflow that gets the best out of your team

 

Jim Techtmann, SVP – Rewards & Incentive Solutions 

Entertainment CMS  

  

Kristen Mangum, Stars Lead - Arizona

Cigna-HealthSpring 

 

3:00PM

Track B: Getting the last few charts: Best Practices for HEDIS Record Retrieval

  • Understand the complexities associated with medical record retrieval for HEDIS
  • Gain tips for managing your HEDIS retrieval projects as smoothly as possible

 

Eugenia Ross, Senior Vice President of Strategy, Product & Marketing  

Ciox Health  

 

3:45PM

Concurrent Sessions

3:45PM

Track A: Updates on Measures to Transition of Care and Opioid Addiction

  • Hear from the experts of your current budget and staff allocations will support the changes in these measures
  • Understand which operational changes may be needed in advance of the introduction of the measures
  • Explore technology solutions that can advance your current operation
     

Gary Melis, Clinical Pharmacist 

Network Health 

3:45PM

Track B: Examining the Role Physician Incentives Play to Improve Patient Outcome and HEDIS Quality Measure Performance

  • Strategies to align physician incentives with health plan efforts to improve patient outcomes  
  • Understand how the role of physician incentives can improve HEDIS quality measure performance 
  • Create incentive-based contracts that can be used to reinforce the desired outcome

Michael Clift, Director of Stars Strategy and Analytics

Cigna

 

Kristen Mangum, Stars Lead - Arizona

Cigna-HealthSpring

 

Melanie Richey, Vice President, Clinical Solutions

Centauri Health Solutions

4:30PM

Closing Panel: Best Practices to Ensure a Member-Centric Approach

  • Strategies to reinforce quality of care for the member throughout all touchpoints  
  • Maximize patient education, understanding, communication & engagement as the key driver of success 
  • Strategies for supporting SDOH to increase quality of care
  • Utilize an equity lens to close gaps in care

Moderator:

Ana Handshuh, Principal

Cat 5

 

Speakers:

 

Jennifer Hawkins, Director, Health Plan Quality Assurance

CareOregon

 

Melanie Weir, Project Principal 

SCAN Health Plan  

 

5:15PM
Networking Cocktail Reception

June 28, 2019

8:00AM
Networking Breakfast

8:45AM

Chairperson’s Opening Remarks

RaeAnn Grossman, Chief Growth Officer 

DataLink 

9:00AM

Total Person Care: Improving Quality and Health by Integrating Behavioral, Social, and Pharma

  • Addressing mental health issues to improve quality of care and scores 
  • Identifying and navigating social determinants of health that influence care plans and quality scores 
  • How substance abuse alters care plans, patient adherence, and risk and quality scores 

RaeAnn Grossman, Chief Growth Officer

DataLink

 

Dave Meyer, Vice President, STARS

Cigna

9:45AM

Examining the Impact of the National Coordinator for Health Information Technology (ONC) Proposed Rule

  • Evaluate the standardized application programming interfaces (APIs) which will need to be adopted
  • Examine the changes to the ONC Health IT Certification Program
  • Identify how plans leverage reduced information blocking to improve quality programs

Amy Salls, Director of Quality Analytics

SS & C Health

10:30AM
Networking Break

11:00AM

Concurrent Sessions

11:00AM

Track A: Case Study: Best practices from a Plan with Consistently High CAHPs and HOS Scores

  • Execute controllable factor to enhance and maintain your CAHPS and HOS 
  • Identify tools and strategies can you use to improve and maintain consumer satisfaction even with limited resources 
  • Overcome the challenge of translating member perceptions of care and operations into actual CAHPS and HOS results 
     

Anne Davis, Director of Quality Programs and Medicare Strategy,

HMS

 

Carmen Lord, Member Rights Manager 

Care Wisconsin 

11:00AM

Track B: Medication Adherence, How to Make Your Adherence Program More Sticky, A Review of Best Practice Benchmarking

  • Case study: SelectHealth recently completed a best practice benchmarking initiative by conducting interviews with three top rated plans regarding medication adherence for diabetes, statin and hypertensive medications.
  • Discuss lessons learned by SelectHealth in developing and implementing a medication adherence program.

 

David Larsen, Director, Quality Improvement

SelectHealth

 

11:45AM
Networking Lunch

1:00PM

Concurrent Sessions

1:00PM

Track A: Panel: Strategies for Improving Hard-To-Move Measures

  • Hear best in show strategies to improve hard to move measures such as access 
  • Benchmark where your peers hard-to-move measures are, and learn from other best practices 
  • Improve clinical data acquisition with legacy evaluation and understand investment needed to move away from chart collection

Moderator:

RaeAnn Grossman, Chief Growth Officer,

DataLink

 

Speakers:

Terri Kitchen, Executive Director, Enterprise Quality and Accreditation,

Blue Cross Blue Shield Illinois

 

Ahmed Ayad, Director of Continuous Improvement, Quality, and Compliance

Blue Cross and Blue Shield of North Carolina

 

Jennifer Pereur, VP of Solutions

Apixio

 

 

1:00PM

Track B: Proven Methods to Encourage Patient Adherence

  • Understand why and when non-adherence is likely to occur, to overcome challenges 
  • How adherence can be assessed and improved within the context of usual clinical care 
  • Examine ways in which trust, motivation and patient-centric collaborative care can be built quickly during consultations 

Ana Handshuh, Principal

Cat 5

 

 

1:45PM

Concurrent Sessions

1:45PM

Track A: Innovations in CAHPS and HOS Tools and Approaches

  • Assess techniques and approaches being used by those who have attained consistently high scores 
  • Tools to connect communications and customer services at every member touchpoint within your plan 
  • How to leverage data to gain insights into how plan decisions impact customer experience and develop action plans  

Moderator:

Michael Blumental, President,

Health Data Decisions

Panelists:

Hagy Wegener, Vice Presient, Quality Improvement,

Buckeye Health Plan

Dominic Henriques, Director of Quality Improvement and Risk Adjustment

Prominence Health Plan

1:45PM

Track B: Optimal Outcomes from Medication Therapy Management (MTM)

  • Generate the correct balance with a Hybrid approach in-house and vendor
  • Maximize member savings and medication adherence with the use of a formulary list of medications
  • Collaborate with providers to identify the best financial options for members pharmaceutical needs

Gary Melis, Clinical Pharmacist

Network Health

 

Jose Diaz-Luna, Vice President of Pharmacy

Trusted Health Plan

 

2:30pm
Networking Break

2:45PM

Conference Closing Panel: Interactive Q & A Panel with Quality Measure Leaders

An amazing opportunity ask our leading speakers anything that you haven’t had an answer to over the past two days across stars strategy, HEDIS scores, CAHPS/HOS surveys and pharmacy-related measures.

 

David Larsen, Director, Quality Improvement

SelectHealth

 

Carmen Lord, Member Rights Manager 

Care Wisconsin