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

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.

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 and 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.

11:00am – 11:45am
Creating a Culture of Quality from the Top Down
To successfully improve and maintain high Star Ratings, health plans must employ an ongoing commitment to creating a culture of quality from the top down. Leadership must make Star Ratings a focal point of their organization. This session will examine how to empower a multi-departmental team responsible for developing and implementing a comprehensive Star Ratings strategy that includes objectives, goals, resource management, frequent evaluation and management updates.

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. 

12:30pm – 1:30pm
Luncheon 

1:30pm – 2:15pm
Telehealth Impact to Star Ratings and Risk Adjustment for Medicare Advantage
Providers are increasingly shifting care towards telehealth due to the COVID-19 pandemic. CMS relaxed requirements related to the use of telehealth visits with Medicare Advantage populations. This session will examine how telehealth can help health plans improve Star Ratings by actively engaging members and delivering better, more frequent care, and provide insight on the impact telehealth visits of telehealth visits on star ratings and risk adjustment.

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

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

3:45pm – 4:30pm
Utilizing AI-Powered Quality Abstraction to Position Your MA Star Ratings for Success
Financial incentives and increased enrollment are some of the benefits associated with a health plan having strong MA Star Ratings, but knowing where to start and how close they may be to reaching the next Star can be tricky. With CMS making regular adjustments to MA Star Ratings, it is common to see measures increase or decrease in weight and be added and retired over time. However, while these changes have come to be expected, plans are still challenged with keeping up with these changes and building a strong quality team that can accurately measure compliance. In addition, plans need to consider finding efficient methods of closing quality gaps on non-standard supplemental data, unstructured data that are buried in medical notes that are most often overlooked when data is abstracted manually. With these factors in mind, plans should consider looking into a solution that allows them to adequately identify and improve quality measures that are close to reaching the next Star. This session will examine how AI-powered quality can help your organization's ability to be successful in your CMS MA Star Ratings. 

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.

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

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 

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

10:15am – 11:00am
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 Star Ratings 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

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.

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. 

12:30pm
Conference Concludes 

Workshop - Friday, September 23, 2022
Venue

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 **

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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