Speaker Presentations
Tuesday, December 7, 2021
2 Hands-on, Interactive Workshops: Stars 101 and Advanced Stars
9:00 - 12:00

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

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

1:00 - 4:00

Advanced Stars Workshop

This workshop will include a detailed review of the technical specifications and best practices for success for new Star measures which go into effect on 1/1/2022, including:

  • Transitions of Care
  • Follow-up After ED Visit for People with High-Risk Multiple Chronic Conditions
  • Plan All-Cause Readmissions
During this workshop, we’ll also allocate extensive time to “Ask the Experts” your burning questions about Star Ratings. No question is off-limits! We’ll cover a wide range of topics, including but not limited to:
  • Changes to HEDIS, CAHPS, HOS and other measure specifications
  • Issues impacting Star Ratings, including telehealth, COVID, the new Administration, etc.
  • Ways to manage the new “Math Path” to 4+ stars
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

Wednesday, December 8, 2021

Networking Continental Breakfast


Welcome & Opening Remarks


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


Panel Discussion: Focusing Your Time and Resources: Shifting from an Era of Stability to Instability


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


Networking Refreshment Break in the Exhibit Hall


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


Christine Leo,Vice President, Senior Products, Cigna


The Changing Trajectory of CAHPS: Mock CAHPS Surveys – What’s Next?


Health Crowd Feature Presentation


Networking Lunch

Member Engagement – From Meeting Members Where They are to Technology Innovations

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


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


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

Kurt Cegielski, SVP, Client Success, Icario


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


Networking Refreshment Break in the Exhibit Hall


mPulse Feature Presentation


Case Study: Leveraging Technology to Improve Member Experience as a Primary Lever for Stars and RA Performance

Oscar has developed a unique customer experience model, assigning a small team of Care Guides to serve each member’s unique needs. We have powered that model through our proprietary technology and targeting algorithms to create customized conversations, while maximizing the effect on STARs by delivering the next best step in real time. The tools allow Oscar to create a connected and consistent experience for members through a variety of channels, assisting members to take the next best step with their physicians, Oscar’s virtual care programs, or non-clinical resources.

Laura A. Breisch,VP of Value Capture, Oscar Health

Bryan Jones, MBA,Director of STARs, Oscar Health


Enhanced Medication Services Feature Presentation


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


Decision Point Feature Presentation

6:00 - 7:00

Networking Reception in the Exhibit Hall

Thursday, December 9, 2021

Networking Continental Breakfast


Chairperson’s Remarks


Feature Presentation


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

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


Feature Presentation


Networking Refreshment Break


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


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


Feature Presentation


Networking Lunch


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

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

Lindsey Giglio,Program Manager, BlueCross BlueShield of South Carolina

Ensuring Access to Quality Care for All Members

Display Measure Data: The Art of the Possible


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


Reducing Readmissions


Close of Conference