The live-streamed virtual event, designed for those involved in Medicare Advantage product design, sales and marketing, and finance and revenue management, will take place Sept. 21-22.
The RISE Medicare Product Design Master Class, now in its fourth year, will center on regulatory updates and the impact of COVID-19, supplemental benefits, data analytics and competitive analysis, and pharmacy design and network improvement.
Take a look at what you can expect:
Preconference on product design, quality measures, and risk adjustment
The master class will begin at 10:10 a.m. EST Monday, Sept. 21, with a preconference workshop that examines the critical connections between product design, quality measures, and risk adjustment. Led by Shannon Decker, vice president of clinical performance, Brown & Toland Physicians, and Bill Jonakin, medical director, Medicare Advantage (MA) and risk adjustment, St. Luke’s HealthPartners, the workshop will review the new CMS guidelines related to Star ratings, specifically in a virtual environment, and the impact of CMS’ hold on Stars data and using last year’s data on your plan’s revenue.
Presentations on 2021 final rule, advanced analytics, supplemental benefits, pharmacy benefit design, provider network, marketing designs
Deep dive into CMS 2021 Final Rule for Part C and Part D: Hank Osowski, managing director, Strategic Health Group, will discuss CMS policy regulation revisions in response to COVID-19; changes to Stars, HEDIS, CAHPs and HOS regulations that may influence product design; relaxed regulations to provide hospital services outside the hospital walls and CMS telehealth requirements; the impact of the 2021 and 2022 MA and Part D proposed rule on product design and member benefits; and the potential influence of 2021 MA capitation rates and Part C and Part D payment policies.
Optimize plan design leveraging advanced analytics: Find out how to ask the right questions and understand the strengths of quantitative analysis to align on anticipated outcomes. The presentation will also help you determine how to predict market shifts using plan design and enrollment trend analysis and how to best use advanced analytics to determine plan features and cost ranges that offer the most appeal in each market.
Competitive intelligence and data analysis of member population: Find out how to maximize data and trends to compare your offerings with competitors in the market to improve your position. Romy Hussain, senior director, health care economics and data science, Johns Hopkins Healthcare LLC, will explain how to analyze your demographics and population to discover high utilizers and calculate ways to improve the value of your product mix.
Strategies to calculate ROI for your supplemental benefit offerings: Decker will return for a presentation that examines the data points that you can analyze when calculating the value of your benefit offerings, how to conduct consumer surveys, and looking at previous offerings to assess their impact on your membership to determine their value.
Utilize pharmacy benefit design as a tool to improve adherence, MTM, and opioid measures: Gary Melis, clinical pharmacist, Network Health, will present on how to apply medical and pharmacy claims data to target higher risk MTM qualified members for specific interventions. He’ll discuss the need to collaborate with case or disease management to improve medication adherence and work with the MTM pharmacist and quality improvement team to enhance Part C measures.
Optimize your provider network to ensure competitiveness within your market: Join Ryan Davis, PAHM manager, pharmacy Medicare programs, Kaiser Health Plan, for a discussion on calculating network coverage for ESRD members, including dialysis centers, to ensure that you meet CMS regulations without exceeding them. David will guide you on examining your out-of-network coverage to identify if you can reduce your current offerings to invest the money elsewhere and estimate the value of narrowing your network, including specialty practices.
Strategies to improve your marketing efforts during a chaotic 2020: Osowski will return to help you analyze changes in consumer behavior during COVID-19 and the election year to identify the best marketing approach and post COVID consumerism changes. He will discuss the benefit of using data analytics to identify which communication tool works best for your membership and adapt your marketing strategy to best target Baby Boomers and the Silent Generation.
Panel discussions on ESRD populations, product design, supplemental benefits, VBID, SSBCI
Strategies for continued success with the inclusion of ESRD population: Planned discussion topics: How to evaluate the total cost of care associated with ESRD members and calculate how to price correctly for their inclusion in your membership; examine D-SNP plans to identify areas of success with unique populations to obtain best practices for high-utilizing membership; assess your current network to identify if you meet the needs of these members.
The impact of COVID-19- adaptation of product design: Talking points to include remote patient monitoring services, a reimagining of the way you market to members, assess how others have adapted to success, how to overcome fear of change with your members and providers.
Differentiate your organization through advanced supplemental benefit selection: Discussion will include how to use data and trends to identify which benefits are most valuable to your members and potential members and how to tailor your benefits to meet the needs of low-income members to improve outcomes and reduce cost of care.
Maximize the Value-Based Insurance Design Model (VBID) and Special Supplemental Benefits for the Chronically Ill (SSBCI) to enhance member care: Talking points will include customizing benefits based on member population needs, how to analyze the impact of the benefits offered to identify areas of improvement, obtain feedback from members on the most essential benefits to improve product offering.