View the 2024 Agenda | Qualipalooza: The RISE Quality Leadership Summit | A RISE Health Conference

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Qualipalooza 2024
June 2-4, 2024
Atlanta

Agenda

Sunday - June 2, 2024

8:00 AM 5:30 PM

7:00 AM 4:30 PM

6:00 AM 3:30 PM

5:00 AM 2:30 PM

Registration Desk Open

9:00 AM 12:30 PM

8:00 AM 11:30 AM

7:00 AM 10:30 AM

6:00 AM 9:30 AM

Preconference Workshop A: HEDIS Supplemental Data Check-Up: Are you Optimized?

  • Maximize plan-collected supplemental data for the HEDIS Electronic Clinical Data Systems (ECDS) measures
  • Maximize plan-collected supplemental data for traditional HEDIS measure reporting, including case management numerator closure opportunities, EHR, HIE, CCD, and data aggregator data
  • Examine opportunities related to NDC code mapping, NLP data, Medicare CMS Data Validation measure supplemental data sources, and lifetime exclusion data
  • Learn supplemental database management approaches to ensure your supplemental data is usable in the HEDIS audit

 

Katharine Iskrant, Practice Leader 

Healthy People, Inc. 

 

Julianne Eckert, Senior Director, Clinical Quality Programs 

Clover Health 

 

*Additional Registration Required

12:30 PM 1:30 PM

11:30 AM 12:30 PM

10:30 AM 11:30 AM

9:30 AM 10:30 AM

Networking Lunch

1:30 PM 5:00 PM

12:30 PM 4:00 PM

11:30 AM 3:00 PM

10:30 AM 2:00 PM

Preconference Workshop B: Deep Dive into Stars Math

  • Understand the Final Rule and perform in-depth review of Stars calculation  
  • Prepare for the Final Rule impacts  
  • Build strategy around:    
  • The new Health Equity Index Reward and removal of the previous Reward Factor   
  • Optimizing the Improvement measure, regardless of the proposed change to the hold harmless provision   
  • Model out contracts with and without the major Stars math drivers above with a customized workbook to develop strategies for YOUR health plan 

 

Rex Wallace, Founder & Principal 
Rex Wallace Consulting 

 

Nate Lucena, Chief Strategy & Analytics Officer 
Rex Wallace Consulting 

 

Mick Twomey, Chief Executive Officer  
Hyperlift 

5:00 PM 6:00 PM

4:00 PM 5:00 PM

3:00 PM 4:00 PM

2:00 PM 3:00 PM

Welcome Cocktail Reception (All Conference Attendees Invited)

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

Monday - June 3, 2024

7:30 AM 8:30 AM

6:30 AM 7:30 AM

5:30 AM 6:30 AM

4:30 AM 5:30 AM

Registration Desk Opens and Networking Breakfast

7:30 AM 6:00 PM

6:30 AM 5:00 PM

5:30 AM 4:00 PM

4:30 AM 3:00 PM

Exhibit Hall Open

8:30 AM 8:40 AM

7:30 AM 7:40 AM

6:30 AM 6:40 AM

5:30 AM 5:40 AM

Opening Remarks

Chairperson to be announced

8:40 AM 9:40 AM

7:40 AM 8:40 AM

6:40 AM 7:40 AM

5:40 AM 6:40 AM

Keynote Address: Capturing the Boomer Consumer

Join us for a strategy-focused deep dive into the Baby Boomer generation that will reveal the secrets to engaging them effectively, harnessing their substantial purchasing power, and meeting their distinctive health and lifestyle needs.

 

We will lay out concrete, practical tactics tailored to Boomers, including:

  • How to build trust
  • How to craft personalized experiences
  • How to effectively engage them to meet quality goals

 

Prepare to receive no-nonsense, powerful strategies and tips that will empower you to position your plan to optimize the Boomer experience. By the end of our session, you will have the knowledge needed to capture, engage, and retain the Boomer consumer.

 

Alexis Abramson, PhD
Emmy and Gracie award-winning journalist, author, world-renowned generational expert/trend spotter

9:40 AM 10:30 AM

8:40 AM 9:30 AM

7:40 AM 8:30 AM

6:40 AM 7:30 AM

Keep Calm and Carry On: Pressing Ahead through the Latest Quality Measures Changes

  • Get to know the latest finalized and proposed Star Ratings changes as well as the implications they may have on your organization
  • Turn regulatory requirements into real opportunities to address care caps and improve member experience and outcomes
  • Recognize potential financial implications of upcoming changes and how to optimize quality improvement dollars

 

Melissa Smith, Founder, Senior Advisor

Newton Smith Group

 

Ana Handshuh, Principal

CAT5 Strategies

10:30 AM 10:50 AM

9:30 AM 9:50 AM

8:30 AM 8:50 AM

7:30 AM 7:50 AM

Networking Break

10:50 AM 11:35 AM

9:50 AM 10:35 AM

8:50 AM 9:35 AM

7:50 AM 8:35 AM

Panel: Data, Data, Data—From Getting it to Using it, and Everything in Between

  • Discuss why most organizations need both vendor and in-house data solutions
  • Explore when and how to select a data aggregator and how to prepare internally to receive that data
  • Consider how to use HEDIS data to support broader plan initiatives and applications, such as population health programs
  • Learn what questions quality leaders must ask to validate data, reduce potential inefficiencies, and ensure systems work correctly to get the data they need

 

11:35 AM 12:20 PM

10:35 AM 11:20 AM

9:35 AM 10:20 AM

8:35 AM 9:20 AM

With Power Comes Responsibility: Leaning into Quality’s Bigger Seat at the Table

  • Explore how to continue to grow and improve quality programs and influence strategy while getting increased attention due to risk adjustment changes and other regulatory challenges
  • Consider how to best align the quality team within your organization to meet current and future regulatory demands and support total cost of care for members
  • Learn how to leverage the spotlight to create a top-down organization-wide culture of quality that aligns with Stars

 

Katie Martin, Vice President, Quality

Baylor Scott & White Health Plan

 

Ryan M. Stalvey, Director of Member Engagement Strategies  

Prospect Medical Systems 

 

Rhonda Farrar, HEDIS & Quality Principal Program Manager 

Advantmed 

12:20 PM 1:15 PM

11:20 AM 12:15 PM

10:20 AM 11:15 AM

9:20 AM 10:15 AM

Networking Lunch

Concurrent Sessions 1:15 PM - 2:00 PM 12:15 PM - 1:00 PM 11:15 AM - 12:00 PM 10:15 AM - 11:00 AM
Track Chairs:

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

Track A

Case Study: Improving Star Performance by Eliminating Health Care Disparities

  • Learn how SCAN Health Plan segmented its data to identify disparities in quality metrics by race and ethnicity
  • Explore how SCAN developed an improvement strategy focused on eliminating disparities in Statin adherence and AbA1c control in the Hispanic population as well as flu vaccine in the Black population
  • Understand how SCAN met their objectives through health education, chronic disease management, and reducing barriers to access

 

Ifedayo Kuye, MD, MBA, VP and Medical Director

SCAN Health Plan

1:15 PM 2:00 PM

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

Track B

Transformation Strategies and Insights for Underperforming Plans (and Fixing Bad Stars Juju)

  • Identify proven performance improvement strategies across multiple plan types from multiple turn-arounds
  • Explore insights from the constantly evolving Quality and Star Rating landscapes plans should consider while designing and executing turn-around strategies
  • Leverage innovations in the Quality and Star Rating landscape that can help bolster turn-around initiatives

 

Daniel Weaver, SVP Stars and Quality

Zing Health

 

Jenn Kerfoot, Chief Strategy and Growth Officer

DUOS

2:00 PM 2:05 PM

1:00 PM 1:05 PM

12:00 PM 12:05 PM

11:00 AM 11:05 AM

Transition Break

Concurrent Sessions 2:05 PM - 2:50 PM 1:05 PM - 1:50 PM 12:05 PM - 12:50 PM 11:05 AM - 11:50 AM
Track Chairs:

2:05 PM 2:50 PM

1:05 PM 1:50 PM

12:05 PM 12:50 PM

11:05 AM 11:50 AM

Track A

The Equitable Care Journey: From Data to Closed Care Gaps

  • Use data to drive strategies and interventions with SDOH and Health Equity within a health care team specific to geo mapping
  • Influence health care through innovative delivery of care

 

Joy Bland, DBH, RN, CCM, CPHQ, AVP Quality HEDIS and Compliance Operations

Aetna

2:05 PM 2:50 PM

1:05 PM 1:50 PM

12:05 PM 12:50 PM

11:05 AM 11:50 AM

Track B

Hot Topic: Becoming a HEDIS Data Quality and Governance Champion

Identify the best methods for describing your plan’s data governance programs and processes in the HEDIS Roadmap

  • Explain data quality testing methods (completeness, accuracy, and conformance) for HEDIS data
  • Leverage best practices for designing data architectures necessary to support traditional and ECDS HEDIS measure reporting

 

Katharine Iskrant, Practice Leader

Healthy People, Inc.

Concurrent Sessions 2:50 PM - 3:05 PM 1:50 PM - 2:05 PM 12:50 PM - 1:05 PM 11:50 AM - 12:05 PM
Track Chairs:

2:50 PM 3:05 PM

1:50 PM 2:05 PM

12:50 PM 1:05 PM

11:50 AM 12:05 PM

Track A

Tools & Tech Spotlight

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization.  

 

Nick Groch, RDN, LDN, Product Manager 

Medline 

2:50 PM 3:05 PM

1:50 PM 2:05 PM

12:50 PM 1:05 PM

11:50 AM 12:05 PM

Track B

Tools & Tech Spotlight

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization. 

 

Kate Wormington, Director of Quality Solutions 

Veradigm 

 

3:05 PM 3:25 PM

2:05 PM 2:25 PM

1:05 PM 1:25 PM

12:05 PM 12:25 PM

Networking Break

Concurrent Sessions 3:25 PM - 4:10 PM 2:25 PM - 3:10 PM 1:25 PM - 2:10 PM 12:25 PM - 1:10 PM
Track Chairs:

3:25 PM 4:10 PM

2:25 PM 3:10 PM

1:25 PM 2:10 PM

12:25 PM 1:10 PM

Track A

A Rocky Road: The Nation-Leading Journey from 3.5 to 4.5 Stars

  • Learn how Blue Cross of Idaho moved from 3.5 to 4.5 Stars in one year
  • Discuss the “Hail Mary” strategy launched during last 2 weeks of HEDIS audit, including cross-organizational collaboration between quality, pharmacy, brand and marketing, and customer experience
  • Leverage successful tactics to sustain performance in future years

 

Amy Blackledge, Director of Clinical Quality Management 

Blue Cross of Idaho 

 

Katie Gries, Manager, Clinical Quality Management 

Blue Cross of Idaho 

3:25 PM 4:10 PM

2:25 PM 3:10 PM

1:25 PM 2:10 PM

12:25 PM 1:10 PM

Track B

Deep Dive into CAHPS Math

  • Address measures with incredibly narrow performance thresholds, where less than 5 points can separate a 1-Star plan from a 5-Star plan
  • Understand how “downgrades” from reliability and statistical significance impact your scores
  • Examine the importance of converting randomly sampled survey measures into actual denominators of members to reach
  • Share strategies to maximize CAHPS performance and impact to Overall Star within the changing Stars landscape

 

Heidi Salerno, CAHPS Consultant

Rex Wallace Consulting

 

Ryan Bernstein, Consultant

Rex Wallace Consulting

4:10 PM 4:15 PM

3:10 PM 3:15 PM

2:10 PM 2:15 PM

1:10 PM 1:15 PM

Transition Break

Concurrent Sessions 4:15 PM - 5:00 PM 3:15 PM - 4:00 PM 2:15 PM - 3:00 PM 1:15 PM - 2:00 PM
Track Chairs:

4:15 PM 5:00 PM

3:15 PM 4:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

Track A

Stars, Part D Outcomes, and the IRA

  • Navigate and position your plan for success with Part D redesign and the 2025 IRA requirements
  • Leverage best practices for maintaining Star Ratings
  • Consider challenges and strategies for improving Part D measures

 

Elizabeth Strachota Benz, Vice President Quality and Clinical Integration 

Network Health  

 

Andy Wheaton, PharmD, MBA, Director of Pharmacy Benefits 

Network Health 

4:15 PM 5:00 PM

3:15 PM 4:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

Track B

Take the Unified Quality Program Plunge: Swimming in the Same Direction to Hit Your High-Water Mark

  • Explore how quality programs can unify to synchronize their swimming to share resources, align program initiatives, and decrease provider abrasion
  • Deep dive into how quality program alignment streamlines administrative processes, enhances member care, and optimizes resources, and the latest updates on CMS’ Universal Foundation of Measures
  • Navigate complex—and sometimes conflicting—regulatory waters while maintaining compliance and maximizing efficiency

 

Elissa Toder, VP Quality Improvement Strategy & Solutions, Product Development

Reveleer

5:00 PM 6:00 AM

4:00 PM 5:00 AM

3:00 PM 4:00 AM

2:00 PM 3:00 AM

Networking Cocktail Reception

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

Tuesday - June 4, 2024

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

5:00 AM 6:00 AM

Registration Desk Opens and Networking Breakfast

8:00 AM 1:30 PM

7:00 AM 12:30 PM

6:00 AM 11:30 AM

5:00 AM 10:30 AM

Exhibit Hall Open

9:00 AM 9:10 AM

8:00 AM 8:10 AM

7:00 AM 7:10 AM

6:00 AM 6:10 AM

Opening Remarks

Chairperson to be announced

9:10 AM 10:00 AM

8:10 AM 9:00 AM

7:10 AM 8:00 AM

6:10 AM 7:00 AM

New Session Coming Soon

Kristy Smith, HEDIS Program Manager 

Martin's Point  

 

Aman Kaur, Director of Risk 

Health Data Decisions 

10:00 AM 10:50 AM

9:00 AM 9:50 AM

8:00 AM 8:50 AM

7:00 AM 7:50 AM

Operationalizing the 2025 Changes to Medicare Part D

  • Learn what the Part D Smoothing copay program means for Stars
  • Consider potential strategies for mitigating the effects of plan and benefit changes on member experience and CAHPS scores
  • Explore how other CMS initiatives such as the health equity index may bring additional changes to Part D quality initiatives

 

Jason Sloan, Vice President, Medicare Advantage Stars and Risk Programs

BlueCross BlueShield of South Carolina

 

Cynthia Griffin, VP of Medicare Pharmacy Programs 

Florida Blue 

 

Ranarda Jones, PharmD, MBA, CEO

PSyn

10:50 AM 11:10 AM

9:50 AM 10:10 AM

8:50 AM 9:10 AM

7:50 AM 8:10 AM

Networking Break

Concurrent Sessions 11:10 AM - 12:00 PM 10:10 AM - 11:00 AM 9:10 AM - 10:00 AM 8:10 AM - 9:00 AM
Track Chairs:

11:10 AM 12:00 PM

10:10 AM 11:00 AM

9:10 AM 10:00 AM

8:10 AM 9:00 AM

Track A

The Power of Three: Strategies for Achieving Nation-leading Results in Triple Weighted Stars Measures

  • Review CMS's triple weighted HEDIS Stars Measures and understand why they are crucial in today's competitive landscape
  • Learn about innovative and proven strategies that can propel your organization to achieve national leadership in Stars Measures, focusing on quality, outcomes, and patient satisfaction.
  • Gain insights from real-world success stories and case studies that demonstrate the application of these strategies, helping you adapt and implement them within your own organization for outstanding results

 

Rebecca Fitch, MD

Permanente Medicine

 

Stephen P. Winn, CPHQ, Senior Director, Quality

Permanente Medicine

 

Gerardo Hernandez Diaz, Senior Director, Quality Improvement

Permanente Medicine

11:10 AM 12:00 PM

10:10 AM 11:00 AM

9:10 AM 10:00 AM

8:10 AM 9:00 AM

Track B

The Missing Link Revealed: Use Behavioral Science & AI to Improve Star Measures, including HEDIS, Medication Adherence, and CAHPS

  • Understand the WHY of a member—why does (or doesn't) a member stay adherent to their medication or get their colonoscopy
  • Explore innovative strategies to raise medication adherence scores to reduce total cost of care and improve outcomes 
  • Engage difficult-to-reach populations and support health equity efforts through behavioral science
  • Leverage the latest technology to drive cost-effective solutions across ALL your membership

 

Asaf Kleinbort, CEO & Co-Founder 

MedOrion 

 

Dave Burianek, Senior Vice President 
MedOrion 

Concurrent Sessions 12:00 PM - 12:15 PM 11:00 AM - 11:15 AM 10:00 AM - 10:15 AM 9:00 AM - 9:15 AM
Track Chairs:

12:00 PM 12:15 PM

11:00 AM 11:15 AM

10:00 AM 10:15 AM

9:00 AM 9:15 AM

Track A

Tools & Tech Spotlight

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization. 

12:00 PM 12:15 PM

11:00 AM 11:15 AM

10:00 AM 10:15 AM

9:00 AM 9:15 AM

Track B

Tools & Tech Spotlight

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization. 

12:15 PM 1:15 PM

11:15 AM 12:15 PM

10:15 AM 11:15 AM

9:15 AM 10:15 AM

Networking Lunch

Concurrent Sessions 1:15 PM - 2:05 PM 12:15 PM - 1:05 PM 11:15 AM - 12:05 PM 10:15 AM - 11:05 AM
Track Chairs:

1:15 PM 2:05 PM

12:15 PM 1:05 PM

11:15 AM 12:05 PM

10:15 AM 11:05 AM

Track A

Panel: Connecting with Caregivers to Improve Quality of Care

  • Discuss best practices, strategies, and regulatory considerations when optimizing communication with caregivers
  • Explore the intersection of caregivers and quality improvement, from CAHPS surveys to medication adherence and beyond
  • Examine how to better identify who caregivers are—and how to get them on your side

 

Moderator: 

Ana Handshuh, Principal 

CAT5 Strategies 

 

Panelists: 

Kristy Smith, HEDIS Program Manager 

Martin's Point 

 

Amanda Rees, Co-founder and CEO 

Bold 

1:15 PM 2:05 PM

12:15 PM 1:05 PM

11:15 AM 12:05 PM

10:15 AM 11:05 AM

Track B

Spotlight on the Voice of the Customer

  • Consider best practices for managing member focus groups and committees, from logistics to compliance
  • Discover how to glean valuable information and put it to use afterwards
  • Leverage member feedback to build trust and improve member experience

 

Rex Wallace, Principal

Rex Wallace Consulting

2:05 PM 2:10 PM

1:05 PM 1:10 PM

12:05 PM 12:10 PM

11:05 AM 11:10 AM

Transition Break

Concurrent Sessions 2:10 PM - 3:00 PM 1:10 PM - 2:00 PM 12:10 PM - 1:00 PM 11:10 AM - 12:00 PM
Track Chairs:

2:10 PM 3:00 PM

1:10 PM 2:00 PM

12:10 PM 1:00 PM

11:10 AM 12:00 PM

Track A

New Session Coming Soon

2:10 PM 3:00 PM

1:10 PM 2:00 PM

12:10 PM 1:00 PM

11:10 AM 12:00 PM

Track B

The HEDIS ECDS Reporting Revolution Has Begun

  • Don’t let the revolution catch you by surprise; join us for a review of the 16 existing ECDS measures, the 4 proposed HEDIS MY 2025 ECDS measures, and 7 ECDS measures currently in development
  • Learn about key ECDS reporting solutions including digital data feed acquisition and optimization, provider portals, NLP chart abstraction, and plan case management approaches
  • Better prepare for the loss of the hybrid option on 6 HEDIS measures that are converting to ECDS reporting: Colorectal Cancer Screening, Childhood Immunization Status, Immunizations for Adolescents, Cervical Cancer Screening, Controlling High Blood Pressure, and Medicare Pain Screening
  • Prepare for successful reporting of the future Medicare Star ECDS measures: Colorectal Cancer Screening, Social Need Screening and Intervention, Depression Screening and Follow-Up for Adolescents and Adults, Adult Immunization Status, and Blood Pressure Control

 

Bryan Hall, HEDIS Data IT Consultant

Clover Health

 

Katharine Iskrant, Practice Leader

Healthy People, Inc.

Concurrent Sessions 3:00 PM - 3:15 PM 2:00 PM - 2:15 PM 1:00 PM - 1:15 PM 12:00 PM - 12:15 PM
Track Chairs:

3:00 PM 3:15 PM

2:00 PM 2:15 PM

1:00 PM 1:15 PM

12:00 PM 12:15 PM

Track A

Closing Remarks

Chairperson to be announced

3:00 PM 3:15 PM

2:00 PM 2:15 PM

1:00 PM 1:15 PM

12:00 PM 12:15 PM

Track B

Closing Remarks

Chairperson to be announced

;