2022 Medicare Advantage Congress

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COVID-19 Advisory: BRI Network holds above all else, the health & safety of our attendees and their families. Currently this event is scheduled as an in-person event. We will however, continue to monitor and follow recommendations regarding capacity from CDC and other health agencies.

About the Conference

Medicare Advantage (MA) is rapidly growing. Enrollment in the program has increased from 26% of Medicare in 2012 to 42% in 2021, now including more than 24 million beneficiaries. As the country’s aging population gets larger, Medicare Advantage participation is expected to swell: the Congressional Budget Office projects enrollment in these plans to rise to about 51% by 2020. Below the surface, though, lie difficult dynamics and increasingly tough competition. Large incumbents, along with powerful regional players, have built strong defenses. New entrants must develop a compelling value case to gain a foothold, much less seize significant share. There’s plenty to attract payers to Medicare Advantage. But playing the game at a winning level requires a defined strategy that is consistent with the organization’s core competencies, and a substantial degree of commitment. In this competitive arena, management teams must carefully assess their opportunities. This conference will explore what health plans need to know to get into the market or increase their current share, as well as how to prepare for a Medicare Advantage boom.

Who Should Attend?

From Health Plans/Health Systems/ Managed Care Organizations:

  • Chief Executive Officers
  • Chief Operating Officers
  • Chief Financial Officers
  • Chief Marketing Officers
  • Chief Medical Officers
  • Chief Strategy Officers
  • Chief Pharmacy Officers
  • Chief Information Officers

Also Presidents, Vice Presidents, Directors and Managers of:

  • Star Ratings
  • Medicare
  • Managed Care
  • Senior Products
  • Quality Improvement
  • Marketing
  • Compliance
  • Care Management
  • Operations
  • Strategy
  • Business Development
  • Regulatory Affairs
  • Risk Management
  • Utilization Management
  • Business Development
  • Medicare Stars
  • Medicare Advantage
  • Government Programs
  • Data & Analytics
  • Sales
  • Medical
  • Product Development
  • Finance
  • Quality
  • Value-Based Care
  • Disease Management
  • Community Health
  • Network Management
  • Pharmacy

Also of interest to Pharmacy Benefit Managers; Solution Providers; Healthcare Consultants; Vendors

Conference Agenda

Day One – Monday, January 31, 2022

7:15am – 8:00am

Conference Registration and Networking Breakfast

8:00am – 8:15am

Chairperson’s Opening Remarks

8:15am – 9:00am
How Medicare Advantage Plans are Reducing Readmissions

Savvy Medicare Advantage (MA) plans have stayed ahead of the curve and have found innovative ways to reduce hospital readmissions. Many have done so for all the right reasons – not because reducing readmission saves MA plans money but because readmissions reduction programs focus on taking better care of patients. This session will explore best practices for an integrated approach and how MA plans are spearheading this change in the healthcare delivery system.

Julie Van Dusen, MSN, RN
Director, Care Coordination
Genesis Medical Center 

Todd Gray, MD
Genesis Medical Center

9:00am – 9:45am
Medicare Advantage Product Bid Process

Each year Medicare Advantage organizations must file their annual bid. The bid process is complex, but a foundational component for your Medicare Advantage success. This session will explore the following questions regarding the product bid process. What you should I know about the MA Product Bid process?  What key inputs should be gathered in preparation for the MA Annual bid?  Should SSBCIs or VBID be considered? Each Medicare organization should take the time to collect necessary inputs to create the best winning product strategy.

Ben Tonga
Director, Medicare Advantage
University of Utah Health Plans

9:45am – 10:15am
Networking and Refreshments Break

10:15am – 11:00am
Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future
Telehealth has experienced a rapid escalation in use during the COVID-19 pandemic. Before the pandemic, coverage of telehealth services under traditional Medicare was limited to beneficiaries living in rural areas only, with restrictions on where beneficiaries could receive these services and which providers could be paid to deliver them. Soon after the federal government declared a public health emergency due to COVID-19 in early 2020, Congress and CMS expanded traditional Medicare’s coverage of telehealth services in order to make it easier for beneficiaries to get medical care and minimize their exposure to coronavirus in healthcare settings. When the public health emergency ends, however, Medicare’s coverage of telehealth services will revert back to the more limited availability that existed before the pandemic, unless policymakers take action to extend the expanded coverage. However, such limitations do not apply in Medicare Advantage plans, which have flexibility to offer additional telehealth benefits not covered by traditional Medicare outside of the public health emergency. This session will explore how to ensure continued access to these services, while balancing concerns about quality of care and spending.

Nikki Hungate, MS, MHA
Senior Leader, Medicare Government Programs Product Strategy & Design
MVP Health Care

11:00am – 11:45am
Strategic Approach to Improving Medication Reconciliation & Reducing Readmission Rates

Many plans experience high readmission rates and often these are unplanned from patients whose conditions deteriorate soon after treatment. This can be an enormous and expensive burden on the care system and health plan. This session will engage attendees on how to strategically leverage medication reconciliation post discharge in-house post hospitalization while reducing readmission rates for their members. After this presentation, attendees will be able to:

  • Identify how to improve the Transitions of Care measure specifically for medication reconciliation
  • Learn how leverage internal staff and/or teams to conduct medication reconciliation
  • Understand the impact of conducting medication reconciliation and its relationship to reducing readmission rates

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

11:45am – 12:30pm
Medicare Advantage Compliance: What You Should Know

CMS requires Medicare Advantage plans to ensure certain compliance requirements are met.
This session will explore what health plans must do to remain compliant with the Medicare Advantage compliance requirements. Topics to be discussed will include:

  • Compliance standards, policies and procedures
  • Employee training and education
  • How to recognize and report noncompliance
  • Routine self-monitoring and auditing
  • Recognizing any potential fraud, waste or abuse
  • Maintaining evidence

Gloria Yu, CHC
Medicare Compliance Officer
Capital Blue Cross

 

12:30pm – 1:30pm
Lunch Break

1:30pm – 2:15pm
Remote Patient Monitoring
As the COVID pandemic wreaked havoc on healthcare systems across the country, innovative methods were used to ensure the right resources were provided to the right patients at the right time in the right place. In addition to utilizing alternate brick and mortar care sites we also developed a program to utilize continuous remote patient monitoring so we could provide treatment in the patient’s home. During this presentation Dr. Keeperman will describe the program characteristics, metrics related to program successes, challenges faced, and benefits obtained.

Jacob B. Keeperman, MD, FACEP, FAEMS, FCCM
Executive Medical Director, Renown Transfer and Operations Center
Intensivist
Renown Health

2:15pm – 3:15pm
Panel: Medicare’s Current and Future Role in Improving Health Equity
As the nation’s largest purchaser and regulator of health care, Medicare plays an important role in expanding coverage, improving the affordability of healthcare for vulnerable populations, and reducing racial and ethnic disparities in health coverage and access to care. Medicare Advantage is associated with better quality outcomes and ambulatory care access for minority populations compared to traditional Medicare. A person’s health is influenced by many non-medical factors, called social determinants of health – where a person lives, grows learns and works. In this session, Medicare Advantage plans will discuss how they are committed to creating new programs and innovative solutions that help members overcome barriers to health, improve individual and community health, and advance health equity while giving members greater peace of mind.

Moderator:

Jan Smith Reed
Director, US Healthcare
T-Base Communications

Panelists:

Naomi Irvin
Chief of Staff – Government Markets
Blue Cross Blue Shield of North Carolina 

Ben Tonga
Director, Medicare Advantage
University of Utah Health Plans

3:15pm – 3:45pm
Networking and Refreshments Break

3:45pm – 4:30pm
How a Successful MTM Program Boosts Star Ratings & Outcomes
Program will cover the impact of the pharmacy department on star ratings, member retention, agent/broker approval with health plan and savings generated by a hybrid MTM in-house program. Will discuss the approach the pharmacist from the health plan takes with providers and members to help them understand the pharmacy benefit. Member and Health Plan cost savings are tracked to show the impact of pharmacy on member and provider satisfaction.

Gary Melis, R.Ph.
Pharmacist
Network Health

4:30pm – 5:15pm
Addressing Social, Medical and Economic Needs
As Medicare Advantage (MA) continues to serve a proportionally higher-risk and more diverse enrollment population, many plans are taking innovative approaches to addressing social determinants of health (SDOH) for MA beneficiaries, while acknowledging barriers that remain. Serving Medicare beneficiaries with complex health care needs requires understanding both the medical and social factors that may affect their health. This session will explore SDOH, discusses the challenges of addressing social determinants in Medicare, and provides examples of how Medicare Advantage health plans are working to directly address social determinants of health. Also learn recommended actions to improve the ability of Medicare Advantage health plans to more directly address social determinants of health to improve patients’ health outcomes.

Wynda Clayton, MS, RHIT
Risk Adjustment Manager
Providence Health Plan

5:15pm
End of Day One

Day Two – Tuesday, February 1, 2022

7:15am – 8:00am
Networking Breakfast

8:00am – 8:15am
Chairperson’s Recap

8:15am – 9:00am
Data Analytics for Medicare Advantage Star Ratings
Health plans need to take into account member surveys and data analytics for best meeting new Medicare Advantage Star Ratings programs. This session will explore using advanced data analytics to identify target member populations and individuals. In addition, the use of episode analytics to help payers to predict healthcare spending and member behaviors for ultimately mapping and isolating member priorities will be discussed.

Leslie Robert Jebson
Executive Director-Clinical Strategy and Initiatives
Texas A&M Health 

9:00am – 9:45am
Patient-Centered Care
The number of baby boomers turning 65 years is growing and the majority of these beneficiaries face the challenges of living with serious chronic conditions. The emphasis on patient-centered, disease-specific, effective care delivery and benefit design in Medicare Advantage is increasingly important as Medicare faces these challenges. With the weight of Member Experience measures going to 4 in 5 STAR quality, there is increased emphasis on patient access and experience that it is an essential driver of health plan quality. This session will explore use cases

  • Key Insights from Voice of the Older Adults to be deliver patient-centered care
  • New member onboarding
  • Continuity of care

Archie Dey
Director of Consumer Experience and Insights
SCAN Health Plan 

9:45am – 10:15am
Networking and Refreshments Break 

10:15am – 11:00am
Expanded Supplemental Benefits: A Look at Availability and Enrollment
Research shows that when medical care is delivered alongside nonmedical services that affect health, patients, caregivers and the health care system overall are better off. Social services not traditionally considered medical services, such as transportation and nutrition, are particularly crucial for meeting the needs of high-need, high-cost Medicare beneficiaries; in addition to improving health outcomes, they may also lower costs. Medicare Advantage (MA) plans are seeing increasing numbers of enrollees who have social risk factors and complex medical needs. Recently, both Congress and CMS have granted these plans new flexibilities in designing benefits, with the goal of improving outcomes and lowering costs, particularly for enrollees with chronic conditions. This session will assess the availability of and enrollment in MA plans offering new types of supplemental benefits. And, in looking ahead, it will be important to better understand the impact of COVID-19 on supplemental benefits in MA, as well as how these benefits can help drive positive health outcomes for members.

Todd Rau
Director, Medicare Markets
Indiana University Health Plans, Inc. 

11:00am – 11:45am
Addressing Social Determinants of Health:  A Holistic Approach to Health and Well-Being
Medicare Advantage plans have increasingly turned their attention to addressing social determinants of health (SDOH), the non-medical factors that influence health outcomes. This focus on SDOH reflects broader trends in the U.S. health care system, including a growing recognition that addressing unmet social needs may have a greater impact on health outcomes than clinical care alone.  This session will explore ProMedica’s innovative approach to connecting patient, member and community needs to address holistic health and well-being

Kate Sommerfeld
President
ProMedica’s National Social Determinants of Health Institute 

11:45am – 12:30pm
The Impact of Provider Engagement on Quality, Costs and Outcomes
Because healthcare market dynamics now impose risk adjustment and quality standards on financial performance across all market segments, including Medicare Advantage, in order to balance risks, improve quality and decrease costs, health plans must move beyond retrospective claims analysis and basic assessments. To optimize potential, health plans must fully engage those who serve on health care’s front lines: providers. Providers are the linchpin in improving plan performance. This session will explore actions plans should focus on, including:

  • Overcoming physician resistance with physician engagement tools and services
  • Filling gaps in physician engagement with member engagement tools and services
  • Establishing an overall performance management infrastructure
  • Building actionable clinical programming that integrates into existing provider workflows and addresses the needs of complex patients

Adam Hoffman
Quality Improvement Program Manager
Clover Health 

12:30pm
Conference Concludes

Workshop – February 1, 2022

12:45pm – 2:45pm
Leveraging the Power of Special Needs Plans to Support Growth and Profitability

This workshop will explore the opportunities available to Medicare Advantage plans to use the power and flexibility of MA Special Needs Plans (SNPs) to target special populations and grow membership. During the workshop, we’ll discuss strategic options for developing SNPs, how to build a state of art Model of Care and how, if managed appropriately, a SNP can contribute to an organization’s top line margin.

Henry W. Osowski
Managing Partner
Strategic Health Group LLC

Featured Speakers

Ben Tonga

Ben Tonga

Director, Medicare Advantage

University of Utah Health Plans

Nikki Hungate, MS, MHA

Nikki Hungate, MS, MHA

Senior Leader, Medicare Government Programs Product Strategy & Design

MVP Health Care

Jamie Galbreath, PhD, MPH, CHES

Jamie Galbreath, PhD, MPH, CHES

Quality Improvement Associate Director

UCare

Gloria Yu, CHC

Gloria Yu, CHC

Medicare Compliance Officer

Capital Blue Cross

Jacob B. Keeperman, MD, FACEP, FAEMS, FCCM

Jacob B. Keeperman, MD, FACEP, FAEMS, FCCM

Executive Medical Director, Renown Transfer and Operations Center

Intensivist
Renown Health

Naomi Irvin

Naomi Irvin

Chief of Staff – Government Markets

Blue Cross Blue Shield of North Carolina

Gary Melis, R.Ph.

Gary Melis, R.Ph.

Pharmacist

Network Health

Wynda Clayton, MS, RHIT

Wynda Clayton, MS, RHIT

Risk Adjustment Manager

Providence Health Plan

Leslie Robert Jebson

Leslie Robert Jebson

Executive Director

Texas A&M Health Science Center

Archie Dey

Archie Dey

Director of Consumer Experience and Insights

Todd Rau

Todd Rau

Director, Medicare Markets

Indiana University Health Plans, Inc.

Kate Sommerfeld

Kate Sommerfeld

President

Adam Hoffman

Adam Hoffman

Quality Improvement Program Manager

Clover Health

Julie Van Dusen, MSN, RN

Julie Van Dusen, MSN, RN

Director, Care Coordination

Genesis Medical Center

Todd Gray, MD

Todd Gray, MD

Medical Director

Genesis Medical Center

Hank Osowski

Hank Osowski

Managing Partner

Strategic Health Group LLC

Venue

Bellagio
3600 Las Vegas Blvd. S
Las Vegas, NV 89109
702-693-7111

“Mention BRI Network to get the discounted rate of $179/night (average rate)”

Sponsors and Exhibitors

Associate Sponsor

For almost 30 years, T-Base has simplified the fast, secure delivery of accessible communications at an enterprise scale, empowering consumers who are partially sighted or blind. By streamlining transcription for braille, large print, audio, accessible PDF and more, delivering documents in alternate formats, and providing PDF remediation and digital accessibility audits, T-Base significantly reduces IT expenses and time for enterprise customers including Fortune 500 companies, leading banks, telecommunications, healthcare and educational institutions.

Exhibitors

FAQ

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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