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, Vice President of Managed Care Services
Ultimate Health Plan

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 

Tejaswita Karve, Ph.D., Director, Medicare STARS, Advantage MD Administration
Johns Hopkins HealthCare LLC

Luis A. Cerda, Business Project Manager
MAPA and Central Florida Stars Lead

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® 
  • Learn how the change from claims-based reporting can impact your star ratings  
  • Understand steps you can take today to prepare for the shift    

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

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

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 Connelly, Senior VP/QI and Accreditation, Health Sun Systems  
  • Tamara Matos, Business Project Manager, Stars Operations Director-MiamiCigna-HealthSpring of Florida 

9:45 AM - 10:45 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

CASE STUDY: Nailing CAHPS: Changing the Conversation So Your Members Rave about You

  • Influence provider and member responses on CAHPS questions by understanding what the question is really asking  
  • Learn about programs that educate members and providers about STAR ratings and the influence members have through CAHPS surveys and how it directly affects benefits 
  • Review a case study on wait times and a program that was able to change perception on the 15-minute wait time 

Jason Allen, Stars Director, TX Market
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 

Rebeca Pacheco, Director Quality
FHC-UNIVERSAL HEALTH SERVICES

12:30 PM - 1:30 PM
Networking Lunch

1:30 PM - 2:30 PM

ROUND TABLES: Incentive Programs for Greater Engagement from Providers and Members

During this hour-long session delegates will break into topical groups – provider and member engagement.  After 35 minutes tables will present group findings on innovative ideas to reach this audience. 

  • Hear about incentives that are working and how the return on investment was defined 
  • Review any creative incentives that are not common knowledge 
  • Discuss incentive programs implemented over the last year that you believe will have a positive effect and why 

Providers: Facilitator: Michelle Fujii, MHA, PMP, Director, Network Quality
SCAN Health Plan

Members: Facilitator: Tejaswita Karve, Ph.D., Director, Medicare STARS, Advantage MD Administration
Johns Hopkins HealthCare LLC

Round table Moderator: Kelly Nelson, Program Manager, Blue Cross Blue Shield NC

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