RISE will host the leading conference in the industry designed for professionals in Medicare Advantage product design, sales, marketing, finance, and revenue management on August 8-9 in New Orleans. Here’s a look at the comprehensive sessions we have planned.
Tuesday, August 8
To kick off The RISE Medicare Product Design Master Class, we’ll hear from Shannon Decker, principal, VBC One, and Ana Handshuh, principal, Cat5 Strategies, who will discuss CMS’ vision for achieving health equity. Decker and Handshuh will review CMS’ goals for prioritizing health equity, how your health plan can adapt its quality measures to align with the new Health Equity Index, and how product design can address social risk factors and improve access to care.
Next, Jen Callahan, chief operating office, ATRIO Health Plans; Spencer Pratt, vice president of growth and strategy, NourishedRx; and Vincent Giglierano, senior manager of health services research, Faegre Drinker, will cover SSBCI vs. VBID vs. Uniformity Flexibility to determine the best route for your plan. Callahan, Pratt, and Giglierano will explore the differences between these CMS programs: Special Supplemental Benefits for the Chronically Ill (SSBCI), Value-Based Insurance Design (VBID), and Uniformity Flexibility, which program will provide the best return on investment (ROI) in your market, and tips to provide supplemental benefits through each program.
There will also be a case study presentation on partnering with providers for a winning product design. Throughout the session, Carrie Meyer, Au.D., director of clinical programs, Amplifon Hearing Health Care, and Nikki Hungate, MS, MHA, director of Medicare and government programs product strategy, MVP Health Care, will discuss MVP Health Care’s successful partnership with the University of Vermont Health Network, as well as strategies to build the right provider network for your members and techniques to successfully collaborate with providers.
After a networking lunch, attendees will delve into breaking new ground with supplemental benefits. Matt Viveiros, VP, product, marketing, and project management office, ATRIO Health Plans; Mark Garnett, managing director, Live Well with Traditions; and April J. Martin, Medicare product strategy and management, Cigna HealthCare, will review the latest innovations in supplemental benefits that can improve the outcomes, engagement, and satisfaction of your members; organizations that have implemented innovative benefits, such as housing, home visit programs to combat loneliness, support for caregivers, and air conditioning for members with COPD; and how to estimate the ROI and find ways to pay for new benefits that will meet member needs.
The CMS Final Rule and its impact on product design will be a pressing topic among a panel of industry leaders, who will discuss the key provisions and how to respond, which portions of your benefit strategy may be affected, and the potential financial impacts. Panelists will include Ana Handshuh, principal, Cat5 Strategies; Melissa Smith, chief consulting officer, Healthmine; and Shannon Decker, Ph.D., MBA, MBA, M.Ed., M.Ed, principal, VBC One.
Next, we’ll hear a session focused on flex cards and whether they are a fantastic flexibility or an annoying abrasion. Kaleb Holt, government program development partner, SelectHealth, and James Hornung, sales director, NationsBenefits, will lead the discussion around recent challenges health plans have experienced with flex cards and possible solutions, ways to incorporate flex cards that will improve the member experience, and lessons learned from developing a flex card strategy that is effective, appreciated, and sustainable.
The day will wrap with a spotlight on market strategy and understanding your members and your market to stay ahead of the competition. Angela Moczan, CFO and COO, Medicare, UPMC Health Plan; Sion Hughes, senior consultant, Wakely Consulting Group, an HMA Company; and Justin Barclay, Ph.D., VP, consumer insights & analytics, Tivity Health, will share tips for gathering member feedback and population health data and using it to create a more competitive product, collaborating with your sales team and brokers to get insight into what members want, determining whether your plan should customize options for specific populations, and ways to remain competitive with a tighter budget.
To close out a busy first day, attendees will enjoy an evening networking cocktail reception with drinks, hors d’oeuvres, and face-to-face networking with peers.
Wednesday, August 9
Day two will start with a spotlight on Stars and how upcoming changes affect product design. Danica Holliston, Medicare product manager III, Regence Blue Cross Blue Shield, and Nate Lucena, senior consultant, Rex Wallace Consulting, LLC, will share an overview of the changes to Star ratings in the CMS final rule and how they will impact product design, how to understand your members outside of their “gaps” and truly address health equity as you prepare for the stars change from the Reward Factor to the Health Equity Index, and tips to create a cross-functional team to develop a cohesive product that drives member retention and growth around a unified stars strategy.
Next, Alla Zilbering, M.D., Medicare national medical director for health equity, Cigna; Bill Friedman, vice president of payer and provider engagement, Wider Circle; and Claire Morrow, DPT, physical therapy consultant manager, Hinge Health, will discuss designing products that address social determinants of health (SDoH). The session will explore making the business case for addressing SDoH with product design; how to assess the specific SDoH needs in your market; your product vision, strategy, and growth goals to ensure meeting the special needs of your members while boosting member satisfaction; and how to design SDoH programs that can improve health equity and access to care, including digital solutions like remote patient monitoring and virtual visits.
We’ll also explore explainable artificial intelligence (AI) and using the latest data science methods to influence product design. Jereme Ayers, chief growth officer, HealthWorksAI, will discuss how an MA plan is leveraging explainable AI to influence product design and maximize growth potential and how data science is evolving and unlocking new insights for health plans. He will also talk about explainability in AI – what it means, how to apply it, and what the future holds.
Attendees will return from a networking lunch to learn about the Inflation Reduction Act through an overview of key pharmacy benefit reforms with Omar Daoud, senior director of pharmacy, Community Health Plan of Washington, and Gary Melis, clinical pharmacist, Network Health. Daoud and Melis will talk about the impact of new pharmacy regulations, including the Medicare Drug Price Negotiation Program, access to recommended adult vaccines without cost-sharing, the expansion of the low-income subsidy (LIS) program, and changes to Medicare Part B.
The afternoon will continue with a session on vendor management, with tips for selecting and managing your vendors. Laura Sheriff, vice president, risk adjustment, Southwestern Health Resources; Craig Fisher, manager, cross segment strategy, Highmark Health; and Daniel Weaver, a Medicare leader, will discuss ways to deal with the constant sales calls and avoid vendor fatigue, strategies to choose vendors and knowing when it’s time to say goodbye, and tips to streamline processes for members when working with multiple vendors.
The conference will close with a discussion on clear communication and enhancing member understanding of benefits, led by Heather Adams, senior product line manager, Blue Cross and Blue Shield of North Carolina, and Archie Dey, senior director, consumer experience and insights, SCAN Health Plan. Adams and Dey will discuss the product team’s role in creating CMS-required member materials, including the Annual Notice of Change (ANOC), Evidence of Coverage (EOC), and Summary of Benefits; strategies for mitigating mistakes in the required materials and preventing the need for errata; and ideas for going beyond the required documents to create engaging, easy-to-understand materials that will attract and retain members.
The RISE Medicare Product Design Master Class will take place August 8-9 in New Orleans. Click here to view the event guide, roster of speakers, and registration information.