RISE is pleased to announce two keynote speakers for Qualipalooza 2021, which will take place June 28-29, 2021 in-person in Orlando and virtually via livestream for those unable to travel.

Keynote Richard E. Wild, M.D., (pictured right) chief medical officer, Atlanta and Boston regional offices at the Centers for Medicare & Medicaid Services (CMS), will kick off the first day of Qualipalooza 2021 with an in-depth analysis of the agency’s overall expectations for quality ratings in 2021 and beyond. 

The next morning, Jeff Tobe, customer experience expert and author, will present his keynote on how to create a new patient experience.

The two keynotes will head up a roster of nationwide leading quality experts who will share best practices and strategies to improve Star ratings, HEDIS® scores, CAHPs and HOS, and pharmacy measures during Qualipalooza 2021, a hybrid event for all professionals involved in quality of care measures. 

The two-day event will take place June 28-29 at the Loews Portofino Bay Hotel at Universal Orlando but will also be available virtually via livestream. It will feature more than 20 speakers from 4-Star and 5-Star plans, 23 informational sessions, and concurrent track sessions. As a bonus, both in-person and virtual attendees will receive access to on-demand recordings to view any sessions they may have missed. 

The planned agenda will feature keynote presentations by:

  • Wild, who among his many accomplishments served as CMS (then HCFA) chief medical officer for reimbursement policy during the initial implementation of the Hospital Prospective Payment (DRG) system. He will provide an update on CMS quality measures at 10:05 a.m. EST., Monday, June 28.
  • Tobe (pictured right), who was dubbed “The Guru of Creativity” by Insider Magazine and is the author of “Coloring Outside of the Lines,” will present at 9:45 a.m. Tuesday, June 29. In an interview with RISE last year, Tobe talked about the patient experience and said the secret to member engagement is to disrupt the status quo. “It’s almost a difference in mindset. You need to think about the end-to-end member experience and aim to shatter the experience your customer expects to have,” he said.

In addition, general sessions will cover: 

CAHPS best practices to improve member satisfaction and perception 
This panel discussion, moderated by Ana Handshuh, principal, CAT5 Strategies, will explore how to capture and leverage data/CAHPS metrics at scale to better understand members and behavioral drivers. Panelists will discuss the shift in focus to member experience and assess how to allocate resources, how to optimize member touchpoints to impact member perception, and consumer-centric models and best practices to help members understand benefits while avoiding abrasion and reducing complaints and grievances. Panelists will include David Larsen, director, quality improvement, SelectHealth; David Meyer, senior vice president, quality outcomes and informatics, NationsBenefits; and Rex Wallace, principal, Rex Wallace Consulting. 

Provider perspectives 
Panelists will discuss effective communication and education efforts around quality and Stars, successful incentive programs, provider motivators to foster strong patient-provider partnerships, best practices on EMR adaptability and integration to reduce provider burnout, and the provider engagement-patient engagement-quality system dynamic. Speakers will include Shannon Decker, Ph.D., vice president, clinical performance, Brown & Toland; Vishal Bhalla, vice president and chief experience officer, Parkland Health & Hospital System; and Jatin Dave, M.D., chief medical officer and director of clinical affairs, MassHealth. 

Actionable collaboration between quality and RA to achieve optimal results
Sharalee Johnson, BSN, RN, director, quality solutions, Pulse8, will lead the session, which will help attendees identify medical record collection overlap and understand how to optimize converging member touchpoint efforts to avoid provider abrasion. Johnson will offer insights into simultaneous review of risk and care gaps as one unified goal between RA and quality. Attendees will also leave with the ability to train staff more effectively for better interdepartmental alignment and synergy and understand considerations for risk adjustment and quality around telehealth encounters, appropriate coding, and closing gaps in care.

Industry roundtable: Stars landscape review and lessons learned from 2020
Join our expert panel for a roundtable discussion on annual wellness visits in 2021, new measures and weights, deferred care, how the Biden administration changes will impact the Stars landscape, and the future of telehealth. Speakers will include David Larsen, director, quality improvement, SelectHealth; Katharine Iskrant, practice leader, Healthy People, Inc.; and Daniel Weaver, VP Stars and government quality improvement programs, Gateway Health Plan.

Building culture of quality and service excellence to achieve or maintain 5 Stars
Martin’s Point Kristy Smith, HEDIS program manager, and Joshua Edwards, Stars program manager, will share best practices to advocate for quality with leadership while showing value and obtaining commitment from higher ups in the organization. They will also discuss evidence-based research, trends and improvements in higher level data, strategies to build-up staff and create a structure for an organization devoted to quality and service excellence, and resources on key measures that will maximize quality results.

Deep dive into HOS initiatives and best practices
Handshuh and Wallace will return to the live and virtual stage to join Renée Golderman, senior vice president, chief quality officer, Capital District Physicians' Health Plan, for a presentation that explains how to empower members to have HOS related conversations with providers. The presentation will also address health literacy, best practices when creating PCP visit checklist/tip sheet for successful visit with PCP focusing on HOS measures, integrating data to identify at risk members and having strategic interventions in place to help members with declining care especially around physical and mental health; and how to educate the customer service team to ask the right HOS-related questions when interacting with members.

Concurrent track sessions will address:

Member experience: Session topics will include insights and tactics into elevating customer experience; how to impact member perception from a marketing lens, and a case study on Highmark’s interdepartmental outreach effort that successfully engaged members with deferred care and at least one chronic condition to receive care and close gaps for MY2020.

Population health: Sessions will cover how to embed social determinants of health (SDoH) in quality programs; a case study (on California Department of Health 2020 Health Equity Award winning program, Insulin Advisors at Scan Health Plan), a targeted engagement initiative for Spanish-speaking members with diabetes; population health strategies and the impact of the pandemic; and embedding SDoH in quality programs.

HEDIS: Sessions will include HEDIS 365: A year-round approach to quality and data collection strategies and the move to digital measures.

Part D focus: Topics will include Medicare Part D 5-star strategy to boost member experience and optimal outcomes from medication therapy management.

Qualipalooza 2021 will take place June 28-29, 2021 in-person in Orlando and virtually via livestream for those unable to travel. Click here to learn more about in-person and virtual attendance options, the complete agenda, list of speakers, and how to register for the event.