RISE looks at the planned sessions for this year’s CMS Bid Bootcamp and shines a spotlight on a presentation that will help attendees evaluate the financial impact of incorporating social determinants of health (SDOH) benefits into the bid process.
It’s the only conference in the market devoted to covering the entire CMS bid process from A-Z. And this year the two-day event will include sessions that look at the impact of CMS’ decision to allow plans to offer beneficiaries “non-medical” health-related supplemental benefits.
Now in its fourth year, the CMS Bid Bootcamp will bring together actuaries and product managers, along with other CMS bid stakeholders, in Fort Lauderdale, Fla., January 27-28, 2020, to examine timelines, critical steps, and strategies to optimize your CMS bid.
The conference will kick off with a two-part orientation to the bid process, including a deep dive into the files and reports crucial to a successful bid submission as well as the financial impacts of changing CMS bid variables. Independent Health’s Benjamin Nadler, director, actuarial services, and Amy Garrow, manager, actuarial services, will lead part one; Kathryn Y. Qin, corporate vice president and chief actuary, SCAN Health Plan, will take over part two of the orientation.
The first day will also include a panel discussion with representatives from Harvard Pilgrim Health Care, BlueCross Blue Shield of Tennessee, and Cigna about project management and year-round process design strategies to ensure a smooth annual bid process. Other sessions will focus on how to define your market strategy and create your most impactful bid; use internal analytics to better customize your plan and boost membership; and roundtables that continue the discussions from earlier in the day as well as topics that focus on related party bid requirements, benchmarks, SDoH, and how to take your Medicare Advantage plan to the next level.
Day two will feature presentations on risk score mechanics and impact to plan revenue; how to use your plan data to build a bid strategy; leverage clinical and financial goals to lower costs; and a review of ESRD eligibility, including changes required by the 21st Century Cures Act and questions to consider for 2021. Other sessions will focus on CMS bid process pitfalls to avoid and legislative and regulatory updates to Part C and Part D. Nadler and Garrow will also return for a case study on how Independent Health handled a successful overhaul and transitioned more than 60,000 members to new plans while completing an $80 million financial turnaround.
Spotlight on SDoH benefits
New to the conference is a look at supplemental benefits for people with chronic disease and how to incorporate them to best serve your members and grow enrollment. In addition to the roundtable discussion, several sessions will touch on CMS’ expansion of the type of supplemental benefits that Medicare Advantage plans may now offer. These benefits, which address the socio-economic factors that have a greater influence on health than direct medical care, has been a game changer in the industry. Medicare Advantage plans now have new opportunities to differentiate their products, but trying to determine which investments will pay off is often a guessing game because there is little data on the impact of these benefits.
Although CMS first announced the benefits in April 2018 and then expanded what they’d allow in April 2019, it was too late for most plans to incorporate them in their 2019 and 2020 bids. However, more plans will be ready to expand their offerings in their 2021 bids.
Allison Hess, vice president of health innovation for Geisinger Health Plans, will look at the early numbers on supplemental benefits, assessing the preliminary results from plans that introduced these new benefits last year. She’ll look at whether the flexibility had an impact on quality of care, members’ plan selection, and plan revenue.
Puneet Budhiraja, chief actuary and senior vice president, Capital District Physicians Health Plan, will look at internal analytics to customize your plans, including innovative approaches and best practices to configure your return on investment for new supplemental benefits.
Rajesh Munjuluri, director and Medicare Actuary, Capital District Physicians Health, will take it a step further and devote an entire session on how to estimate the financial impact of adding SDOH-driven supplemental benefits, such as transportation to doctors’ appointments, providing meal delivery, or offering in-home support services to your most vulnerable member populations.
Plans don’t have to offer these benefits to their entire membership, only to a segment of the population with chronic disease that needs it. But how do you determine which members you want to target? Munjuluri will offer a model on how to figure out your target population, which benefits to offer, and once administered, what it will really mean in terms of dollar savings. He’ll also discuss how plans can administer the benefits and who they may want to partner with to be competitive in the marketplace. Those partnerships may include vendors, such as an Uber or Lyft, or community-based organizations that already address SDoH needs in the community.