Agenda

Rave Reviews from STARS 2023 Attendees!
Speaker Presentations
Tuesday
June 4, 2024

Join this Pre-conference Hands-on, Interactive Workshop: 3-Hour, Topic-specific, Small Group Session

Join this exclusive Think Tank workshop where industry leaders present top of mind opportunities and challenges in an intimate program format. This highly acclaimed, popular conference feature is your best opportunity to get questions answered on the spot, share winning solutions, lessons learned and challenges. Go home armed with information critical to your plan’s success.

12:00

Registration

1:00

Creating a Multi-Dimensional Member Journey that Drives Star Ratings & Health Equity

Understanding member needs, barriers to positive health outcomes, drivers of dissatisfaction, and disparities across our populations are key to delivering member-centric experiences and improving performance across Star Ratings & Quality Improvement Programs.

  Furthermore, what are the methodologies for evaluating the effectiveness of engagement campaigns, channels, and vendors? Member outreach efforts can sometimes remain untouched and unquestioned for years before they are vetted and updated. This session will dive into ways in which to ensure campaign effectiveness and measurable outcomes.  

Register for this interactive workshop that will cover a proven and practical framework to activating holistic and effective journeys for your members.  

Key focus areas will include:

  • Personalized Engagement: Identifying barriers and tailoring outreach based on member needs and risk factors
  • Outreach Channel Diversity: Ways to intervene using a diverse range of channels, meeting the members where they are and understanding each individual member’s likelihood to engage 
  • Equity First: Understanding the disparities in health status, access, and quality of care – reviewing practical approaches to member selection and program enrollment helping to bring equity to the forefront 
  • Targeted Education: Closing knowledge gaps and driving health outcomes by ensuring members receive adequate education around their unique challenges and those key moments for navigation within their healthcare journey
  • Workshop Leaders:

    Lisette RomanVice President of AnalyticsDecision Point by mPulse

    Reva SheehanSenior Director, Customer Insights mPulse

4:00

Close of Workshop

Wednesday
June 5, 2024
7:00

Registration & Networking Breakfast

8:00

Co-Chairpersons’ Opening Remarks

Jessica AssefaChief Quality OfficerATRIO Health Plans

Melissa SmithFounder, Senior AdvisorNewton Smith Group

Strategic Initiatives to Remain Competitive Amid Dramatic Market Changes
8:10

Anticipate & Adapt: Navigating Regulatory Changes for Star Ratings and HEDIS®

How can your organization stay ahead of the dynamic nature of regulatory changes in Medicare Advantage (MA) while remaining nimble? Join The Alliance of Community Health Plans’ (ACHP) Michael Bagel as he shares insights into optimizing your MA star strategy and leveraging cross-functional teams, provider engagement and data management to enhance performance. This session will also feature an analysis of recent regulatory changes and a lookahead into what to expect next. Michael will share an overview of the policy recommendations in ACHP’s MA for Tomorrow initiative and how these strategies can spark positive change for the future of MA. Don’t miss this session, where you can stay ahead of the ever-evolving MA landscape while discovering ways to enhance performance and ensure adaptability for your health plan now and in the future.

Michael Bagel Associate Vice President of Public Policy Alliance of Community Health Plans

8:40

Achieving Stars Success in an Era of Change: Focusing on New & Evolving Technical & Regulatory Changes

As CMS continues introducing significant measure-level and program changes to Medicare Advantage and Star Ratings, this session will include:

  • Review of known and proposed Star Ratings changes impacting 2024 and 2025
  • Review of key Medicare Advantage operational changes impacting Star Ratings
  • Discussion of the impact known and proposed changes will have on operations, budgets and QBPs
  • Aligning the organization around the New Needs of Stars

Melissa SmithFounder, Senior Advisor Newton Smith Group

9:10

Increasing Resources to Expand STARS & HEDIS® Programs – Communicating the Value Story & Business Case to Your Leadership

Kim ShellPrincipalFreedom Healthcare Consulting

9:40

Case Study: Data Driven Strategies to Integrate Stars, Quality & Risk – Breaking Down Silos

In a value-driven climate, increased collaboration, and identification of synergies across “like areas” have proven advantages, particularly as it relates to health care data.  Learn how taking a strategic approach toward health information management, interoperability, electronic health record exchange can provide the full member picture while enabling better care and achieving risk adjustment and quality outcomes.

Chayla BeasonDirector, MA Clinical Data Strategy & Execution, Senior Health Services Blue Cross Blue Shield of Michigan

10:10

Networking Refreshment Break

Sponsored by

10:40

Feature Presentation

Operationalizing the Health Equity Index & SDOH
11:10

Panel Discussion: Integrating Health Equity, Diversity, SDOH into Stars & Quality Programs

This panel will explore ways that organizations are leveraging unique solutions to address and overcome barriers associated with Social Determinants of Health in ways that positively impact health equity, racial diversity disparities, and measurable program results such as Medicare Star Ratings. This discussion will explore unique programs, incentive and engagement strategies, in- home and community-based solutions, and the role that the upcoming Health Equity Index component of the Star Ratings program will have on strategic investments and Stars performance planning. Finally, we will explore ways that these initiatives and solutions have been and can be effectively integrated into daily health plan operational DNA.

Moderator:

Andrew BellMedicare Stars Practice Leader ProspHire

Panelists:

Michael BagelAssociate Vice President of Public Policy Alliance of Community Health Plans

Tamara Migut Director of Quality Management Health Alliance

Sabrina ZerzouriSr. Program Manager, Medicare Quality Point32 Health

11:55

Networking Lunch

12:55

Case Study: Navigating the Health Equity Index: Elevating Health Outcomes and Safeguarding Star Ratings

  • Learn the Ins and Outs of CMS’ Health Equity Index and how to ensure your plan is prepared for what’s next in Stars
  • How to engage plan leadership and providers, equip them for the challenges of this calculation, and hold them accountable for performance 
  • Balance your HEI Strategy with your oganization’s overall Equity Strategy
  • Learn how HEI preparations can improve your overall Stars scores – even among the landscape of plans that does not meet the population requirements
  • Brendan Generelli Lead Program Manager for Stars and QualityBlue Cross Blue Shield of Rhode Island

1:25

Beyond Risk – The Importance of Dual Advocacy

Dual Advocacy was the first social care program to see widespread adoption among Medicare Advantage plans. For more than two decades MA organizations have worked to identify members who are eligible for Medicaid, Medicare Savings Programs, or the Low-Income Subsidy and helped them enroll. They have also provided assistance to help those members through the annual renewal to maintain those benefits. An effective program increased risk adjustment revenue for the plan and provided vital financial assistance to the member. Today, these initiatives are more important than ever as CMS has identified Dual members, including those receiving LIS, as having significant Social Risk Factors and counted them into the denominator of the Health Equity Index. 

We will review one client's initiative to deliver meaningful social care through one integrated member engagement campaign. Together, we'll examine how this drives accurate risk adjusted revenue, closes gaps in care, and helps members to live better lives.

Keslie Crichton Chief Sales OfficerBeneLynk

Member Engagement Solutions to Boost
CAHPS & HOS Scores & Increase Retention
1:55

Decision Point Feature Presentation

2:25

Best Practices: Enhanced Member Outreach Strategy through Interdepartmental Collaboration

  • Creating a tactical plan utilizing various departments within the organization
  • Calculated and thoughtful messaging with several modalities
  • Collaborating with outside vendors to compliment Blue Shield of California Marketing Communications strategy

Eden Anne Encarnacion, MHA,Sr. Manager, HEDIS – Medicare Star ProgramBlue Shield of California

Tamara Khachikyan,Operational Program Manager, Medicare Star ProgramBlue Shield of California

2:55

Networking Refreshment Break

3:25

Panel Discussion: Innovative Tools and Strategies to Improve Quality and Star Ratings

4:00

Feature Presentation

4:30

Best Practices: Leveraging Your Appeals and CTM’s Measures to Boost Star Rating Scores

  • Learn first-hand strategies to implement to increase the likelihood that IRE is aligned with you.
  • Discover Best Practices that can help you prevent CTM’s in order to minimize its impact on your Star measures.

Moraima Rios Gonzalez Medicare STARS Program DirectorMedical Card System, Inc.

5:00

Best Practices: Unlocking the Power of HOS: Elevating Your Star Ratings Strategy

  • Maximize Star Ratings Success:

    Discover how strong Health Outcomes Survey (HOS) measure performance is the key to achieving and sustaining high Medicare Star Ratings. Uncover the strategies that will propel your health plan to the top tier.
  • Strategic Insights from CMS Reports:

    Explore the untapped potential of HOS data beyond star ratings. Learn how detailed CMS reports can be leveraged to drive actionable insights, enhance member outcomes, and strengthen your overall healthcare strategy.
  • Navigating Changes for Future Success:

    Stay ahead in the dynamic landscape of HOS with insights into recent and upcoming CMS proposed and codified changes. Understand the impact on star ratings math and gain strategies for adapting to ensure continued success.
  • Practical Strategies and Interventions:

    Delve into effective member and provider- facing strategies that have a high impact on HOS. Learn actionable interventions that can be implemented to improve member experiences and elevate HOS scores.

Jessica AssefaChief Quality OfficerATRIO Health Plans

5:30

Networking Reception

Thursday
June 6, 2024
7:00

Networking Continental Breakfast

8:00

Co-Chairpersons’ Remarks

Jessica AssefaChief Quality Officer,ATRIO Health Plans

Melissa Smith Founder, Senior Advisor,Newton Smith Group

8:15

Feature Presentation

Enterprise-wide Team Work to Break Down Silos: STARS, QA & Risk
8:45

Case Study: Quality & Risk Collaborations to Reduce Care Gaps

Becky Simmons, RN, BSN,Stars Program Manager Security Health Plan

Katie Capadona,Manager – Risk Adjustment Revenue Security Health Plan

9:15

Best Practices: Building Strong Provider Relationships to Drive Medicare Excellence in VBC Models – Beyond Metrics

Jenna Pinnell,Medicare Quality Program Manager, Elevance Health

Giuliano Torelli,Medicare Quality Program Manager, Elevance Health

Expanding Access to Care – Reaching Underserved
Populations through CBO Partnerships
9:45

Case Study: Increasing Access to Care for Underserved Communities: Rural and Urban -- Building Trust & Enhancing Health

This presentation will explore the impactful role of community-based partnerships in enhancing Medicare beneficiary engagement. It will focus on the UPMC for Life Medicare Faith and Wellness Program, a pioneering initiative by UPMC Health Plan that leverages Faith-Based Organizations (FBOs) to improve health outcomes in underserved communities. This session will highlight how the program utilizes the unique trust and network of FBOs to bridge healthcare gaps and positively influence Medicare Advantage plan ratings. Insights will be shared on how adopting a holistic, community-centered approach to wellness leads to increased preventive care, improved member satisfaction, and better-quality measures. Attendees will learn about effective strategies for building community networks, with an emphasis on the importance of trust and engagement in achieving significant health outcomes in the Medicare sector. This description highlights the key aspects of your program and its relevance to the conference's focus, emphasizing the innovative and community-centric approach to improving Medicare engagement and outcomes.

Camille Clarke-Smith, EdD, MS, CHES, CPT, Program Director, Quality Improvement, Medicare/SNP STARs, UPMC Health Plan

Tyler Chancellor, Program Manager, UPMC Health Plan

10:15

Networking Refreshment Break

Pharmacy Spotlight: Improving Medication Adherence & Staying Ahead of Evolving Regulatory Changes
10:45

Case Study: Innovative Approaches to Improve Part D Quality Measures

  • Case study by Community health Plan of Washington highlighting Medicare adherence Pilots
  • Leveraging Community resources to engage members in medications adherence
  • Hybrid models to move the needle on CMR completion rates
  • Customizing your approach to meet your member populations

Omar DaoudSenior Director of PharmacyCommunity Health Plan of Washington

11:15

Feature Presentation

Tools & Strategies to Improve HEDIS® & Quality Measures
11:45

Case Study: Supporting Providers to Close Gaps in Care to Improve HEDIS® & STARS

12:15

Networking Lunch

1:15

Best Practices: Provider Group Strategies to Achieve Nation Leading HEDIS® Results

  • Review provider engagement tactics that focus on patient care and reduce abrasion
  • Discuss strategies to create actionable reports to close care gaps and improve HEDIS®
  • Stephen P. Winn, CPHQSenior Director, QualityPermanente Medicine

1:45

Case Study: Implementing a Hospital to Home Program to Maximize Transitions of Care and Reduce Readmissions

This hospital to home program is designed to provide members with a positive experience while in the hospital making sure they are prepared for discharge and have a plan for follow up care. The goals of this program are to increase the use of transitional management visits, decreasing hospital readmission, and providing the member with a positive inpatient experience increasing their quality of healthcare and satisfaction while also  promoting increased provider and hospital collaboration and satisfaction.

Mike FarinaVice President of Healthcare QualityCapital District Physicians’ Health Plan

2:15

Best Practices: HEDIS® Data Integrity & Data Discovery to Improve Performance Scores

Abby Hoffman, R.N.Director of Quality AnalyticsCommunity Health Plan of Washington

2:45

Case Study: Addressing Interoperability: A Multi-Pronged Approach to Close Gaps in Care and Drive Value

Nazanin SalehitezangiManager, Health Data Exchange Adoption and Analytics,Health Care Service Corporation (HCSC)

3:15

Close of Conference