Agenda

June 28, 2021

9:00 – 10:00AM EST
Morning Networking

10:00 – 10:05AM EST

Welcome Remarks

10:05 – 10:35AM EST

Keynote Address: CMS Quality Measures Update

An in-depth analysis of the overall CMS expectations for quality ratings in 2021 and beyond 

Richard E. Wild, MD, JD, MBA, FACEP, Chief Medical Officer, Atlanta and Boston Regional Offices
Centers for Medicare and Medicaid Services (CMS)

10:35 – 10:50AM EST
Networking Break

10:50 – 11:35AM EST

CAHPS Best Practices to Improve Member Satisfaction and Perception

  • Explore how to capture and leverage data/ CAHPS metrics at scale to better understand members and behavioral drivers 
  • Examine the shift in focus to member experience and assess how to allocate resources to pivot effectively 
  • Hear how to optimize member touchpoints and understand how to work cross functionally in the enterprise to impact member perception and satisfaction 
  • Discuss a consumer-centric model and best practices to help members understand benefits while avoiding abrasion and reducing complaints and grievances 

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

David Larsen, Director, Quality Improvement
SelectHealth

David Meyer, Former Vice President
Cigna

Rex Wallace, Principal
Rex Wallace Consulting

11:35 – 11:50AM EST
Networking Break

11:50 – 12:35PM EST

Provider Perspective Panel Discussion

  • Hear from providers on effective communication and education efforts around quality and Stars  
  • Get insights into successful incentive programs used with providers to steer behavior  
  • Understand strong motivators for providers and how to foster a strong patient/provider partnership 
  • Gain best practices on EMR adaptability and integration into provider’s workflow to reduce burnout 
  • Discuss the Provider Engagement/Patient Engagement/Quality system dynamic 

Dr. Shannon Decker, M.Ed., MBA, PhD., Vice President, Clinical Performance
Brown & Toland

Vishal Bhalla, MBA,MS,CPXP,SPHR, Vice President and Chief Experience Officer
Parkland Health & Hospital System

Dr. Jatin Dave, Chief Medical Officer and Director of Clinical Affairs
MassHealth

12:35 – 1:35PM EST
Lunch and Networking Break

1:35 – 2:20PM EST

Concurrent Sessions

Track A: Member Experience Journey - Full 360 View of Touchpoints

Member Services Spotlight: Insights and Tactics into Elevating Customer Experience

  • Gain insights into call volume trends, top concerns, and wait times 
  • Examine ways to proactively support and train the member services team  
  • Discuss best practices to develop tracking of members with unresolved issues that might result in CTMs and ways to escalate them 
  • Hear how to proactively address pain points and identify them 

Jason Smith, Director of Operations & Performance Improvement
Sharp Health Plan

Track B: Population Health

Making SDoH Practical: Embedding SDoH in Quality Programs

  • Examine health disparities and understand how to embed SDoH into quality program initiatives to create scalable impact  
  • Hear initiatives to impact specific populations through alignment of quality and SDoH efforts 
  • Discuss ways to strategize and use social determinants of health to drive and tailor services and remove barriers 

Kurt Waltenbaugh, Founder and CEO
Carrot Health

Julia Joseph-Di Caprio, M.D., M.P.H., Senior Vice President and Chief Medical Officer
UCare

 

 

 

Track B: Population Health

Case Study: Hear from California Department of Health 2020 Health Equity Award winning program, Insulin Advisors at Scan Health Plan.

A targeted engagement initiative for Spanish-speaking members with diabetes.

Available to Virtual Audience

Melanie Weir, Chronic Condition Project Principal,
Scan Health Plan

Rosaneli Loza, Manager, Connecting Provider to Home
Scan Health Plan

2:20 – 2:35PM EST
Networking Break

2:35 – 3:20PM EST

Concurrent Sessions

Track A: Member Experience Journey - Full 360 View of Touchpoints

Marketing/Member Acquisition Spotlight: Impacting Member Perception from a Marketing Lens

  • Gain insights into disenrollment trends and member engagement strategies  
  • Hear how to draw attention to benefits to impact member perception  
  • Understand how to look at member behaviors to tailor communication preferencesavoid member abrasion, and ensure positive survey results 

Steven Selinsky, Vice President of Product Strategy, Marketing and Community Outreach
Health Alliance Plan

Track B: Population Health

Case Study: Hear from California Department of Health 2020 Health Equity Award winning program, Insulin Advisors at Scan Health Plan. A targeted engagement initiative for Spanish-speaking members with diabetes.

Melanie Weir, Chronic Condition Project Principal,

Scan Health Plan

Rosaneli Loza, Manager, Connecting Provider to Home
Scan Health Plan

Track B: Population Health

Population Health Strategies and Analyzing the Impact of the Pandemic

  • Understand how to stratify member population to best target and meet members’ needs
  • Explore which population health initiatives have been most effective and hear ways to gauge or measure results
  • Discuss looking at quality measures through a health equity lens and hear how to educate providers to speak the right language
  • Discuss the different mental health and substance abuse implications of the pandemic and how to manage care moving forward


Tejaswita Karve, Ph.D., Director, Quality Improvement
Johns Hopkins HealthCare

Janine Sala, Director, Population Health, Quality Improvement
UnitedHealthcare

Kimberly Swanson, MPA, Vice President, Quality and Clinical Integration,
Network Health

Mallory Mueller, BSN, RN, Director Quality Health Integration
Network Health

3:20 – 3:35PM EST
Networking Break

3:35 – 4:20PM EST

Concurrent Sessions

Track A: Member Experience Journey - Full 360 View of Touchpoints

Case Study: Highmark’s interdepartmental outreach effort that successfully engaged members with deferred care and at least one chronic condition to receive care and close gaps for MY2020.

Haidy Metz, CPC, CRC, CPMA, Supervisor, Quality, HEDIS & Coding, Revenue Program Management
Highmark

Track B: Population Health

Population Health Strategies and Analyzing the Impact of the Pandemic

  • Understand how to stratify member population to best target and meet members’ needs 

  • Explore which population health initiatives have been most effective and hear ways to gauge or measure results 

  • Discuss looking at quality measures through a health equity lens and hear how to educate providers to speak the right language 

  • Discuss the different mental health and substance abuse implications of the pandemic and how to manage care moving forward 

Tejaswita Karve, Ph.D., Director, Quality Improvement
Johns Hopkins HealthCare

Janine Sala, Director, Population Health, Quality Improvement
UnitedHealthcare

Kimberly Swanson, MPA, Vice President, Quality and Clinical Integration,
Network Health

Mallory Mueller, BSN, RN, Director Quality Health Integration
Network Health

Track B: Population Health

Making SDoH Practical: Embedding SDoH in Quality Programs

  • Examine health disparities and understand how to embed SDoH into quality program initiatives to create scalable impact  
  • Hear initiatives to impact specific populations through alignment of quality and SDoH efforts 
  • Discuss ways to strategize and use social determinants of health to drive and tailor services and remove barriers 

Kurt Waltenbaugh, Founder and CEO
Carrot Health

Julia Joseph-Di Caprio, M.D., M.P.H., Senior Vice President and Chief Medical Officer
UCare

4:20 – 4:35PM EST
Networking Break

4:35 – 5:20PM EST

Actionable Collaboration between Quality and RA to Achieve Optimal Results

  • Identify medical record collection overlap and understand how to optimize converging member touchpoint efforts to avoid provider abrasion 
  • Gain insights into simultaneous review of risk and care gaps as one unified goal between RA and quality 
  • Train staff more effectively for better interdepartmental alignment and synergy  
  • Understand considerations for risk adjustment and quality around telehealth encounters, appropriate coding, and closing gaps in care 

 

Sharalee Johnson, BSN, RN, Director, Quality Solutions
Pulse8

Sharon Kuhrt, RN, DNP, Advisor, HEDIS
Priority Health

5:20 – 5:25PM EST

Closing Remarks

5:25 – 6:25PM EST
Networking Reception

In-person attendees will enjoy a socially distanced reception, compliant with CDC guidelines, providing networking opportunities among other in-person attendees, speakers, solutions providers and guests. Be sure to RSVP when you register. As an attendee you can bring a guest to our evening reception. 

For virtual attendees, turn on your camera and join us in the virtual networking lobby for face-to-face networking with other attendees that are joining us from the comfort of their home. No matter how you join, you’ll have access to those hallway conversations we’ve all been missing. 

June 29, 2021

9:00 – 9:40AM EST
Morning Networking

9:40 – 9:45AM EST

Welcome Remarks and Day One Recap

9:45 – 10:35AM EST

Keynote Presentation: Coloring Outside the Lines in Healthcare; Creating a NEW Patient Experience

Jeff Tobe, M.Ed, CSP, Customer Experience Expert and Author
“Coloring Outside of the Lines”

10:35 – 10:50AM EST
Networking Break

10:50 – 11:35AM EST

Industry Roundtable: Stars Landscape Review and Lessons Learned from 2020

  • Explore annual wellness visits revamp in 2021 and strategic messaging around safety  
  • Look into new measures and weights such as Transitions of Care and Member Experience measures and discuss ways to modify strategies to tackle them 
  • Address deferred care across the board through patient stratification and discuss the impact of the pandemic on chronic condition management and spending in 2021 
  • Navigate the future of telehealth and examine opportunities with leniency from CMS   

 

David Larsen, Director, Quality Improvement
SelectHealth

Katharine Iskrant, MPH, CHCA, CPHQ, Practice Leader
Healthy People, Inc.

Daniel Weaver, VP Stars and Government Quality Improvement Programs
Gateway Health Plan

11:35 – 11:50AM EST
Networking Break

11:50 – 12:35PM EST

Building Culture of Quality and Service Excellence to Achieve or Maintain 5 Stars

  • Hear best practices to advocate for quality with leadership while showing value and obtaining commitment from higher ups in the organization 
  • Provide evidence-based research and understand how to show trends and improvements in higher level data   
  • Dive into strategies to build-up staff and create structure for an organization devoted to quality and service excellence  
  • Explore ways to focus resources on key measures that will move the needle and maximize quality results  

Kristy Smith, HEDIS Program Manager
Martin’s Point

Joshua Edwards, STARS Program Manager
Martin’s Point

 

12:35 – 1:35PM EST
Lunch and Networking Break

1:35 – 2:20PM EST

Concurrent Sessions

Track A: HEDIS

HEDIS 365: A Year-Round Approach to Quality

  • Get best practices for a more robust interventions during “off-season”  
  • Discuss supplemental data strategies to close gaps throughout the year  
  • Explore innovative ways to engage members and close gaps in a COVID-19 environment 
  • Hear provider training tactics to understanding HEDIS and Stars as a year-round process 

Jennifer Pereur, VP of Solutions
Apixio

Track B: Part D Focus

Medicare Part D 5-star Strategy to Boost Member Experience

  • Discuss correlation between access to medication and CAHPS and how to thrive in a COVID-19 environment  
  • Examine ways to synergize efforts between part D and part strategies to maximize quality results 
  • Navigate regulatory changes coming down the pipeline in part D around CMS rebates and pricing that can impact customer satisfaction  

Noris Reyes, Chief Operating Officer
PrimeHealth Physicians

Ryan Davis, Medicare Market & Operations, Senior Manager
Centene

TrackB: Part D Focus

Optimal Outcomes from Medication Therapy Management (MTM)

  •  Explore the exponential rise of MTM star cut points and discuss strategies to achieve positive results  
  • Navigate plan design from an MTM perspective and hear ways to maximize member savings and medication adherence
  • Understand challenges and opportunities of in-house, vendor, or hybrid MTM programs

Gary Melis R.Ph., Clinical Pharmacist
Network Health

2:20 – 2:35PM EST
Networking Break

2:35 – 3:20PM EST

Concurrent Sessions

Track A: HEDIS

HEDIS Data Collection Strategies and the Move to Digital Measures

  • Navigate the move to digital measures and how payers are positioning themselves to tackle this new shift 
  • Hear how plans continue to work with providers to collect data and close gaps in a COVID-19 environment while avoiding abrasion 
  • Discuss provider incentive structure for data and chart collection and hear what should be incentivized for optimal results 
  • Address barriers to care and examine initiatives to work around them such as in-home kits and telehealth to meet patients’ needs 

Katharine Iskrant, MPH, CHCA, CPHQ, Practice Leader
Healthy People, Inc.

Track B: Part D Focus

Optimal Outcomes from Medication Therapy Management (MTM)

  • Explore the exponential rise of MTM star cut points and discuss strategies to achieve positive results 
  • Navigate plan design from an MTM perspective and hear ways to maximize member savings and medication adherence
  • Understand challenges and opportunities of in-house, vendor, or hybrid MTM programs

Gary Melis R.Ph., Clinical Pharmacist
Network Health

Track B: Part D Focus

Medicare Part D 5-star Strategy to Boost Member Experience

  • Discuss correlation between access to medication and CAHPS and how to thrive in a COVID-19 environment  
  • Examine ways to synergize efforts between part D and part C strategies to maximize quality results 
  • Navigate regulatory changes coming down the pipeline in part D around CMS rebates and pricing that can impact customer satisfaction  
  • Hear best practices to improve medication adherence while reducing member abrasion 

Noris Reyes, Chief Operating Officer
PrimeHealth Physicians

Ryan Davis, Medicare Market & Operations, Senior Manager
Centene

 

3:20 – 3:35PM EST
Networking Break

3:35 – 4:20PM EST

Deep Dive into HOS Initiatives and Best Practices

  • Understand how to empower members to have HOS related conversations with providers 
  • Address health literacy with members and providersHear best practices when creating PCP visit checklist/tip sheet for successful visit with PCP focusing on HOS measures 
  • Integrating data to identify at risk members and having strategic interventions in place to help members with declining care especially around physical and mental health 
  • Explore ways to educate customer service team on how to ask the right HOS related questions when interacting with member 

Rex Wallace, Principal
Rex Wallace Consulting

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

Renée Golderman, Senior Vice President, Chief Quality Officer 
Capital District Physicians' Health Plan (CDPHP®)

4:20 – 4:25PM EST

Conference Closing Remarks