The 6th Annual CMS Bid Bootcamp will return as a live, in-person event, January 13-14, 2022 at the Luminary Hotel & Co. in Fort Myers, Fla. From a pre-conference workshop on bid essentials to strategies that support and improve Star ratings, here’s everything we’ve planned to help you create, update, and execute your own CMS bid roadmap to set your organization up for plan growth year after year.
This year’s event will kick off at 9 a.m. Thursday, January 13, 2022 with a pre-conference workshop on bid essentials and mechanics for new team members and those who need a refresher course.
Part 1 is an orientation to the bid process, which includes key terms and reports crucial to successful bid submission, a calendar that connects interdepartmental input and project management timelines to the CMS bid submission schedule, and how to make the most of the CMS Bid Training Modules.
Part 2 will take place at 10:40 a.m. and will focus on the financial impacts of changing CMS bid variables. The session will explain how base bids, benchmark rates, risk scores, and other bid variables in CMS bid calculation affect health plan revenue. Attendees will also learn how to prioritize CMS tools and tests–and their dependencies–that determine pricing.
After a networking lunch, the main conference will begin at 1:15 p.m. with a session on The Bid Calendar: Project Management and Year-Round Process Design Strategies led by Lisa Franklin, manager, government product lifecycle, CareFirst BlueCross BlueShield. She’ll offer tips on how to make the perfect bid team, discuss how various health plans construct their timelines, and explain how to create a successful project management structure with C-suite buy-in, a multi-disciplinary review, and CMS deadline-driven project schedule for a smoother bid process.
Next, attendees will learn about Competitive Intelligence and Variables That Drive Shopping Decisions. Kristy Croom Tucker, director of marketing, BayCare Health Plans, will explore the key factors you should know about your market and where to find the data to strategically gain an edge on your competition; explain which key variables drive shopping decisions and how to weigh each in the bid strategy; the pros and cons of offering virtual options to your members; and how to evaluate strengths, weaknesses, and what brings the most value to your target market.
Rex Wallace, founder and principal, Rex Wallace Consulting, will then lead a session on how to Leverage the Bid to Improve Star Ratings. He’ll discuss bid strategies that support and improve Star ratings; explain how to use the bid to improve the member experience, which is now 58 percent of Star measures; dive into the new cut-point methodology changes for Stars measures and the significance of CMS implementing guard rails for this first time; analyze the two new HEDIS measures coming to Stars; and will dissect the impact COVID will have and what to expect for the next Star ratings.
Participants will then head into the session, Understand How Risk Adjustment Drives Revenue Projections, led by Shannon Decker, vice president, clinical performance, Brown & Toland Physicians. She’ll go over how various plans structure the risk adjustment piece of the CMS bid, and with what combination of finance, actuarial, and analytics work. Decker will also discuss who drives the risk score assumptions and how assumptions figure into revenue modeling for the bid. Attendees will also learn how to build up a risk profile based on current members and how ongoing retrospective and prospective risk adjustment activities contribute to revenue projections.
The final general session of the day will focus on how to Navigate COVID-Related Medical Loss Ratio (MLR) Reductions. Attendees will learn how health plans are successfully incorporating surplus dollars into various initiatives; gain additional accounting guidance for expenditures related to COVID-19 permissive actions and other costs in the MLR calculation for CY21; and better understand what expenses constitute quality improvement activities, or QIAs under CMS MLR rules.
Before breaking for a networking reception, attendees will have an opportunity to “Choose Your Own Adventure” facilitated group discussions on topics such as:
- Hospice VBID Plans in Action
- Pros and Cons of Health System and Insurer Partnerships
- Best Practices for ANOC and EOC Submission
- Supplemental Benefits Trends to Consider for 2023
The learning continues with a session on Member Retention Through Part D: Optimize Your Formulary Design. Attendees will gain an understanding of the components and how the rebate allocations work; learn what can optimize the Part D formulary tier structure to boost member retention and Star ratings; and discuss CMMI’s Part D Senior Savings Model and strategies for plan revenue.
Next, attendees will head into a session on CMS Bid Pharmacy Fundamentals for PBMs to better understand how Part C bid submission is impacted by Part B drug claims accessed at pharmacy now that the line for outpatient has blurred and CMS has allowed Part B step therapy programs.
The morning will continue with the session, Deep Dive into Flex, Special Supplemental Benefits for the Chronically Ill (SSBCI), and Value Based Insurance Design (VBID): Analysis and Benchmarking, led by Mike Spicer, director, product innovation & research, Capital District Physicians' Health Plan. He’ll provide a clear roadmap and framework to the seemingly endless benefit possibilities, from companion providers to pet sitting to transportation. Attendees will also learn what plans are offering and where in the bid benefits were placed; compare what was filed and what CMS accepted; and will discuss how COVID impacted benefit selection and financials.
Ashley Tyrner, founder and CEO, FarmboxRx, will provide a case study on Learnings to Clear the Confusion Around Meal and Grocery Benefits. She’ll explain step by step how one plan successfully incorporated grocery benefits for better member outcomes. Attendees will learn how to parse the options, from prepared meals to a la carte, nonperishable groceries, and fruit and vegetables to best serve the communities within your membership; and will gain assessment frameworks to determine the best food.
Next, attendees will learn how to Optimize Vendor Selection, Timing and Strategies to Ensure You Delight Your Members. Hannah Neylon, manager, government products and relations, Network Health, will explain methodologies and best practices for researching and vetting benefit providers to ensure you partner with the best choice; discuss timetables for vendor research, selection, and involvement relative to bid development and submission; and offer a blueprint of essentials to assess and of what to avoid to make selections efficiently and confidently.
Puneet Budhiraja, senior vice president, value based analytics, and chief actuary, Capital District Physicians’ Health Plan (CDPHP), and Donna Doebler, AVP, Medicare SNP product & analytics, UPMC Health Plan, will then help attendees Differentiate Your Plan Through Better Outcomes for Vulnerable Populations. They’ll discuss challenges of the CHRONIC Care Act and how health plans are responding through innovative benefit offerings; help attendees create frameworks for determining the special needs to address with an appropriate SNP; and explain how to build product designs, case management, pick benefits, and select and onboard the best providers for the SNP.
The afternoon will continue with a session on Desk Review, Audits and Required Changes After Bid Submission, where attendees will survey recent health plans’ experiences with bid desk review and audits, to get advance knowledge on what bid reviewers scrutinize; learn how best to analyze performance post-bid to measure attractiveness to beneficiaries, to assess competitiveness, and to evaluate the accuracy of bid pricing assumptions; gain best practices to limit mistakes and bid reuploads; and prepare for CMS’ announcement on Part D National Average Bid Amount (NABA) and its impact to your bid planning.
The last session of the conference will be a Strategy Update: Regulatory and Legislative Actions to the Medicare Program Mid-Pandemic. Attendees will get up to speed on the status and trajectory of Biden Administration proposals and legislative reform to Medicare Advantage and Part D, assess the continuing impact of COVID-19 tumult on bids and how that informs bid strategy for 2023, and prepare for rulemaking changes and their downstream impacts to 2023 bids.
The 6th Annual CMS Bid Boot Camp will take place January 13-14 at the Luminary Hotel & Co. in Fort Myers, Fla. Proof of a negative COVID test or proof of COVID-19 vaccination is required to attend the event. Click here for more information, complete health and safety protocols, and how to register for the event.