8:00 |
Registration
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Preconference Hands-on, Interactive Workshops | ||
9:00 a.m. – 12 p.m. |
Choose Workshop A or B (Refreshment Break at 10:30)
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A. STARS 101: Back to Basics “Nuts & Bolts” WorkshopThis workshop will include an in-depth review of all elements of the Star Ratings program. We’ll cover everything you need to know about Star Ratings, including:
Workshop Leaders:Melissa SmithExecutive Vice President, Consulting and Professional ServicesHealthmine Cynthia Pawley-MartinSenior ConsultantHealthmine |
B. Improving Health Equity: Bringing Practical Strategies and Tactics to Life to Reduce Disparities, Improve Care and Succeed in StarsThis workshop will include education and collaboration on Heathy Equity and Diversity. We will cover everything you need to know to prepare for current and future Health Equity program and reporting requirements, including: This workshop will include education and collaboration on Heathy Equity and Diversity. We will cover everything you need to know to prepare for current and future Health Equity program and reporting requirements, including:
Workshop Leaders:Kimberly SwansonSenior Vice President of Consulting & Professional ServicesHealthmine Dwight PattisonVice President of Consulting & Professional ServicesHealthmine |
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12:00 – 1:00 |
Lunch Sponsored by
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1:00 p.m. - 4 p.m. |
Choose Workshop C or D (Refreshment Break at 2:30)
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C. Advanced Stars Workshop: Deep Dive into Known & Proposed Technical ChangesThis workshop will include a detailed discussion into the technical changes impacting Star Ratings in 2023 and 2024, including:
Workshop Leaders:Melissa SmithExecutive Vice President, Consulting and Professional ServicesHealthmine Cynthia Pawley-MartinSenior ConsultantHealthmine |
D. Digital Quality Measurement: Understanding and Evolving dQM, FHIR, ECDS and InteroperabilityAs NCQA implements its transition to fully digitized HEDIS measurement and reporting, this workshop will include a deep dive into everything you need to know for success including:
Workshop Leaders:Dwight PattisonVice President of Consulting & Professional ServicesHealthmine Kimberly SwansonSenior Vice President of Consulting & Professional ServicesHealthmine |
7:00 |
Registration & Networking Continental Breakfast
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8:00 |
Chairperson’s Opening Remarks
Denise Doucette-Ginise, MSN, RN, CCM, CHPN,Director of Member Experience, Medicare, Point32Health, Harvard Pilgrim Health Care & Tufts Health Plan |
8:10 |
Stars in the Aftermath of the PandemicThis session will include a technical and regulatory update including in industry landscape update based on the 2023 Star Ratings and a detailed review of known and proposed changes on the horizon for 2023. We’ll cover an array of emerging industry developments impacting HEDIS, CAHPS, HOS and Part D measures. Melissa Smith,Executive Vice President, Consulting and Professional Services, Healthmine |
Real Solutions for Member & Provider Engagement – From Data to Relationships – Boosting CAHPS & HOS Scores | |
8:40 |
Member Experience: Using Claims Analytics to Increase CAHPS ScoresWorried about member satisfaction? Annual CAHPS scores not providing enough data and insight to drive improvement programs in this area? Join Hagy from Buckeye Health Plan and her longtime consultant and collaborator Liz to explore the projects and challenges they’ve worked on together for the past 6 years. Dive into new claims-based indicators that the team is using to measure member experience on a monthly basis to get real-time insight into pain points and opportunities for improvement. Come away from this session with creative ideas to implement in your own organization to address member experience and satisfaction. Hagy Wegener,Senior VP of Quality and Risk Adjustment, Centene; Buckeye Health Plan and WellCare of Kentucky Liz Carr, Vice President, Product Delivery & Client Services, Nagnoi Health |
9:10 |
Prepare a Winning HEDIS and DV Star Strategy for Today and TomorrowThis session will explore actionable steps to prepare for existing, new, and future HEDIS Star measures. Learn tips and tricks for the BCS and COL Star transition to ECDS reporting and how to get ready for Social Need Screening and Intervention (SNS-E), a possible future Star. Develop reporting synergies between the HEDIS and Data Validation Star measures including: Comprehensive Medication Review, Transitions In Care, SNP Care Management and Care of Older Adults. Julianne Eckert, RN BSN, CCM, CMCN, ACMPSenior Director of Clinical Quality Programs, Clover Health Katharine IskrantPresident, Healthy People |
9:40 |
Panel Discussion: Member Experience & Engagement Tools & Strategies – Increasing CAHPS & HOS Scores
Moderator:Kimberly Swanson,Senior Vice President of Consulting & Professional Services, Healthmine Panelists:Cindy Aguglia,Manager, Medicare STARS & Quality, The Health Plan Brandon Solomon,Vice President, Client Advisory & Business Development, Convey Health Solutions Jacilyn Bennett,Area VP of Healthcare and Research Incentives,Blackhawk Network |
10:25 |
Networking Refreshment Break
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10:55 |
Charting a Path to 5-Star CAHPS: Challenges, Strategies, and Lessons Learned
Saeed Aminzadeh,Chief Executive Officer,Decision Point Healthcare Solutions Mark Pencek,Vice President, Customer Experience,Medical Mutual |
INTEROPERABILITY AND DATA CAPTURE – ACCESSING, ANALYZING AND ACTIONING DATA FROM MULTIPLE SOURCES | |
11:25 |
Case Study: Interoperability Realized: Harnessing NLP & AI for Data Capture and Quality Measurement
This session will engage participants about a health plan’s road map to utilize technology for data
capture and quality measurement.
Renee Golderman,Senior Vice President, Chief Quality Officer, Capital District Physicians’ Health Plan(CDPHP) |
11:55 |
Obtaining Clinical Data at Scale is the Only Way to Win at Stars and HEDIS!Clinical data acquisition is at the heart of CMS’s strategy to relieve the burden from providers for chart requests and get to outcome measures that matter. NCQA's roadmap is to eliminate hybrid in the next 5 years and go only digital measures. What can you do about that? We will discuss strategies that work. There is no silver bullet, just lots of data access channels and a lot of hard work. Terri Kitchen, Divisional Vice President, Quality & Accreditation,Health Care Service Corporation(HCSC) |
12:25 |
Networking Lunch
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1:25 |
Exploring the Evolving Supplemental Benefit and Other New Products and Services to Boost Outcomes and Member ExperienceThis panel will explore how emerging products and services help health plans deliver exceptional member experiences and boost quality outcomes and scores. Hear how leaders in supplemental benefits and clinical solutions are: reinventing product delivery; embracing changes to Stars, marketing guidelines, and benefit design policies; and working with health plan partners to define, measure, and impact critical performance metrics. Moderator:Daniel Weaver,Executive Vice President of Product Operations and Stars Strategy,NationsBenefits Panelist:Nikki Hungate, MS, MHA, Director, Medicare & Gov’t Programs Product Strategy,MVP Health Care Dr. Rob Mordkin, MD, FACS, Chief Medical Officer,LetsGetChecked Dr. Claude Pinnock, Chief Medical Officer, Wider Circle |
2:10 |
Star Measure Updates: 2023 Results and 2024 Changes
Dani Cronick, FSA, MAAA,Senior Consulting Actuary, Wakely Consulting Group Christina Byrne ASA, MAAA,Consulting Actuary, Wakely Consulting Group |
The Clinical Measures – Maintaining Compliance and Increasing Quality of Care | |
2:40 |
How to Tackle the New CMS 2024 Medicare Stars Clinical Measures
Mallory Mueller,Director Quality Health Integration, Network Health |
3:10 |
Networking Refreshment Break
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3:40 |
Balance Compliance with SMS Outreach to Engage Medicare Members and Improve Outcomes
What does it take to balance compliance concerns with modern outreach to engage more Medicare members toward better health? Learn how one health plan satisfied internal requirements and successfully expanded outreach beyond mailers and email to savvy seniors with SMS technology.
Allie El-Tawil,Stars Business Analyst, Blue Cross Blue Shield of Arizona Reva Sheehan,Customer Insights Director, mPulse Mobile |
4:10 |
Developing Innovative Partnerships for Diverse Populations with Severe and Persistent Mental Illness to Close Gaps in Care
Disparities across various preventive measures go beyond addressing race/ethnicity and one’s language.
Disparities also exist between population groups for members who experience severe and persistent
mental illness (SPMI). These individuals are at risk of dying 10-20 years earlier than the general
population. Closing gaps in care for these unique population groups require distinct engagement
strategies. In addition, these members often experience social barriers to care and require culturally
appropriate engagement strategies to understand 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 for the SPMI
population. After this presentation, attendees will be able to:
Jamie Galbreath, PhD, MPH, CHES,Quality Improvement Director, UCare |
4:40 – 5:40 |
Networking Reception
Sponsored by![]() |
7:00 |
Networking Continental Breakfast
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8:00 |
Chairperson’s Remarks
Denise Doucette-Ginise, MSN, RN, CCM, CHPN,Director of Member Experience, Medicare, Point32Health, Harvard Pilgrim Health Care & Tufts Health Plan |
Plan-wide Innovations to Increase Performance Scores | |
8:05 |
Maintaining Market Share as a 5 Star Plan in a 5 Star MarketHear from a community based, not-for-profit health plan about the impacts of being a 5 star plan in a 5 star market. In 2022, this plan found itself in the unique position of earning a 5 star on all three of it’s contracts. While a record number of other plans also earned this achievement in 2022, the Western New York market had two other organizations with this 5 star rating on one of it’s contracts which set up for a very interesting 2022 selling season. We will discuss the impacts star ratings having on beneficiary plan selection, enrollment data in a very competitive market, as well as considerations for brokers and other marketing factors while maintaining and growing market share in a very competitive environment. Dawn Odrzywolski,Vice President, Medicare Programs, Independent Health |
8:35 |
Panel Discussion: That Nobel Dream -- Targeted Approaches for Raising Particular Star MeasuresEach year, invest more in raising their star ratings and with recent policy changes set to lower star ratings, these investments are more necessary than ever. The tried and true star rating strategies discussed in other sessions is good and important, but in this session, you’ll learn about unconventional star-raising strategies focused on particular measures. They include: Rx Real Time Benefit Tools that substantially lower the drug spend, drug alternatives that lessen the need for adherence monitoring, and platforms that successfully manage in-home services that can either raise or crash CAHPS scores. Moderator:Kacey Dugan, Director, Faegre Drinker Consulting Panelists:Keith Gaetano, PharmD, Director of Pharmacy – Health Plans, Rx Savings Solutions Elizabeth Klodas, MD, FACC Founder Step One Foods Andy Friedell, Founder and CEO, healthAlign |
9:25 |
Utilizing the Local Pharmacist for Interventions that Drive Quality Performance and Member ExperienceThe local Pharmacist can execute on clinical intervention engagement and completion to drive quality performance for health plans. Pharmacists interact with their patients more often than any other healthcare provider and we’re seeing improvement on quality and the member experience. Leveraging the relationship between the local pharmacist and the community they serve, has shown to be a successful model for engagement and maintaining relationships. During this presentation, you will see how presenting these opportunities allows pharmacists to act in a timely and efficient manner in their everyday practice. Dean Koskinas,Executive Sales Director,Enhanced Medication Services |
9:55 |
Networking Refreshment Break |
10:25 |
Key Strategies to Overcoming the New Hurdles to Attaining/Maintaining High Star Ratings
Moderator:Daniele Chenal,Co-Founder CAG Solutions, Director, Inspire Innovations Panelists:Cortney Resto, VP Appeals and Grievances, EmblemHealth Rebecca Croft,Manager of Process Automation, Commonwealth Care Alliance |
Focus on Social Determinants of Health & Health Equity -- Meeting Evolving Regulatory Mandates and Increasing Access to Care and Quality of Care | |
10:55 |
The Growing Intersections Between SDOH Needs and Care GapsThis session will highlight several of the surprising data intersections between SDOH needs and care gaps that DUOS has surfaced in our work supporting Medicare Advantage populations and the resulting impacts - and opportunities - for critical health plan performance indicators. Eric Santa, Chief Growth & Strategy Officer,DUOS |
11:25 |
Addressing SDOH Barriers to Drive Improvements in Health Equity through a Community Health Model
This session will highlight how a payer started a journey that entailed a retrospective look at its
approach to traditional care models to an SDOH pilot later yielding a fully scaled program, committed to
whole-person care to improve outcomes rooted in addressing social needs. At a glance Horizon
Neighbors in Health is promoting the following for our members and the communities we serve.
Tracy Parris-Benjamin,Director, Community Health and Health Equity, Horizon Blue Cross Blue Shield of New Jersey |
12:05 |
Unpacking the New HEDIS Social Need Screening and Intervention (SNS-E) MeasureIn this session take a look at the technical specifications for the new ECDS SNS-E measure and gain a better understanding of the screening tools and codes that are required for numerator compliance. We will explore current state of SDOH data in relationship to the SNS-E measure. Sharon Kuhrt, RN, DNP,Director, HEDIS and Data Analytics, Priority Health |
12:35 |
Close of Conference |