Agenda

December 12, 2019

8:00 AM - 9:00 AM
Registration and Breakfast

9:00 AM - 9:15 AM

Welcome Remarks

Chairman:
Malik Abdur-Razzaq, MPH, Director, Marketing and Enrollment
Partners Health Plan

9:15 AM - 10:00 AM

Keynote: CMS Address

  • Receive an update on CMS policy as it pertains to the Medicare Stars program
  • Review the Medicare Stars quality measures and gain an understanding of changes for the upcoming year
  • Learn about the latest CMS policy related to Medicare Advantage and the work CMS is involved in related to overall quality improvement and health system transformation


Ashby Wolfe, Chief Medical Officer, Regions VIII, IX & X
CENTERS FOR MEDICARE & MEDICAID
SERVICES (CMS) (invited)

10:00 AM - 11:00 AM

FIRESIDE CHAT: Digitizing Quality Measures and Star Ratings

There will be a 20-minute presentation followed by 40-minute fireside chat with the moderator. Questions from audience will be welcome. 

  • Review NCQA initiatives to move from claims-based reporting of quality measures to automated digital quality measures to streamline data processing for plans 
  • Gain an understanding about how the technology would work and how they envision the implementation 
  • Participate in an open discussion and Q&A, bring your questions 

Paul Cotton, Director, Federal Affairs
National Committee for Quality Assurance (NCQA)


Moderated by
Ana Handshuh, Principal
CAT5 Strategies

11:00 AM - 11:30 AM
Networking Break

11:30 AM - 12:30 PM

Achieve Operational Excellence for Advancing Star Ratings

  • Hear strategies to combat star oversight challenges in a siloed system 
  • Learn how to prioritize resources when establishing best practices 
  • Create a program that emphasizes everyone has an impact on star ratings 

Luis A. Cerda, Stars Market Operations Northeast Region Director 
Cigna-HealthSpring

Jim Techtmann, SVP - Sales & Marketing
Entertainment - Rewards & Incentives

12:30 - 1:30 PM
Networking Lunch

1:30 PM - 2:15 PM

Prepare for the Shift: Digital and ECDS HEDIS® Measures

  • Gain more insights into Digital and ECDS measurement reporting for HEDIS® 
  • How to make performance data accessible at the point of care 
  • Understand steps you can take today to prepare for the shift    

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

Sara Hansen, Manager, Risk Adjustment
Avera Health Plans & DAKOTACARE

 

2:15 - 3:00 PM

Strategies for Increasing Star Ratings for Special Need Plans (SNPs)

  • Understand what the discrepancies are between what a SNP plan must deal with vs average MA plan and how that impacts your ratings 
  • Explore nuances built into the measurement process to help offset the negative bias 
  • Review ways to address the extra measures for a DSNP on a limited budget 

Daniel Weaver, VP Stars, Quality, & Risk Adjustment
Gateway Health Plan


Kent Holdcroft MA, Executive VP of Enterprise Accounts and Strategic Partnerships
AdhereHealth 

3:00 PM - 3:30 PM
Networking Break

3:30 PM - 4:15 PM

SPECIAL FEATURE: Learn the Results of the RISE/Engagys Survey on Healthcare Consumer Engagement

  • Understand how engagement budgets are changing and where the opportunities are 
  • Discover how the various channels of outreach drive varying results 
  • Discover how you can benchmark your plan against your peers 

Kevin Mowll, Executive Director
RISE

Kathleen Ellmore Managing Director
ENGAGYS LLC

4:15 PM - 5:00 PM

Solving the Rubik's Cube of Star Ratings & Social Determinants of Health

During this engaging session we’ll explore: 

  • How healthcare is changing to focus on SDoH and the impact it could have on CMS requirements for Stars
  • Health plan examples that are successfully overcoming barriers as a result of SDoH
  • Why SDoH is such a big focus and what’s next 

Jeff Fritz, CEO
Revel Health

Sara Ratner, SVP, Government Programs and Strategic Initiatives
Revel Health

Tamilyn Armstrong, Senior Director of Operations, Government Programs
UnitedHealthcare

5:00 PM - 6:00 PM
Networking Cocktail Reception

December 13, 2019

8:00 AM - 8:55 AM
Networking Breakfast

8:55 AM - 9:00 AM

Opening Remarks

Chairman:
Malik Abdur-Razzaq, Director Marketing and Enrollment
Partners Health Plan

9:00 AM - 9:45 AM

Panel: How to Be Successful in Your Quest for a Five Star Rating

  • Review top 3 achievements that are attainable by any plan 
  • Recognize the top 5 things needed to move the needle 
  • Examine ways to push teams to achieve those goals 

Moderator:
Timothy Brown, Executive Director, Chief Medicare Officer
Aetna  
 

Panelists: 

  • Ally Thomas, Ph.D., Director, Medicare STARsUPMC  
  • Karen Connolly, RN, Senior VP/QI and Accreditation, HealthSun Health Plans  
  • Tamara Matos, Stars Market Operations South Region Director,  Cigna-HealthSpring of Florida 

9:45 AM - 10:30 AM

Innovations for Improving the Medication Therapy Management (MTM) Program CMR Completion Rate

  • Demonstrate successful programs for patient outreach and what parts can be reproduced by different types of organizations 
  •  Examine ways the MTM Program can be tied into other 5-star metrics 
  • Set your organization up for success by creating a thoughtful program description and make full use of the data your organization has access 

Ryan Davis, PAHM Manager, Pharmacy Medicare Programs
Kaiser Permanente

10:30 AM - 11:00 AM
Networking Break

11:00 AM - 11:45 AM

Challenge: Overcoming the Language Barrier

  • What role does language play
  • How can you communicate effectively in a multi-language environment
  • How do you win in the Member Experience realm knowing this

Jason Allen, Stars Market Operations West Region Director  
Cigna-HealthSpring

11:45 AM - 12:30 PM

Behavioral Health in The STAR Ratings Program, A Multifactorial Approach

  • Discuss behavioral health measures that impact STAR Ratings 
  • Review behavioral health measures on display and relationship to other measures 
  • Hear examples of new initiatives for behavioral health measures and how they are positively impacting members and ratings 

 

12:30 PM - 1:30 PM
Networking Lunch

1:30 PM - 2:30 PM

Leveraging Data Analytics & Member Preferences to Improve Star Ratings with Meaningful Engagement

  •  Engaging with members at the right time with the right message:  How to determine when a member is truly compliant with HEDIS and PDE measures, and which modality/messaging to use with a given individual. Eligibility, claims, and consumer data feeds consolidated to build out a 360-degree view of each member, including product choice, demographics, socioeconomics, communication preferences, hobbies, aptitudes, clinical and non-clinical risk profiles

  •  Survey data:  Understanding a member's perception of the health plan, their provider, and their health outcomes and what to do about it. Leveraging HOS data and off-cycle surveys data sources, which fund predictive models that allow results to be generalized to all members as part of the 360-degree view of each member

  • Provider engagement:  Using data to inform collaborative discussions with providers to manage member care delivery; leverage provider scorecards and benchmarking as a means to actionable information

 

Kena Hahn, Director Medicare Stars & Health Improvement
Health Alliance Medical Plans

Kurt Waltenbaugh, CEO
Carrot Health 

 

2:30 PM - 3:15 PM

Member Retention, Touchpoints and 5-Star Ratings: Effective Utilization of Sales and Marketing to Increase Star Ratings

  • Review the constant member touchpoints of role of sales and marketing, and how that is an opportunity to influence members and CAHPS survey 
  • Analyze ways to work closely with teams to evaluate improving measures through engagement activities, year-round to communicate with members regarding improvement 
  • Evaluate effective social media and other outreach programs that will look different but work for large,  medium and midsize plans  

Malik Abdur-Razzaq, MPH, Director, Marketing and Enrollment
Partners Health Plan

3:15 PM - 3:20PM

Closing Remarks

Malik Abdur-Razzaq, MPH, Director, Marketing and Enrollment
Partners Health Plan