The RISE annual quality leadership summit is headed to Miami June 20-22. If you are responsible for quality improvement in Medicare and Medicaid, you don’t want to miss the conference devoted to best practices and strategies to improve Star ratings, CMS clinical data measures, member surveys, CAHPS and HOS, and pharmacy measures.
More than 20 presenters from high Star rating plans will join RISE June 20-22 for Qualipalooza 2023 in Miami to share their insights about the most pressing hot topics this year. Here’s a sneak peek at what we’ve planned so far:
Two half-day preconference workshops
The morning preconference, on Tuesday, June 20, will focus on everything you need to know to be ready for Electronic Clinical Data Systems (ECDS). A team of industry experts will explain how to overcome the challenges of ECDS reporting and go over the proposed digital measures. Participants will learn how to create a data journey for each data source and integrate siloed data and how to build and execute a digital roadmap.
Instructors include Melissa Smith, EVP consulting and professional services, Healthmine; Julianne Eckert R.N., BSN, CCM, CMCN, ACMP, senior director, clinical quality programs, Clover Health; and Katharine Iskrant, MPH, CHCA, CPHQ, founder and practice leader, Healthy People, Inc.
The afternoon preconference will take a deep dive into the new Stars math. Rex Wallace, founder and principal, Rex Wallace Consulting, will lead a team of experts who will go over the calculation of Stars based on the final rule. Participants will learn how the new health equity index reward differs from the previous reward factor, what the change to the hold harmless provision for the improvement measures applying to 5-Star plans means for your plan, the impact of the reduced member experience weights on your score, and what the departure of guardrails means for cut-point movement.
In addition to Wallace, workshop leaders include Jessica Muratore, senior consultant, Rex Wallace Consulting; Nate Lucena, senior consultant, Rex Wallace Consulting; Luis Cerda, senior consultant, Rex Wallace Consulting; and Mick Twomey, chief executive officer, Hyperlift.
Keynote presentation
Best-selling author Christie McMullen, Ed. D., CEO, AIM...Analyze, Improve, Move, will kick off the second day of the main conference with a presentation on how to clearly communicate the right things to the right people the right way. Participants will take away how to chunk information and determine focus, recognize how to decide who needs to know what and when, and how to deliver information so people will remember it.
Hot topic sessions
Ana Handshuh, CHC, principal, CAT5 Strategies, and Jessica Assefa, chief quality officer, ATRIO Health Plans, will explain the new quality measures in CMS’ final rule. They’ll explain the key changes from the final rule and how they impact Stars math, will help attendees formulate the best strategy to respond to changes based on their health plan demographics, and discuss how to prepare a flexible Stars gameplan that can withstand future changes.
A team of experts will lead attendees through 5 steps to 5 Stars. They discuss leading from the top, designing benefits, partnering with providers and suppliers, making key touchpoints count, and how leveraging cutting edge listening and analytics have enabled plans to achieve a 5-Star rating. The presentation will also focus on the use of predictive analytics, CAHPS ratings, the impact of provider partnerships and provider network training, and how a holistic approach to member experience can improve multiple key measures, such as CAHPS and the net promoter score.
Presenters will include Ally Thomas, Ph.D., associate vice president, quality improvement, UPMC Health Plan; David L. Larsen, R.N. MHA, senior advisor payor solutions, Press Ganey; Adam Higman, DHA, FACHE, partner, strategic consulting, payer consulting, Press Ganey; and Mallory Mueller, director, quality health integration, Network Health.
The conference will also feature a spotlight on health equity: new and equitable ways to provide interventions. Speakers Jenn Kerfoot, chief experience officer, FarmboxRx, and Ellen Fink-Samnick, chair, RISE SDoH community, will explain health equity versus social determinants of health (SDoH), the intersection of quality improvement programs with case management and patient engagements, and will explore a case study that started with health equity at the center, not as an add on.
Learn how to eliminate the chart chase—leveraging discrete data from your health care partners with a panel of experts. Amanda Banister, CPC, senior manager, provider engagement, Veradigm Payer, Veradigm, will moderate the discussion, which will include how to leverage standard supplemental data from provider EMRs and HIEs; new Star measure data capture opportunities; innovative ways to capture other measures via ADT Systems; how to collaborate with provider EMR systems to capture coding behind the scenes without any additional clicks; and pseudoclaims for data captured outside a claim.
Panelists include Savannah Gonsalves, R.N., MHA, director of quality, Hometown Health; Erika Paquette, manager of risk adjustment and analytics, Hometown Health; and Kate Wormington, director, solutions management, Veradigm.
Attendees will also hear from Melissa Silva, payer solutions lead, Ciox Health, who will present how to leverage digital access to member data to improve outcomes. She’ll explain how to incorporate member data to improve Stars ratings, identify how the new quality measure changes impact health equity, and how recent regulatory changes impact data.
The conference will also include a discussion on how to drive quality initiatives through an integrated social care strategy. Join Keslie Crichton, chief of sales, BeneLynk, and Elizabeth Benz, vice president of quality and clinical integration, Network Health, for the presentation that will discuss new NCQA and CMS regulatory requirements, how to identify and document solutions and other health equity data elements to gain a holistic understanding of members, and how SDoH advocacy can improve member engagement and enhance brand awareness and loyalty.
Additional sessions, planned activities
Each day of the main conference will feature two concurrent tracks with sessions that address quality. Topics include:
- Breaking down barriers to health equity: The critical need for race, ethnicity, and SDoH data
- Build a quality improvement culture across all lines of business
- Playing to win: Quality whac-a-mole
- Benefits du jour: Refreshing your quality-driven benefits menu
- Older & wiser: Engaging today’s seniors through digital health
- Common ground: The provider vs. plan perspective on the CMS final rule
- Case study: A decade of excellence, lessons learned from a Medicare 5-Star plan
- The wisdom of patients, unlocking VBH with a transparent approach to patient experience
- How to avoid health plan annual quality measure reporting pitfalls
- Quality and risk adjustment: Bringing it all together
- Panel incorporating providers into your quality outcomes
- Lessons learned: Quality improvement in Medicaid and marketplace plans
- How to master ECDS measure reporting
- A business case to prioritize quality improvement, health equity, and Stars
Each track will also include Tools & Tech Spotlights, featuring 15-minute presentations from service providers who will showcase their offerings. Scheduled companies include Baxter International, New Vision Healthcare Solutions/Choice Medical Group, Biomedix, Everly Health, and Ingenia Health.
A RISE event always includes expanded networking sessions. This year’s Qualipalooza will feature cocktail receptions on Tuesday and Wednesday evenings in the exhibit hall, as well as networking breakfasts and lunches on Wednesday and Thursday.
Qualipalooza 2023 will take place June 20-22 at the Hyatt Regency Miami. Click here for the complete agenda, roster of speakers, and registration information.