Agenda

Rave Reviews from past STARS virtual summit attendees!
Speaker Presentations
Module #1
Tuesday, December 7, 2021 : 10 a.m. ET – 12:00 p.m. ET
2 Hands-on, Interactive Workshops: Stars 101 and Advanced Stars
10:00

STARS 101: Back to Basics “Nuts & Bolts” Workshop

This workshop will include an in-depth review of all elements of the Star Ratings program. We’ll cover everything you need to know to work in a Stars program, including:

  • Detailed review of Star measures, cutpoints and ratings calculation
  • Deep dive into data sources used in Star Ratings, including timing and scoring
  • Technical program changes
  • CMS goals and uses of Star Ratings
This hands-on, interactive workshop will help staff new to Stars thoroughly understand the program at a foundational level – and is a great refresher for long-time Stars staff!

Melissa Smith,Executive Vice President, Consulting and Professional Services, Healthmine

James Haskins,Director of Government Programs, Healthmine

Cynthia Pawley-Martin,Senior Consultant, Healthmine

Dwight Pattison, Consultant, Healthmine

Module #2
Tuesday, December 7, 2021 : 2:00 – 4:00 p.m. ET

Advanced Stars Workshop

This workshop will include a detailed review of the hot topics impacting Star Ratings in 2022, including:

  • Review of new 2022 Star measures, including Transitions of Care, Follow-up After ED Visit for People with High-Risk Multiple Chronic Conditions, Plan All-Cause Readmissions
  • Updates on CMS’ new 2022 Rewards & Incentive Regulations
  • Deep dive into the CAHPS surveying and scoring methodology
This hands-on, interactive workshop will provide specific tools and insights to help you earn and sustain your 4+ star rating!

Melissa Smith,Executive Vice President, Consulting and Professional Services, Healthmine

James Haskins,Director of Government Programs, Healthmine

Cynthia Pawley-Martin,Senior Consultant, Healthmine

Dwight Pattison, Consultant, Healthmine

Module #3
Wednesday, December 8, 2021: 10 a.m. ET – 1:00 p.m. ET
10:00

Welcome & Opening Remarks : How to Maximize Your Virtual Conference Experience

Roz Applebaum,Vice President, Conferences, Strategic Solutions Network

10:05

Star Ratings Landscape: Where We Are Today & What’s on the Horizon for 2022 & Beyond

CMS’ release of the 2022 Star Ratings gave us our first glimpse into the most recent performance data for Medicare Advantage plans. Underscoring the data are many trends worth noting (and watching closely), including even more emphasis on the importance of member experience. This session will include an overview of the 2022 Star Ratings for MA plans and provide attendees with data-driven guidance on the right areas of focus for 2022 and beyond. After this presentation, you will:

  • Understand the key takeaways from the 2022 Star Ratings, supported by notable data points and exclusive analysis
  • Have critical insight into current market trends, proposed policy updates, and future changes to Star Ratings
  • Learn how to leverage technology to build successful member experience and quality improvement strategies

Melissa Smith,Executive Vice President, Consulting and Professional Services, Healthmine

10:30

Congratulations! You’re the New Stars Manager! Building Cross-Functional Focused Teams & Reports

You’ve just been hired as a Stars program manager and don’t know where to begin. Keeping track of all of the stars measures and who in your company leads the HEDIS, CAHPS, HOS and Pharmacy teams is a good place to start, but there’s more. This session will be led by a Stars Program Manager who has started two successful Stars programs with two health plans. By the end of the session you will be able to identify the teams and reports you will need to begin your journey into the world of stars ratings.

Cindy Aguglia,Medicare STARS & Quality Manager, The Health Plan

10:50

Virtual Networking Break

11:00

Panel Discussion: Re-engaging & Supporting Members in the New Post-Covid Environment: Meeting Members Where They Are

Moderator:

Kim Barrus, MSN, BSCIS, RN, PMP,Director, Clinical Outcomes Management, SelectHealth

Panelists:

Christine Leo,Vice President, Senior Products, Cigna

Louise Briguglio,SVP, Integrated Experience, Icario

David Kirkus, PharmD,Director, Consulting Services, EnlivenHealth™

Dr. Nathan Estrada, VP of Clinical,Nymbl Science

11:40

Panel Discussion: Adding Virtual Benefits and Services to Raise Your Stars: Three Innovative Approaches

Moderator:

Michael S. Adelberg,Principal, Lead, Healthcare Strategy Practice, Faegre Drinker Consulting

Panelists:

Michael Rea,CEO and Founder, Rx Savings Solutions

Evelyn Chojnacki, MPH, Director, Health Plan Product Strategy, SWORD Health

Henry MahnckeCEO Posit Science

12:20

Improve Star Ratings and Quality with PBP, ANOC, EOC, SB, Multi-channel Content Automation

Medicare Advantage organizations often depend on Excel grid-driven homegrown processes to manage benefit plans resulting in operational inefficiencies. The session will explore how health plans can address those challenges by auto-generating documents, simplifying competitive intelligence, automating PBP bid submissions and creating customized reports based on key parameters like Star ratings, geographical distribution, plan type, and so on. The attendees will learn how a single source of truth can help health plans minimize errors, gain competitive advantage, improve star ratings, increase speed-to-market, and improve compliance.

Mohammed VaidChief Executive Officer and Chief Solution Architect Simplify Healthcare

12:45

Virtual Lunch Break in the Exhibit Hall

Module #4
Wednesday, December 8, 2021 : 2:00 – 5:35 p.m. ET
Member Engagement – From Meeting Members Where They are to Technology Innovations
2:00

Texting For Health?! How To Engage Today's Seniors For Better Outcomes

More than ever, seniors are engaging with digital technology as this generation was already tech-savvy before aging into Medicare. Learn how Elderplan partnered with HealthCrowd on a digital communications strategy that produced valuable member feedback and positive outcomes. Hear about lessons learned over the years as foundations for growth as they continue to iterate digital campaigns that engage members and impact outcomes.

  • Developing relevant messaging
  • Obtaining valuable member feedback and positive outcomes
  • Iterating to build adaptable and relevant campaigns

Dana Friedman, Assistant Director, Performance Improvement, Elderplan

Leslie Groves, Head of Marketing, HealthCrowd

2:20

Clinical Interventions to Boost Star Ratings

  • Strategy to move the OMW measure during the pandemic and beyond
  • Diabetes eye exam:  How we plan to leverage the same strategy for in home BMD testing and more towards in home eye exams. 
  • In home testing kit strategy during the pandemic lessons learned and next steps.

Mallory Mueller, Director Quality Health Integration, Network Health

2:40

Panel Discussion: Real Innovations in Boosting CAHPs & HOS Scores – What’s Actually Working?

Moderator:

Julianne Eckert RN BSN, CCM, CMCN, ACMP, Director of Quality Improvement, Clover Health

Panelists:

Melissa Smith, Executive Vice President, Consulting and Professional Services, Healthmine

Cindy Aguglia, Medicare STARS & Quality Manager, The Health Plan

Enam Noor,Founder & CEO, Insightin Health

Anthony Davis,Managing Director Quality, Health Management Associates

3:25

Networking Break

3:35

Member-Centric Communication: Creative, Customized Outreach Programs to Close Gaps in Care

Although CMS continues to put more emphasis on member experience, it’s important that we remain diligent in gap closure efforts for HEDIS measures. Developing a personalized member outreach strategy can have impacts that span across various measure sources. Learn about Health Alliance’s journey from campaign member selection to deployment and beyond.

Haley Kesler,Star Rating Manager, Health Alliance Medical Plans

3:55

Achieving 5-Star CAHPS: Transparency, Engagement and Outcomes

  • Creating CAHPS Transparency: Deploying machine learning and artificial intelligence to identify the members that will have the greatest impact on your CAHPS scores
  • Engaging Members: Building an effective CAHPS engagement timeline across the year to elevate CAHPS scores and improve the member experience
  • Engaging Providers: Identifying which providers are caring for your negative CAHPS raters to activate collaborative CAHPS and member experience efforts
  • Measuring Outcomes: Setting a process to analyze CAHPS and member experience intervention results for sustained improvement

Lisette Roman,Director of Client Analytics, Decision Point

4:15

Case Study: When the Stars Align: Improve Every Life Using Technology to Drive a Comprehensive Personalized Member and Provider Experience

  • Use data to embed health equity into DNA to drive optimized health outcomes for members 
  • Drive lower cost and better outcomes through the use of technology
  • Adapt and leverage technology to help members and providers during the recent pandemic

Julianne Eckert RN BSN, CCM, CMCN, ACMP,Director of Quality Improvement, Clover Health

Shaila Kapur,Consultant, Clover Health

4:35

Putting Patients First! Innovating to Ensure A Top Notch Patient Experience

Exploring how we take lessons learned from patient-centric HEDIS and Drug Safety measure interventions and apply them to innovative efforts to ensure high performance on member experience measures

Anna HallDirector of Quality Services Enhanced Medication Services

Dean Koskinas, PharmDExecutive Sales Consultant Enhanced Medication Services

4:55

Virtual Networking Reception in the Exhibit Hall

Module #5
Thursday, December 9, 2021 : 10 a.m. ET – 12:30 p.m. ET
10:00

High-Value Pharmacy Services: How Targeted Pharmacy Care Can Drive Star Ratings & Improve Outcomes for Medically Complex Members

Learn the role that high-value pharmacy services can play in improving health plans’ pharmacy quality ratings, while also improving the pharmacy experience for medically complex members. Discover how the combination of population health analytics and targeted pharmacy services can help to reduce medical utilization, improve pharmacy quality, and enhance member experience. Topics will include:

  • How a high-value pharmacy service can address member and health plan needs evident in the current MAPD landscape
  • The distinct needs of medically complex and vulnerable plan members
  • The process of identifying high-need members for enrollment into value-based pharmacy care management programs
  • A case study and most recent outcomes of a clinically intensive care model, including improved measures of pharmacy quality and member medication use

Patricia Powers, PharmD, BCPS, Director of Clinical Services, Mosaic Pharmacy Service

10:20

Case Study: Taking Member Events Digital: Creating Meaningful Engagement in a Virtual-First World

While in-person events are a long-held staple in the world of member engagement, COVID-19 has changed the ways in which we’re able to connect with Medicare beneficiaries. Plans have been challenged to think virtual-first when it comes to staying attuned to the voice of the member, requiring flexibility and creative thinking to maintain meaningful interactions with a face-to-face feel. In this session, we’ll cover what it took to transition a plan’s popular in-person member event to a digital experience, sharing best practices and lessons learned along the way.

Samantha Vinton Bartholomew,Sr. Improvement Specialist, Priority Health

Provider Engagement – Relational and Financial Strategies to Boost Performance Scores & Outcomes
10:40

Case Study: The Impact of Value-Based Care on CMS Star Ratings

How the design and impact of a value-based care program can promote increased stars outcomes and improve both member and provider satisfaction.  How to choose measures that provide high value to both health plan and providers. How providing high touch provider interaction can drive quality and satisfaction results.

Michael Farina,Director Health Care Quality, Capital District Physicians’ Health Plan

11:00

Harnessing Real Time Data & Population Health Strategies to Improve Clinical Measures & Outcomes

  • Capitalizing on interoperability to enhance data strategies to improve risk and quality coding
  • Utilizing publicly available data sources such as HIEs to build triggers into pop health programs
  • How partnership with providers through value-base care initiatives that focus on sharing data can improve quality measures and outcomes
  • Preliminary results on NLP and other pilot programs

Kimberly Swanson,VP Quality and Clinical Integration, Network Health Plan

11:20

Virtual Networking Break

11:30

Building Provider Relationships through Dedicated Clinic Support to Boost Clinical Measures and Member Outcomes

SelectHealth will share how their Advanced Primary Care (a.k.a., patient centered medical home) program and supporting team has improved clinical measures and member outcomes.  This program aligns dedicated staff to participating clinics to provide consulting support on medical home transformation, process/quality improvement, performance measures, transition of care and social determinants of health work. The team provides a great deal of support via regular meetings, ongoing electronic communication, and on demand reporting to support all aspects of the program. Best practice sharing is also a benefit of program participation, all participating practices are invited to participate in the annual Best Practices symposium.

Kim Barrus, MSN, BSCIS, RN, PMP,Director, Clinical Outcomes Management, SelectHealth

11:50

Impact of Pharmacy on Stars & Quality -- Leveraging the Pharmacist for Clinical Care

Lynn Deguzman, Pharm.D., BCGP,Regional Clinical Operations Manager, Kaiser Permanente Northern California

12:10

Adapting Annual Provider Incentive Programs to Drive Part C & D Performance?

The paths to achieve Medicare Stars Part C and D goals are constantly changing. Measures come and go; thresholds are rising and plans need marked year-over-year improvement. How can you adjust the elements of your incentive program to meet these challenges? Blue Shield of California shares the evolution of its Medicare provider incentive program over the last five years and how it adapted to drive provider performance for Part C and D measures

Amanda Calvert,Medicare Clinical Program Manager, Blue Shield of California

12:30

Virtual Networking Lunch in the Exhibit Hall

Module #6
Thursday, December 9, 2021 : 2.00 p.m – 3:45 p.m. ET
2:00

Panel Discussion: Boosting CAHPS Scores through Provider Engagement, Education & Incentives

Moderator:

Haley Kesler, Star Rating Manager, Health Alliance Medical Plans

Panelists:

Dena Miller, RN MSN, VP Medicare Stars and Risk, Florida Blue

Lindsey Giglio,Program Manager, BlueCross BlueShield of South Carolina

Michael Farina,Director Health Care Quality, Capital District Physicians’ Health Plan

Ensuring Access to Quality Care for All Members
2:45

Innovative Community Partnerships to Close Gaps in Care for Diverse Populations – A Strategic Approach

Closing gaps in care for diverse population groups requires distinct engagement strategies. Members often experience social barriers to care and require culturally appropriate engagement strategies to understanding preventive care and necessary health screenings. This session will engage attendees on how to strategically leverage community partnerships to address social barriers to care, provide culturally tailored support and work to close gaps in care. After this presentation, attendees will be able to:

  • Identify how to leverage three unique partnerships within a community to work with diverse members.
  • Learn how community organizations can empower members to address their health screenings.
  • Understand how partnering with community organizations can make a difference on closing racial and health equity gaps in care for preventive screens.

Jamie Galbreath, PhD, MPH, CHES,Quality Improvement Associate Director, UCare

3:05

Addressing Social Determinants of Health & Health Inequity to Boost Outcomes, Member Experience & Quality Performance

Truly making a positive impact on SDOH and inequities within a community, is not a single source solution. Any program aiming to address SDOH and inequities requires a commitment and partnerships with trusted and existing community based resources, which is why Gateway Health could not do this alone. The community and its leaders must be involved in every step of the process to effect real change. Gateway Health was able to leverage local CBO and providers in not only addressing its members SDOH needs but also improving quality scores and member experience.

Konark Rana, Sr. Director – Strategy and Innovation, Gateway Health Plan

3:25

Close of Conference