The live-streaming virtual event offers actuaries, product managers, and CMS bid stakeholders interactive discussions, comprehensive updates, and key strategies for the CMS bid process from start to finish.
RISE’s 5th Annual CMS Bid Boot Camp will be held as a virtual event on January 21-22. Check out some of the topics and speakers on this year’s agenda:
Day one highlights
The conference will kick-off with an in-depth session on regulatory and legislative overhauls with Kathryn Qin, FSA, MAAA, corporate vice president & chief actuary, SCAN Health Plan, and Deana Bell, FSA, MAAA, principal and consulting actuary, Milliman.
Qin and Bell will explore the COVID-19 fallout on cost utilization, the benchmark, and OPE, and its influence on bid strategy; how to prepare for legislative proposals to reform Medicare Advantage; and Part D changes and new executive orders. During the discussion, Qin and Bell will address the recent finalization of the drug rebate rule by the Trump administration that is set to take effect on Jan. 1, 2022 as well as the anticipated legal challenges the rules may face prior to or after the effective dates.
Ana Handshuh, principal, CAT5 Strategies, non-executive director, The RISE Association, Quality & Revenue Community, will moderate a panel discussion for a bird’s eye view of the bid cycle and requisite project management. Panelists from Harvard Pilgrim Health Care, Health Alliance Plan, and UPMC will review how health plans construct their timelines to coordinate inputs from a multitude of functional areas for optimal bid build and how to create a successful project management structure with C-suite buy-in, a multi-disciplinary review, and a CMS deadline-driven project schedule.
The conference will also feature two back-to-back sessions to master plan revenue:
- Part one will focus on CMS bid variables 101 and will be led by Lucretia Hydell, director of actuarial services, Johns Hopkins HealthCare, and Ryan Swenson, FSA, MAAA, principal and consulting actuary, Milliman. The session will cover how base bids, benchmark rates, risk scores, and other bid variables in CMS bid calculation impact health plan revenue; CMS tools and tests that determine pricing; the financial mechanics of bid relationships; and the importance of risk scores on plan revenue.
- Part two will address risk score mechanics for accurate modeling with Benjamin Nadler, director, actuarial services, Independent Health. Nadler will share best practices to build a risk profile for your bid, discuss how retrospective and prospective risk adjustment activities contribute to revenue projections, and review the calendar of CMS mid-year adjustments, “sweeps” activities, and assumptions that factor into bid cycle milestones.
Day one will wrap-up with four facilitated group discussions led by industry experts. Attendees will be able to choose from the following groups:
- Improvements and challenges to Medicare-Medicaid coordination with Bill Jensen, vice president, Independent Care Health Plan (iCare)
- Avoid the NOID led by Sara Wedlock, senior product manager, Harvard Pilgrim Health Care
- Processes for completing the ANOC and EOC submission coordinated by Monica Pagels, senior product manager Medicare product oversight, Health Alliance Plan
- Tactics to financially manage a product after its release with Lisa Franklin, market portfolio manager, CareFirst BlueCross BlueShield
Day two highlights
The second day of the virtual event will jump into a session with Donna Doebler, AVP Medicare product & analytics, UPMC, who will address how to translate supplemental benefits flexibility’s hard data into actionable conclusions. Doebler will explore preliminary results from introducing health-related supplemental benefits newly allowed by CMS, how investing in social programs reduces health care costs, and how the uniformity requirements flexibility impacted quality of care, members’ plan selection, and plan revenue.
Attendees will also learn how to effectively forecast Star measures during a session led by Christina Latterell-Loganimoce, vice president, quality improvement, Alignment Healthcare, and Rex Wallace, founder and principal, Rex Wallace Consulting. The session will delve into real-time operations for better long-term outcomes, the future financial impact of health plan operations on the Medicare Star Program, and bid strategies that support and improve Star ratings.
In the afternoon, Puneet Budhiraja, chief actuary and senior vice president, Capital District Physicians Health Plan, will address COVID-19-driven MA benefit innovations. Budhiraja will explore what constitutes a Special Supplemental Benefits for the Chronically Ill (SSBCI) and how introducing health-related supplemental benefits impact plans’ quality of care and cost results, as well as what telemedicine will look like in 2021.
Virtual seminar perks
Throughout the two-day conference, attendees will have several opportunities to network virtually with colleagues and peers. Participants will also be able to submit questions to presenters throughout the live presentations for real-time answers.
Attendees will have access to conference presentations for 90 days after the live event, making it easy to re-watch sessions or catch any presentations that may have been missed.