2020 Star Ratings & Quality Improvement Summit
Operational and Engagement Strategies to
Enhance Star Ratings and Quality Performance

January 26-28, 2020 * Fairmont Scottsdale Princess * Scottsdale, AZ

2020 Star Ratings & Quality Improvement Summit








About the Conference

To be best in class in today’s healthcare environment, a high Star Rating is just the beginning of a comprehensive quality assurance strategy. Challenging timelines and multiple performance areas make managing a Star program a complex and sometimes perplexing process. Increasing competitiveness requires us to continually strive for improvement even in those areas where we are performing well. Success necessitates constantly considering new tools and processes.

Savvy health plans that are attuned to member needs are building infrastructures and integrating key departments to drive quality from within. From capturing and implementing data to building a quality-oriented culture, these plans have excelled beyond traditional performance levels.

Also, with CMS setting high stakes and moving targets for Star Ratings, it is more important than ever to develop a winning game plan that will revamp your operational strategies, enhance your data gathering and analytics execution, and drive your quality goals forward.

Drive your plan forward by getting the latest techniques at the conference showcasing proven best practice strategies and innovations as implemented by top health plans and hear how they achieved high ratings. We’re bringing together leaders to explore the toughest questions that the industry struggles to answer, including – how do you continue to improve quality to earn and maintain 4 or 5-Star ratings? Join a range of experts from top-rated health plans and industry innovators to share information that you can put to use to boost quality in your own organization.

Who Should Attend?

From Health Plans; Health Systems/Hospitals; Service Providers; Consultants

  • Quality Improvement
  • Medicare Advantage
  • Pharmacy Administration
  • Utilization Management
  • Marketing
  • Product Development
  • Star Ratings
  • Care Management
  • Clinical Improvement
  • Business Development
  • Customer Service & Member Experience
  • Quality Analytics
  • Medicare Star Ratings
  • Behavioral Health
  • Member Outreach & Engagement
  • Informatics
  • Data Management
  • Chief Medical Officers
  • Analysts
  • Sales
  • Government Programs
  • Clinical Director

Also of Interest to Vendors; Solution Providers; Pharmaceutical

Conference Agenda

Day One – Sunday, January 26, 2020

4:00pm – 6:00pm

Exhibitor Set-up

6:00pm – 7:00pm

Cocktail Reception

Day Two – Monday, January 27, 2020

7:15am – 8:00am

Registration & Networking Breakfast

8:00am – 8:15am

Chair’s Opening Remarks

8:15am – 9:00am

Keynote: The Star Ratings Landscape

For health plans, an understanding of CMS’s 2018 Star Ratings and what’s in store for the future is crucial to developing and implementing effective operational and quality improvement strategies. This keynote will examine the current healthcare landscape and its impact on Star Ratings for health plans. Topics to be discussed will include:

– Highlights of CMS Star Ratings for Medicare Advantage plans
– Overview of future changes to CMS Star Ratings
– Quality improvement strategies to focus on
– Policy changes & impact

9:00am – 9:45am

Designing a Leading Healthcare Consumer Engagement Program to Improve and Sustain Strong Quality Performance

A Star Rating is about delivering real value to the consumer. To consistently yield positive outcomes, plans must move from siloed engagement approaches to a holistic approach designed to address and overcome barriers and improve outcomes. This requires change: changes to the types of data available for members; the approach to member interventions; and most importantly to the health plan’s philosophy and internal, departmental-level responsibility of impacting multiple outcomes. In this session, learn how plans have deployed a holistic member Star approach as part of their population health strategy. Topics to be discussed will include:

– Driving quality, risk adjustment and member satisfaction
– How an engaged consumer closes more care gaps while costing less in the long-term.
– Balancing, targeting and engaging members that are at greatest risk for undesirable, disparate outcomes
– Improving quality, satisfaction and growth.
– How to design a successful engagement program that matches your business objectives
– Core elements and benefits of an intelligently designed engagement program
– How to differentiate your brand and position for long-term success

9:45am – 10:15am

Networking Break

10:15am – 11:00am

The Impact of Social Determinants of Health on Star Ratings

This session will examine how to effectively address social determinants of health to enhance Star Ratings. Topics to be discussed will include:
– Improving quality of life, clinical outcomes and healthcare resource utilization
– Patterns in compliance
– Informing the design of targeted interventions
– Working with physicians and community stakeholders to address root causes of chronic diseases
– Interventions that have been effective in overcoming quality improvement challenges inherent in our communities’ social determinants of health
– How the data related to the social determinants of health be evaluated and used to promote higher quality scores

11:00am – 11:45am

Aligning Population Health Management and Physician Engagement to Boost Quality, Patient Satisfaction and Star Ratings

Provider engagement is key to nearly all Star measures. This presentation will focus on proven strategies to increase provider engagement and improve star ratings. Topics to be discussed will include:

– Boosting star ratings with an effective pay-for-performance strategy
– How to develop unique and targeted interventions to improve satisfaction of population segments within product lines
– Analyze results by provider to identify, inform and improve performance of outliers within your network
– Building a collaborative environment with your provider groups to establish a partnership

11:45am – 1:00pm


1:00pm – 1:45pm

Developing an Effective Incentive Program: A Vital Tool to Enhance Star Ratings

This session will examine how to use a quality incentive program to drive improvement. Examine how to improve outcomes and enhance engagement and deliver a comprehensive incentive program with quality as the driver. Topics to be discussed will include:

– Initiating an incentive program
– Compliance and reporting requirements
– Measuring the outcomes of an incentive program

1:45pm – 2:30pm

Medication Adherence: Innovative Strategies from a Highly Rated Plan

This session will examine insights and trends identified in medication adherence, including new approaches and best practices. Topics to be discussed will include:

– Identifying members at risk for non-compliance to implement targeted interventions
– Tools, programs, and resources that improve member adherence
– Types of pharmacy and partnerships that will improve member compliance
– Raising medication adherence scores by focusing on those members who are most likely to improve their adherence
– Effective strategies for ensuring provider collaboration
– Easy-to-implement strategies for using pharmacy data to assess trends and issues with medication adherence
– The use of analytical dashboards to better understand how to leverage limited resources for improving medication adherence
– Incorporating data into medication adherence outreach efforts
– Preparing for medication reconciliation post-discharge

2:30pm – 3:00pm

Networking Break

3:00pm – 4:15pm

Panel Discussion: Best Practices to Achieve Excellent Star Ratings

During this panel discussion, top-rated plans will share inside tips on making it to the top of Star Ratings. They’ll discuss specific interventions and processes that have helped them along the way. This discussion is designed to give you the opportunity to learn from your peers and colleagues in the Star Ratings trenches. Topics to be discussed will include:

– Strategies used to manage difficult populations and overcome barriers
– Member and provider engagement techniques vital for success
– Processes that have been used to maintain their highest ratings

4:15pm – 5:00pm

The Role of Data and Analytics in Improving Quality

Advanced analytics provide some of the best opportunities to leverage today’s massive amounts of data to its greatest advantage. This presentation will examine the current state of data management for health plans and providers, the main obstacles to successful data analytics, and the technology and tools that can help remove those challenges and deliver stronger health engagement. Topics to be discussed will include:
– Leveraging data analytics to measure and demonstrate superior clinical quality and program results
– Running reports to determine which measures to focus on
– Where most health organizations fail in terms of data, and the role that silos play in destroying its potential
– Key performance indicators that are the building blocks for higher Star Ratings
– Driving population health with improved access to data
– Implementable analytics strategies for targeting specific factors in quality ratings
– Looking at data qualitatively and developing an action plan
– Exploring sources of data
– Leveraging analytics to inform and change member behavior
– Using data to build a complete and culturally competent analysis of your member population


End of Day One

Day Three – Tuesday - January 28, 2020

7:15am – 8:00am

Networking Breakfast

8:00am – 8:15am

Chair’s Recap of Day 1

8:15am – 9:00am

Managing a Star Ratings Program Across a Matrix Organization

An effective Star Ratings program requires the input of everyone working within the organization. Departmental silos are seen as a pain point in many highly successful organizations. It is imperative that leadership prepares and equips teams with the tools needed to effectively eliminate silos, without impacting working relationships. This session will discuss how to create a unified vision for success and develop and implement a collaborative team to focus on improving Star Ratings, including:

– Cross-departmental responsibilities for outcomes and execution
– Steps to execute Star Rating projects across different departments and how to make this work
– How to get other departments to “own” Star Ratings measures
– Setting measurement goals for departments and getting their buy-in
– Building relationships with other departments to achieve organizational success
– Eliminating organizational silos to improve Star Rating outcomes
– Tools needed to communicate the plan and results to the C-suite

9:00am – 9:45am

Improving the Effectiveness of Stars Interventions Through Predictive Modeling

This session will examine how to leverage predictive analytics to target the members most likely to engage within a given intervention. The model seeks to address the challenge inherent in many Stars interventions, which is to provide the right messaging to the right member through the right channel to drive the right outcome. Examine the basic concepts of predictive modeling, including where it is commonly used and the potential applications—and limitations—of predictive models for Star Ratings and other quality measures. Topics to be discussed will include:

– Approaches to using predictive techniques to identify potential health risks that can be proactively targeted for interventions
– Fundamentals of how predictive modeling can drive quality improvement
– Types and components of predictive models that can be used for quality measures and Star Ratings

10:15am – 11:00am

Star Rating ROI

Star Ratings have been fully integrated into the Medicare payment methodology for several years. This session will discuss the financial impact of Star Ratings. Learn about the impact of Star Ratings on health plan revenue, and its impact on plan design.

11:00am – 11:45am

Integrating Risk Adjustment and Quality Improvement to Boost Scores

In this session you will learn about learn about how to boost quality scores by better integrating your risk adjustment and quality improvement programs. Hear about strategies for more effective utilization of both quality and risk data that can enhance intervention development. Understand the benefits of fully incorporation risk adjustment for streamlined processes, and how to develop contracts with providers that support risk adjustment and Star Ratings.

11:45am – 12:30pm

Leveraging the Opportunities between Medicare Advantage 5-Star and MACRA

This session will examine how MACRA’s quality components affect 5-Star Ratings. Attendees will gain a better understanding of MACRA regulations, examine how MACRA is impacting providers, and how plans can support providers and align incentives to improve quality ratings.


Conference Concludes

Workshop – Thursday, January 28, 2020



Fairmont Scottsdale Princess
7575 East Princess Drive
Scottsdale, AZ 85255

“Mention BRI Network for a special discounted rate of $269/night”

Sponsors and Exhibitors



Are there group discounts available?

  • Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee

Are there discounts for Non-Profit/Government Organizations?

  • Yes – please call us at 800-743-8490 for special pricing

What is the cancellation policy?

  • Cancellations received 4 weeks prior to the event will receive a refund minus the administration fee of $225. Cancellation received less than 4 weeks prior to the event will receive a credit to a future event valid for one year.

Can the registration be transferred to a colleague?

  • Yes – please email us in writing at info@brinetwork.com with the colleague’s name and title

Where can I find information on the venue/accommodations?

  • Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.

What is the suggested dress code?

  • Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket

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