The annual conference returns for its seventh year, January 23-24, 2023, at The Hotel Monteleone in New Orleans.
RISE’s 7th annual CMS Bid Boot Camp is headed to New Orleans in late January for learning and networking. Here’s a sneak peek at what we’ve planned so far.
New pre-conference workshop on Monday morning
New to the bid process? Join RISE for a two-part preconference workshop on Monday, January 23, an Orientation to the Bid.
Anant Galande, director, Medicare actuarial, Blue Cross and Blue Shield of Kansas City, and Matthew Kridgen, associate actuary, Milliman, will lead the first part of the discussion, reviewing key terms, files, and reports crucial to successful bid submission. They’ll also discuss how base bids, benchmark rates, risk scores, and other bid variables in CMS bid calculation affect health plan revenue. Participants will learn CMS tools and tests that determine pricing and how to optimize financial mechanics, base bids and benchmarks, and other bid relationships. Part One will take place from 9 a.m. to 10:35 a.m.
The second part of the preconference workshop will focus on how to navigate the plan benefit package (PBP) data entry system. Kylie Severson, senior actuarial analyst, Milliman, will join Ana Handshuh, principal, CAT5 Strategies, and the chair of the RISE Association’s Quality and Revenue Community, to provide an update on the newly designed PBP, walk participants through the sections, fields, and rules of the PBP data entry system, and will offer completion strategies to give your health plan a competitive edge. Part two will take place from 10:50 a.m. to 12:20 p.m.
Note: The preconference workshop is an add-on to conference registration and an extra cost.
Main conference sessions on Day One (with special guest from CMS)
The conference kicks off at 1:30 p.m. with a fireside chat with Sibel Ozcelik, deputy director, division of health plan innovation, Seamless Care Models Group, CMS Innovation Center. Moderated by Lauren Driscoll, founder and CEO, NourishedRx, the discussion will focus on various bid and benefit flexibilities available through the value-based insurance design (VBID) model and other special programs, how to address health equity priorities via the bid, and the ROI of investing in benefits focused on health equity.
Lawrence Butler, capture manager, Google Public Sector, will moderate a discussion with Heather Adams, senior product line manager, and Joshua Caudill, senior communications advisor, both from Blue Cross and Blue Shield of North Carolina, about year-round project management and process strategies to optimize the bid cycle. The discussion will focus on the bid team, creating a timeline, and following a successful project management structure with C-suite buy-in and a multi-disciplinary review that meets CMS deadlines.
A panel of experts will explain how to define your market strategy to shape a successful bid. Discussion will focus on how to analyze key factors and data about your market, which key variables drive shopping decisions and how to weigh each in the bid strategy, and how to evaluate what brings the most value to your target market while staying on budget. Panelists include Pamela C. Getsie, plan president, Vermont Blue Advantage; Pritpal Virdee, president, Emergient/BCBS of Michigan; and Daniel Weaver, executive vice president, product operations and Stars strategy, NationsBenefits.
Future-proof your bid with Melissa Smith, EVP, consulting and professional services, Healthmine. The presentation will explain the value of developing a three-year bid strategy, how to project future CMS payments to increase benefit offering stability, and how to design benefits for member cohorts to improve medical loss ratio, social determinants of health, and boost member loyalty. Smith will also discuss rewards and incentive packages that can be submitted via the VBID framework.
Main conference sessions on Day Two
Planned sessions on Tuesday, January 24, will focus on the bid and Star ratings, supplemental benefits, CMS desk review, and regulatory changes.
Learn how risk adjustment drives revenue projections with panelists Thomas B. Glasner, managing actuary, Health First Health Plans; Shannon Decker, M.Ed, MBA, Ph.D., principal, VBC One; and Laura Sheriff, R.N, MSN, CPC, CRC, vice president operations, risk adjustment, Southwestern Health Resources. They’ll explain how risk score assumptions figure into revenue modeling for the bid, how to build up a risk profile based on current members, and how ongoing retrospective and prospective risk adjustment activities contribute to revenue projections.
Rex Wallace, founder and principal, Rex Wallace Consulting, will lead the discussion on how to develop a bid that boosts Star ratings. He’ll discuss bid strategies to improve Star ratings, including the heaviest-weighted member experience measures, and help participants understand how bid changes impact different members and how to mitigate potential dissatisfaction.
A panel will go over the ins and outs of supplemental benefits, including unique offerings, techniques to determine what supplemental benefits to offer and how to include them in your bid, how the benefits can help address social determinants of health, and the pros and cons of participating in Special Supplemental Benefits for the Chronically Ill, Value-Based Insurance Design and other special programs. Panelists include Vincent Giglierano, senior manager, health services research, Faegre Drinker; Mike Spicer, vice president, product, Capital District Physicians’ Health Plan; and Tom Pelegrin, senior vice president & chief revenue officer, Convey Health Solutions.
Danica (Dani) Holliston, Medicare product manager III, Regence BCBS, and Michael O'Malley, plan administrator, AIDS Healthcare Foundation, will lead a presentation on The CMS Desk Review: What to expect and how to prepare. They’ll discuss what bid reviewers are likely to scrutinize, offer best practices to limit mistakes and bid reuploads, and how to prepare for CMS’ announcement on Part D National Average Bid Amount (NABA) and its impact on bid planning.
The final session will address Part D regulatory changes. Omar Daoud, director of pharmacy, Community Health Plan of Washington, and Haitham Aly, Consulting Actuary, Milliman, will explain how Part D changes in the Inflation Reduction Act— including Medicare negotiation of drug prices and a cap on insulin cost—will affect your bid. He’ll also discuss the new pharmacy Direct and Indirect Remuneration (DIR) rules and OTC hearing aids, and the bid-related implications of the end of the COVID-19 public health emergency.
Networking opportunities
In addition to learning sessions, we’ve planned plenty of opportunities to network with your peers and our exhibitors, including breakfast, lunch, and breaks throughout the conference.
A networking cocktail reception, including drinks and hors d’oeuvres, will take place 5:15 p.m. to 6:15 p.m., Monday, January 23.
The 7th annual CMS Bid Boot Camp will take place January 23-24, 2023, at The Hotel Monteleone in New Orleans. Click here for the full agenda, list of speakers, and registration information.