2022 Star Ratings and Quality Improvement Summit
September 22-23, 2022 * The Westin Kierland Resort & Spa * Scottsdale, AZ

2022 Star Ratings and Quality Improvement Summit

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About the Conference:

Achieving value-based healthcare and obtaining a five star score is at the forefront of Medicare Advantage organizations today. CMS measures are continuing to evolve and today there are new measures surrounding the member experience. As the Five Star Quality Rating System continues to evolve and expand and set higher stakes, organizations are seeking out new methods and interventions which will allow them to maintain or achieve the desired Five Star Ratings. Health plans and providers are engaging in collaborative partnerships to improve quality and performance, engage providers and members, improve patient outcomes, improve access, while reducing spending.

We have created an exciting, high-level forum featuring knowledgeable leaders and executives from the nation’s leading health plans, hospitals and health systems who will share their perspectives, valuable insights and expertise on how to be best equipped for the rapidly evolving and critical changes in achieving Five Star Ratings. Attendees will benefit from learning about new best practices, initiatives and strategies that have been deployed to improve the quality and delivery of healthcare while reducing costs, boosting revenue and improving member satisfaction.

 

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
  • 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
  • Pharmacy
  • Disease Management
  • Community Health
  • Network Management
  • Pharmacy

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

 

Conference Agenda

Day One - Thursday, September 22, 2022

7:15am – 8:00am
Conference Registration & Networking Breakfast 

8:00am – 8:15am
Chairperson’s Opening Remarks 

8:15am – 9:00am
The Star Ratings Landscape
For health plans, an understanding of CMS’s Star Ratings and what’s in store for the future is crucial to developing and implementing effective operational and quality improvement strategies. This session 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 and impact

Julia Rosenbaum
Director, Stars Programs
Devoted Health 

9:00am – 9:45am
Rating The Medicare Advantage Star Ratings—Improving The Status Quo
As enrollment rises, the MA star ratings program will be an increasingly important tool for helping Medicare patients access high-quality health coverage. Determining how to best structure the program can guide future policy discourse on the most effective ways to measure the quality of health insurance. To improve the star ratings program, its measures must include fewer administrative measures, risk-adjusted mortality rates, and more equitable risk-adjustment formulas. Ultimately, the star ratings program must be adjusted to emphasize and incentivize each plan’s commitment to the fundamental purpose of health care: improving health. This session will explore ways to improve the MA star ratings measures.

Ericka Saielli
Health Services Director
NATIVE Health 

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

10:15am – 11:00am
Building a Comprehensive Strategy for Medicare Advantage Star Ratings
Health plan leaders are well aware that achieving and maintaining excellent Medicare Advantage Star Ratings has become increasingly difficult. At best, a high rating is a moving target as CMS continually evolves the program and consumers refine their expectations. For example, CMS recently placed greater emphasis on measurement categories that have often eluded health plans: improving medication adherence & member experience. Does your health plan have the right tools to hit critical Medicare Advantage Star Ratings cut points required to earn quality bonus payments, even as competition becomes more fierce? This session will explore how health plans can build or improve upon a strategy to achieve the highest MA Star Ratings.

David Manning
Owner
Five Stars Insurance Plans 

11:00am – 11:45am
Creating a Culture of Quality from the Top Down
In today's healthcare environment, HEDIS scores and Star Ratings are becoming an essential part of your overall marketing strategy. The best way to improve your scores is by making sure you have a streamlined and complete medical record system. This session will cover the following topics:

- Why accurate patient data is important

- What impact a complete chart may have on your rating

Jatin Dave
Chief Medical Officer
Mass Health 

11:45am – 12:30pm
Ways to Improve STAR Ratings with Member Engagement
Medicare Advantage carriers typically focus their business development efforts on annual enrollment sales for growing new members. But while the annual enrollment period is certainly important, smart health insurers are beginning to provide proactive, knowledgeable, skillful member engagement tactics throughout the year to improve member satisfaction and retention, and ultimately, improve STAR ratings. This session will explore best practices your member engagement call center should follow to ensure customer satisfaction and retention all in a strategic effort to improve your STAR rating.

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

12:30pm – 1:30pm
Luncheon 

1:30pm – 2:15pm
Virtual Care Impact to Medicare Advantage Care Delivery and Star Ratings
Payers and providers are continuing to shift care towards virtual solutions designed to be more accessible, cost effective, and delivered in a safe convenient in-home setting.   COVID-19 contributed to this accelerated shift, and CMS continues to recognize the value with relaxed requirements related to the use of tele/virtual health visits with Medicare Advantage populations. This session will examine how this evolving landscape can help health plans improve Star Ratings by actively engaging members and delivering better, more convenient, and frequent care, and provide insight on the impact on star ratings and risk adjustment. 

Evelyn Chojnacki
Director, Heath Plan Product Strategy
SWORD Health 

2:15pm – 3:15pm
Panel: 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

Moderator
Jan Smith Reed
Director, US Healthcare
T-Base Communications 

Panelists

Steven Peskin, MD, MBA, FACP
Senior Medical Director
Horizon Blue 

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

Judith Hamlin, RN, MS, FNP-C, CCM
Manager of QI, Member Engagement
WellCare Health Plans 

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

3:45pm – 4:30pm
Star Ratings and Medicare Advantage Medication
With the new Value-Based Care model, payers are looking at medication adherence as a key performance measure. Payers understand that chronic disease management is key to controlling costs and providing better outcomes for patients. Star Ratings are based on the Medicare Advantage and Part D Prescription Drug Plan comparison of performance on relevant measures of quality, health care outcomes, member satisfaction and customer service

Helen Liu
Vice President of Pharmacy Operations
ATRIO Health Plans 

4:30pm – 5:15pm
Integrating Risk Adjustment and Quality Improvement to Boost Scores
In this session you will 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.

Dr. Brian Stein
Chief Quality Officer
Rush University Medical Center

Dr. Thomas Webb
Associate Vice President, Quality Analytics
Rush University Medical Center 

5:15pm
End of Day One

Day Two – Friday, September 23, 2022

7:15am – 8:00am
Networking Breakfast 

8:00am – 8:15am
Chairperson’s Remarks 

8:15am – 9:00am
Strategies to Jumpstart HEDIS and Star Ratings Success
Juggling the many moving parts of quality management can be complex and time-consuming, so getting a jumpstart on HEDIS and Star Ratings improvement initiatives is critical. Timely and targeted campaigns that drive members to visit a provider not only promote better patient care but help close gaps early in the year. Health plans can use data to recognize impactful actions and reach appropriate members earlier than ever before. Topics to be discussed will include:

- Understanding membership needs for prioritizing resources and prepping for care services

- Incorporating consumer engagement to drive HEDIS and Star Ratings improvement

- Key dates, important updates, and tips for success

Brian Grgurich MSW, MPA, CPHQ
Director, Quality and Performance Improvement
Apricus Health 

9:00am – 9:45am
How Medicare Advantage Plans Can Boost Star Ratings with Proactive, Data-Driven Care

In order for Medicare Advantage plans to achieve the highest possible Star Ratings, it is important that they leverage clinical data and high-quality healthcare providers to offer proactive care in an efficient, convenient, and consumer-friendly way. This session will examine the following topics:

  • Using data to identify opportunities to improve care delivery
  • Curating a high-quality provider network built for success
  • Proactively engaging beneficiaries in their care

Ali Farrokhroo
Senior Vice President of Medicare Programs and Pharmacy
Alignment Healthcare 

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

10:15am – 11:00am
TBD

11:00am – 11:45am
Incentive Programs: Best Practices to Improve Member Health
Implementing a compliant incentive program that impacts Star Ratings is no easy task. For health plans to differentiate themselves, incentive plans need to take their cues from consumer loyalty programs—healthcare is more about the individual than ever before—and missing the mark on a consumer engagement strategy can result in a budget deficit, or even fines. This session will examine best practices for successful incentive rewards programs that impact Star Ratings. Topics to be discussed will include how to implement an incentive program and incentivizing with savings and experiences. 

Rohit Kumar
VP Strategy, Data and Information Technology (Medicare)
Aetna, a CVS Health Company 

11:45am – 12:30pm
Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans
Dually enrolled beneficiaries in Medicare and Medicaid are less likely to be enrolled in Medicare Advantage (MA) plans that perform well in the MA Star Rating program than non–dually enrolled beneficiaries. Some plans with a high proportion of dually enrolled beneficiaries, however, perform well in the MA Star Rating program. This session will explore ways MA plans and plans participating in the MMP demonstration are working to meet the needs of their dually enrolled beneficiaries. 

Mischael Metelus
Assistant Director Quality Management Medicare Part C/D
MetroPlusHealth

12:30pm
Main Conference Concludes

Workshop - Friday, September 23, 2022

12:45pm - 2:45pm
Strategies to Engage High-Risk Members and Boost Medicare Advantage Star Ratings

The Medicare Advantage Star Ratings heavily favor health plans that can effectively engage high-risk members who often struggle with medication adherence and access to chronic disease management resources. How can plans reach these challenging populations to boost their ratings and improve outcomes? For Medicare Advantage health plans, the Star Ratings system is a critical opportunity to showcase positive results in a dynamic, highly competitive marketplace. The public-facing ratings are hugely influential in member decision-making, not to mention that high performance is required to access quality bonus funds and enhanced marketing opportunities. To achieve the highest rankings, MA plans need to focus on several key areas, including member experiences and medication adherence – especially among high-risk, high-complexity members. Health plans that hope to hold onto their top marks in this pressure-filled environment will need to make a concentrated effort to identify, engage, and address the holistic needs of high-risk individuals. This session will explore how they can get started.

Tom Lutzow
Principal
Health Management Association

Featured Speakers

Christine Leo

Christine Leo

Vice President, Senior Products

Cigna

Ericka Saielli

Ericka Saielli

Health Services Director

NATIVE Health

David Manning

David Manning

Owner

Five Stars Insurance Plans

Jatin Dave

Jatin Dave

Chief Medical Officer

Mass Health

Jamie Galbreath, PhD, MPH, CHES

Jamie Galbreath, PhD, MPH, CHES

Quality Improvement Associated Director

UCare

Evelyn Chojnacki, MPH

Evelyn Chojnacki, MPH

Director, Heath Plan Product Strategy

SWORD Health

Jan Smith Reed

Jan Smith Reed

Director, US Healthcare

T-Base Communications

Steven Peskin, MD, MBA, FACP

Steven Peskin, MD, MBA, FACP

Senior Medical Director

Horizon Blue

Julianne Eckert RN BSN, CCM, CMCN, ACMP

Julianne Eckert RN BSN, CCM, CMCN, ACMP

Director of Quality Improvement

Clover Health

Judith Hamlin, RN, MS, FNP-C, CCM

Judith Hamlin, RN, MS, FNP-C, CCM

Manager of QI, Member Engagement

WellCare Health Plans

Helen Liu

Helen Liu

Vice President of Pharmacy Operations

ATRIO Health Plans

Dr. Brian Stein

Dr. Brian Stein

Chief Quality Officer

Rush University Medical Center

Dr. Thomas Webb

Dr. Thomas Webb

Associate Vice President, Quality Analytics

Rush University Medical Center

Brian Grgurich, MSW, MPA, CPHQ

Brian Grgurich, MSW, MPA, CPHQ

Director, Quality and Performance Improvement

Apricus Health

Ali Farrokhroo

Ali Farrokhroo

Senior Vice President of Medicare Programs and Pharmacy

Alignment Healthcare

Mischael Metelus

Mischael Metelus

Assistant Director Quality Management Medicare Part C/D

MetroPlusHealth

Rohit Kumar

Rohit Kumar

VP Strategy, Data and Information Technology (Medicare)

Aetna, a CVS Health Company

Tom Lutzow

Tom Lutzow

Principal

Health Management Association

Venue

Westin Kierland Resort & Spa

6902 E. Greenway Pkwy
Scottsdale, AZ 85254
480-624-1000

** Mention BRI Network to get a discounted rate of $289/night ** or use the link below to make reservations:

https://book.passkey.com/gt/218473555?gtid=231c7840aef43875ca7a6e83a882cb1

Sponsors and 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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