Agenda

December 14, 2020

9:00AM – 9:15AM EST

Welcome Remarks: Conference Chairperson

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

9:15AM – 10:00AM EST

Keynote and Q&A: CMS Policy Update

Ashby Wolfe

Chief Medical Officer, Regions VIII, IX & X         

Centers for Medicare & Medicaid Services (CMS)

10:00AM – 10:15AM EST
Break

10:15AM – 11:00AM EST

Industry Roundtable: Staying Abreast of Regulatory Changes Amid a Pandemic and Looking into the Future

  • Join your peers to analyze all recent interim rulesand understand the impact of the adjustments made by CMS  
  • Explore the expansion and implications of Telehealth services
  • Prognosticate what Star ratings and reporting will look like moving forward and discuss cut point trends

 

Moderator: 

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

 

Presenters: 

Daniel Weaver

VP Medicare & Medicaid Quality Programs

Gateway Health Plan

 

Ryan Davis

Manager, Pharmacy Medicare Programs

Kaiser Permanente

 

David Dodge  

Medicare Stars Program Director, Government Programs

Cambia Health Solutions 

11:00AM – 11:15AM EST
Break

11:15AM – 12:00PM EST

From 2x to 4x: Cracking the Code of Member Experience to Maximize Results

  • Understand how to prioritize and operationalize customer experience/CAHPS to increase scores
  • Hear best practices from industry leaders on how to approach member experience holistically for better health outcomes
  • Analyze interoperability strategies to ensure focus of care is shifted towards member experience and member satisfaction

 

Rex Wallace

Principal

Rex Wallace Consulting

 

Michelle D. Chang

Director, Network Quality

SCAN Health

 

Ana Handshuh

Principal

CAT5 Strategies

12:00PM – 12:30PM EST
Lunch Break

12:30PM – 1:00PM EST

Keeping Momentum: Best Practices to Maintain or Improve Star Ratings

  • Understand how to focus efforts on clinical quality such as preventive care screenings and condition management
  • Learn how to maximize each visit and interaction with members for meaningful and streamlined engagement
  • Hear best practices to boost medication adherence 
  • Understand how to approach the tripling of health care: cost, quality, and access

 

Tejaswita Karve, Ph.D.

Director, Quality Improvement

Johns Hopkins HealthCare

1:00PM – 1:15PM EST
Break

1:15PM – 2:00PM EST

Aligning Risk Adjustment and Quality Efforts to Improve Star Ratings

  • Discuss lessons learned from interoperability winsand how RA fits in the broader spectrum
  • Learn how to streamline information from RA and Qualityand navigate innovative ways to collect data 
  • Closing the loop with providers and preventing provider abrasion

 

Sara Hansen

Director of Quality & Clinical Risk Services

 

Avera Health Plans & DAKOTACARE

 

Margaret Ciancetta 

Senior Quality Business Analyst

Pulse8 

2:00PM – 2:15PM EST
Break

2:15PM – 3:00PM EST

Part D Focus: Getting it Right and Achieving Outcomes

  • Discuss and analyze 2020 metrics surrounding medication adherence and MTM measures
  • Discuss year-over-year changes in pharmacy utilization
  • Share member engagement stories and strategies during the pandemic to maximize care

 

Matthew Dinh, PharmD

Director, Pharmacy Quality & 5 Star

SCAN Health Plan

 

Kerri Petrin 

VP of Strategy and Business Development

RxAnte 

3:00PM – 3:15PM EST
Break

3:15PM – 4:00PM EST

Maintaining and Leveraging Telehealth Visits to Close Gaps and Maximize Results

  • Hear how plans have pivoted their strategy to be more digital in nature and discuss impact on star ratings
  • Understand how to continue to utilize telehealth to integrate quality and make the best use of it
  • Navigate the future of delivery of care via telehealth

 

Ally Thomas

Director, Medicare STARs

UPMC

 

Natasha Khouri

AVP, Telehealth Strategic Solutions

UPMC

4:00PM – 4:15PM EST

Closing Remarks: Conference Chairperson

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine 

December 15, 2020

8:55AM – 9:00AM EST

Opening Remarks

Chairperson to be announced

9:00AM – 9:45AM EST

NCQA Fireside Chat: Where Do We Go from Here? A Look into the Current Star Ratings Landscape

  • Explore lessons learned from COVID-19 era and how they can be applied to other outbreaks such as the flu season
  • Discuss insights on whether 20-21 will be used by CMS and how to proactively plan to get in line with changes
  • Hear what NCQA has to say about the future of Stars

 

Paul Cotton

Director, Federal Affairs

NCQA

9:45AM – 10:00AM EST
Break

10:00AM – 10:45AM EST

So COVID happened! What's next for your Medicare Part D 5-star Strategy?

  • Discuss if your organization should give additional consideration to metrics that are lower in weighting 
  • ​Hear how to ensure a positive member experience outside of traditional surveys while improving your quality scores
  • ​Understand how to leverage cross-functional relationships to get the job done.  

 

Ryan Davis

Manager, Pharmacy Medicare Programs

Kaiser Permanente

10:45AM – 11:00AM EST
Break
11:00AM - 11:45AM EST
2021 Star Ratings Industry Update: Where We Are Now & What’s on The Horizon
  • Explore an overview of the 2021 Star Ratings for Medicare Advantage plans
  • Gain insights on current market trends, proposed policy changes, and the impact on future Star Ratings
  • Learn how to leverage technology to build successful quality improvement strategies for 2021 and beyond

 

Melissa Smith 

Executive Vice President, Consulting & Professional Services

HealthMine  

11:45AM - 1:00PM EST
Break

12:00PM – 12:45PM EST

SNPs Highlight: Increasing Star Ratings for Special Need Plans

  • Understand nuances between a SNP plan and the average MA plan’s roadmap to successful ratings
  • Discuss med adherence best practices for the SNP population
  • Explore coordination of services and benefits for dual eligibles during and after the pandemic

 

Daniel Weaver

VP Medicare & Medicaid Quality Programs

Gateway Health Plan

 

Kurt Cegielski 

Senior Vice President, Client Success

Revel-Health 

12:45PM – 1:15PM EST
Lunch Break

1:15AM – 2:00PM EST

Roundtable Discussion: Gathering of the Minds (lively discussion of topics in a roundtable/debate setting)

  1. Why strive for 5 stars? Is there a drawback?
  2. What you don’t want your provider to know and vice versa
  3. RBRVS paying method for providers: is it working? What could other possibilities be?
  4. Health plans talk about suggestions made to CMS 
  5. Are we really on a path to a healthy population?

 

Kathleen Faulk

General Manager, Government Programs

Regence

 

Tejaswita Karve, Ph.D.

Director, Quality Improvement

Johns Hopkins HealthCare

 

John Suarez 

CEO and Founder

iCare Intelligence 

 

Ana Handshuh 

Principal

CAT5 Strategies 

2:00PM – 2:15PM EST
Break

2:15PM – 3:00PM EST

Presenting the Results of State of Healthcare Engagement Survey and Discussion on Closing Gaps in Care during a Pandemic through Member Engagement

  • Hear how to collaborate with providers to engage members with deferred care and ensure their safety 
  • Navigate SDoH’simpact on member engagement and explore telehealth and other available options to remove barriers to care 
  • Understand how to produce strategic messaging to engage members and promote safety 
  • Hear how to adjust communication to your targeted audience while maximizing utility of engagement with provider and streamlining information

 

Kathleen Ellmore 

Managing Director

Engagys 

3:00PM – 3:10PM EST

Closing Remarks

Chairperson to be announced