Star Ratings and Quality Improvement Summit
Achieve and Sustain High Star Ratings, Enhanced Quality, Performance and Engagement Strategies
September 13-14, 2021 * Aria Resort & Casino * Las Vegas, NV

Star Ratings and Quality Improvement Summit

Day(s)

:

Hour(s)

:

Minute(s)

:

Second(s)

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

Organizations are continuing to implement innovative new approaches to improve performance and quality measures as the nation continues to move forward in achieving Value-Based Health and success with CMS Star Ratings. 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 four or five-star ratings. Health plans and providers are engaging in collaborative partnerships to improve quality, close gaps in care, improve patient outcomes, engage members while reducing spending creating savings.

As the Star measures continue to change and evolve, health plans are also following suit in order to achieve high star ratings which will determine reimbursement revenues, bonus payments, member enrollment, and marketing opportunities. We have created an exciting, high-level forum featuring knowledgeable leaders and executives from the nation's leading Health Plans 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 four or five Star Ratings.

Attendees will benefit from learning about new best practices, initiatives, and strategies that have been deployed to address the challenges presented under the Affordable Care Act to improve the quality and delivery of healthcare while reducing costs, boosting revenue, and improving member satisfaction. By attending the 2021 Congress for Star Ratings and Quality Improvement Summit you will learn about innovative programs and initiatives that have been implemented at leading Health Plans to successfully achieve and maintain high star ratings.

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
  • CAHPS
  • Customer Service & Member Experience
  • Quality Analytics
  • Medicare Star Ratings
  • Behavioral Health
  • Member Outreach & Engagement
  • Informatics
  • Data Management
  • Chief Medical Officers
  • Analysts
  • Telehealth
  • Sales
  • Performance Improvement
  • Director of Population Health
  • Compliance
  • Nursing
  • Government Programs
  • Clinical Director

Also of Interest to Vendors; Solution Providers; Pharmaceutical

Conference Agenda

Day One – Monday, September 13, 2021

7:15am - 8:00am
Registration & Breakfast

8:00am - 8:15am
Chairperson's Opening Remarks

8:15am – 8:55am
Addressing Social Determinants to Boost Quality and  Star Ratings 

Social Determinants of Health have significant impact on many aspects of the health care continuum from managing costs to achieving quality ratings. For SNP plans, these barriers can be even more significant. This session will explore successful strategies to address SDOH barriers and generate outcomes including:

Methods to identify and socialize SDOH barriers, engagement methodologies for a transient population,
community collaborations, as well as effective supplemental product design and strategic vendor partnership.

Daniel Weaver
VP Stars, Quality, and Risk Adjustment
Gateway Health Plan

8:55am - 9:35am
How the Pandemic Has Affected Medicare Advantage Plans and Navigating the Future

 This session will explore the impacts of the COVID19 pandemic and how it affected Medicare Advantage plans’ past and future.  The talk will focus on its impact on STARS, revenue, plan design, enrollment,     utilization, as well as sales and marketing.

Christine M. Leo
Associate Vice President, Senior Products
Cigna

9:35am – 10:05am
Mid-Morning Break

10:05am – 10:45am
Leveraging Telehealth to Improve Patient Access 

This session will discuss Kelsey-Seybold’s Virtual Health program and how it provided a critical bridge during the pandemic to continue care for Medicare Advantage plan members enrolled in its 5-star KelseyCare Advantage (KCA) plan.  The presentation will discuss how KCA members conducted more than 30,000 Virtual Visits from March – December 2020, allowing them to safely see their primary care doctors and specialists. Virtual Health Risk Assessments were also launched to allow members access to this important preventive exam with their doctor and support maintaining 5-start rankings for KCA.

Donnie Aga, M.D.
Medical Director for Healthcare Innovation
Medical Director
KelseyCare Advantage

10:45am – 11:25am
Embracing the Digital Transformation for Strong Star Ratings 

Melissa Smith
Executive Vice President of Consulting and Professional Services
Healthmine

Ken Holdcroft
Executive Vice President of Growth
Healthmine

11:25am - 11:55am
Breaking Down the Stars Performance Improvement Levers

Micky Twomey
President & Chief Operating Officer
Hyperlift

11:55am – 12:45pm
Lunch Break

12:45pm - 1:25pm
Improving the Member Experience to Achieve High Quality Scores 

Focusing on member experience and achieving high CAPHS rating has always been important, but achieving 5 Star CAHPs ratings is significantly more important due to the weightings of member experience measures being increased to a weighting of 4 for the CMS 2023 Star ratings. This presentation will focus on using predictive analytics to target those members who will mostly likely rate the plan lower and who are also more likely to respond to the survey if they receive it in the mail. The talk will also focus on the targeted interventions to reach out to those members.

David Larsen
Director, Quality Improvement
SelectHealth

1:25pm – 2:05pm
What’s in the Stars for the 2022 Star Ratings

Melissa Smith
Executive Vice President of Consulting and Professional Services
Healthmine

2:05pm – 3:05pm
Panel Discussion:   Innovative Strategies to Achieve Five Star Ratings in the New Landscape 

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

Panelists:

David Larsen
Director, Quality Improvement
SelectHealth 

Les Jebson
Executive Director
Texas A and M 

Daniel Weaver
VP Stars, Quality, and Risk Adjustment
Gateway Health Plan

3:05pm – 3:30pm
Mid-Afternoon Break

3:30pm – 4:10pm
Evolution of Telehealth Through the Pandemic.... The Adoption of These Technologies by Payors, Providers and Patients 

SPEAKER TBA

4:10pm - 4:50pm
Innovative Medication Adherence Strategies to Improve Outcomes and Boost Scores

Did you ever wonder why there is such an emphasis on Medication Adherence?  The weighting is a clear signal from CMS to partner with both members and Network Providers to ensure Medicare Beneficiaries achieve the best possible outcomes.  These measures are critical for achieving high star ratings.  This session will reveal how it starts with collaboration and how network Providers rely on payers to partner with them to point out trends or identify/remove barriers.   The talk will discuss how performance will depend on intentional collaboration and shared strategy in the following areas: Pharmacy Benefits Manager Strategy, Provider Strategy, and Member Strategy

Liz Haynes, MSN, RN, CCM
Director, Risk Adjustment and Stars - Government Programs
Blue Cross Blue Shield of Kansas City

4:50pm - 5:30pm
Partnering with Payers to Improve Chronic Disease Metrics

The Centers for Disease Control and Prevention (CDC) estimates that 90 percent of healthcare spending currently goes toward chronic disease management and mental healthcare.  As such, productive collaboration between the 3P’s [Patient, Provider, Payer] may lead to efforts in cost reduction and improved patient outcomes.  With this, the CDC has specifically identified heart disease and stroke as not only the most expensive, but also the leading cause of mortality.  This engaging and interactive presentation provides basic steps and real-world examples for scaling collaborative programs in efforts to reverse these trends.  The talk will examine focused collaborations leveraging payer expertise, primary care and behavioral health clinicians and EMR’s – in the identification and prioritization of defined patient populations for targeted interventions.

Les Jebson
Executive Director
Texas A and M

 5:30pm
End of Day One

Day Two – Tuesday, September 14, 2021

7:15am
Networking Breakfast

8:00am – 8:15am
Recap of Day One

8:15am – 8:55am
The Role of Data and Analytics in Improving Quality

Within healthcare organizations, the role of the data and analytics teams are becoming increasingly important toward improving the quality and external quality ratings of the organization. This session will discuss how the data and analytics teams have responsibility to provide insights to the organization from use of the vast data assets in healthcare. The talk will also delve into how data and analytics teams also play a critical role in advocating to external stakeholders, such as governments and other rating agencies, for better ways to measure quality.

Thomas Webb
AVP System Quality Analytics
Rush University Medical Center

8:55am – 9:35am
To Infinity and Beyond: Driving Star Ratings through Collaboration

Medicare Star Rating is profoundly consequential to Medicare Advantage Health Plans with substantive financial, marketing, and reputation consequences.  Meaningful and sustained collaboration between health plans and clinical organizations in the MA plan network is a lynchpin of success.  This session will review key success factors for effective payer/ provider collaboration. The talk will use specific examples and will offer lessons learned

Steven Peskin, MD, MBA, FACP
Executive Medical Director of Population Health and Transformation
Horizon Blue Cross Blue Shield

9:35am – 10:05am
Mid-Morning Networking Break

10:05am – 10:45am
Developing, Implementing and Sustaining Provider Engagement Strategies to Ensure Cost Effective, Healthy Outcomes

With the Covid-19 pandemic changing our daily activities, many of us have not been paying attention to external measures of quality. But our patients are paying attention, and we want to sustain the trust and belief they have in us as providers. This session will discuss how to re-focus your efforts on cost-effective high quality care and sustain the best outcomes for your patients.

Mary Reich Cooper, M.D., J.D.
Program Director, Healthcare Quality and Safety
Associate Professor, Population Health
Jefferson College of Population Health
Thomas Jefferson University
Chief Quality Officer and Senior Vice President, Clinical Services
Connecticut Hospital Association

10:45am – 11:25am
Intervention Strategies to Improve HEDIS Scores and Star Ratings 

HEDIS measures continue to have a significant role in the healthcare industry as a tool used for closing gaps in care and reducing costs through preventive services. This session will review successful tactics that UCare has used to improve HEDIS scores and ultimately Star Ratings.

Rachel Sterner, MPH
Stars Program Manager
UCare

11:25am – 12:05pm
Creating Sizzle for Your Consumer Appeal Steak 

This session will discuss how to effectively appeal and conduct outreach to your consumer.  The talk will explore how to deploy a coverage continuity program as well as making better use of Explanation of Benefits (EOBs). The presentation will also cover: Outreach to AI-predicted disenrollment candidates,
cultivating LTSS transfers for better coverage, as well as expanding in-home assessments

Thomas H. Lutzow, PhD, MBA
Chief Administrative Officer
Independent Care Health Plan (iCare)

12:05pm – 12:45pm
Maintaining ED Quality and Care During A Pandemic 

COVID-19 impacted the delivery of care in Emergency Departments from triage to admission.  This session will discuss how Stanford Health Care implemented various programs and initiatives to maintain high quality care during the pandemic.  The talk will delve into innovative ways to manage and test PUIs/COVID patients, communication in the ED, and patient flow.

Sam Shen MD,MBA
Associate Professor
Vice Chair, Clinical Operations and Quality
Patient Safety Officer/Associate Chief Quality Officer
Stanford Healthcare 

Patrice Callagy, RN, MPA,MSN, CEN
Executive Director, Emergency Medicine
Stanford Hospital and Clinics 

12:45pm
Conference Concludes

Workshop – , Tuesday, September 14, 2021

12:45pm – 2:45pm
Succeeding in a New Era of Star Ratings: How to Effectively Strategize, Operationalize and Execute Star Ratings Programs in a Post COVID-19 Medicare Landscape

This workshop will focus on how to prepare your organization to succeed in a post COVID world by achieving higher star ratings by examining changing consumer preference and different market forces organizational focus and execution. The workshop leaders will address how to strategize, operationalize and execute your organization’s star ratings programs with changing competitive landscape, evolving consumer expectations and changing provider landscape. We address what these challenges look like and how an organization can position itself to effectively respond to these barriers and share our perspective on potential solutions to optimize execution enabling plans to achieve 4 or high star ratings.

Akhil Sanjay Rao, MHA
Senior Manager
Deloitte

 

About the Workshop Leader:

Akhil brings a unique combination of consulting and industry experience along with a deep understanding of the myriad of market forces and regulatory requirements that shape today’s Medicare marketplace.

Led strategic financial transformations at large Medicare plans, helping clients redefine their strategy and improve operational excellence. Using powerful operational levers such as differentiated product portfolios, competitive pricing,  enhanced provider partnerships, advanced consumer engagement and care management redesign, he has helped plans create optimized revenue channels through improved quality-stars and risk adjustment, which has positioned them for sustained growth and long term success.

Prior to Deloitte, Akhil lead the Stars Strategy and Execution team at United Healthcare that included 11 Medicare Advantage health plans covering ~1.2M managed care lives. His responsibilities included setting overall enterprise strategy and enabling local markets deliver on their strategic commitments. Preceding that, he worked at an integrated care system where he led various inpatient and outpatient clinical quality improvement and care management initiatives.

Featured Speakers

Daniel Weaver

Daniel Weaver

VP Stars, Quality, and Risk Adjustment

Gateway Health Plan

Christine M. Leo

Christine M. Leo

Associate Vice President, Senior Products

Cigna

Donnie Aga, M.D.

Donnie Aga, M.D.

Medical Director for Healthcare Innovation

KelseyCare Advantage

Melissa Smith

Melissa Smith

Executive Vice President of Consulting and Professional Services

Healthmine

David Larsen

David Larsen

Director, Quality Improvement

SelectHealth

Liz Haynes MSN, RN, CCM

Liz Haynes MSN, RN, CCM

Director, Risk Adjustment and Stars- Government Programs

Blue Cross and Blue Shield of Kansas City

Les Jebson

Les Jebson

Executive Director

Texas A and M

Thomas Webb

Thomas Webb

AVP System Quality Analytics

Rush University Medical Center

Thomas H. Lutzow, PhD, MBA

Thomas H. Lutzow, PhD, MBA

President/Chief Executive Officer

Independent Care Health Plan (iCare)

Steven Peskin, MD, MBA, FACP

Steven Peskin, MD, MBA, FACP

Executive Medical Director of Population Health and Transformation

Horizon Blue Cross Blue Shield

Rachel Sterner, MPH

Rachel Sterner, MPH

Stars Program Manager

UCare

Mary Reich Cooper, M.D., J.D.

Mary Reich Cooper, M.D., J.D.

Program Director, Healthcare Quality and Safety, Associate Professor, Population Health

Jefferson College of Population Health
Thomas Jefferson University
Chief Quality Officer and Senior Vice President, Clinical Services
Connecticut Hospital Association

Ken Holdcroft

Ken Holdcroft

Executive Vice President of Growth

Healthmine

Sam Shen MD, MBA

Sam Shen MD, MBA

Associate Professor, Vice Chair, Clinical Operations and Quality, Patient Safety Officer/Associate Chief Quality Officer

Stanford Healthcare

 Patrice Callagy, RN, MPA, MSN, CEN

Patrice Callagy, RN, MPA, MSN, CEN

Executive Director, Emergency Medicine

Stanford Hospital and Clinics

Akhil Sanjay Rao, MHA

Akhil Sanjay Rao, MHA

Senior Manager

Deloitte

Jan Smith Reed

Jan Smith Reed

Director, US Healthcare

T-Base Communications

Micky Twomey

Micky Twomey

President & Chief Operating Officer

Hyperlift

Sponsors and Exhibitors

Educational Underwriter

HealthMine

HealthMine is the industry’s leading technology-enabled member engagement and rewards solution focused on empowering people to take the right actions to improve their health. We build personalized, ongoing member engagement strategies for health plans in all markets that drive health actions through customized incentives and rewards, enhance member experience, and improve outcomes. HealthMine customers have transparency into real-time, actionable insights on the success of member engagement and satisfaction initiatives, as well as the ability to identify priority areas of opportunity to improve quality measures and Star Ratings. Connect with HealthMine on LinkedIn and learn more at www.HealthMine.com

Luncheon Sponsor

Hyperlift’s Stars Management Suite

OUR MISSION IS TO ELEVATE STARS RESULTS AND MITIGATE RISK THROUGH SIMPLE, PROVEN PROCESS AND TECHNOLOGY.
Hyperlift’s Stars Management Suite helps Stars teams Deliver Demonstrable Results and Meaningful Stars Improvement. The Stars Management Suite is a proven approach that combines people, process, and product to provide Stars teams with the insights, data, and presentation-ready materials they need, when they need it, to make immediate and effective decisions to achieve their Stars objectives.

 

Associate Sponsor

T-Base is the largest and fastest growing North American provider of high-quality and secure alternate format communications, providing alternate format and digital communications for end users who are low vision or blind. Serving International Banking, Healthcare, Telecommunications, Education, and Government we are HIPPA certified, PCI-DSS, SSAE 18 and SOC2 Type2 Certified. Consult with T-Base for all things Digital, large print reflowed documents, audio, Braille and all other alternate formats.

Media Partner

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

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
Request Brochure

Register Your Team Today!

Register Now

Mention Promo Code WB100 and Save an Additional $100 off the Registration Fee!

Ask A Question

Be A Thought Leader And Share!

Pin It on Pinterest