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Government Programs 2016 Value Visit

Event Date: 8/2/2016 - 8/4/2016

Event Overview

Government Program 2016

If your health plan is in the Medicare, Duals, or Medicaid markets - or is thinking about entering government-sponsored health care - you can't miss this 2 1/2 day event, one of the biggest Value Visits the Alliance hosts each year.  Join your peers for an agenda filled with case studies and open discussion between member plans, as well as timely presentations from industry experts.

The agenda features the perspectives of policy makers, regulators, operational experts and subject matter experts -- not to mention multiple case studies from member plans. Click the "Agenda" tab to view the detailed schedule.

Highlights include:

Case studies from these plans:

  • SelectHealth and AvMed on member engagement and incentive programs
  • Johns Hopkins on their community-coordinated care program, J-CHiP
  • Presbyterian Health Plan on Stars
  • Geisinger on managing prescription drug abuse

And the member plan case studies are complemented by guest faculty such as:

  • Jeff Myers, President and CEO, Medicaid Health Plans of America (MHPA)
  • Hemi Tewarson, Program Director, Health Division, National Governors Association Center for Best Practices
  • Lauren Gavin, Health Insurance Specialist, Medicare-Medicaid Coordination Office, CMS
  • Christine Aguiar, VP for Medicare and Managed Long-term care, Association for Community Affiliated Plans (ACAP)
  • Martha Roherty, Executive Director, National Association of States United for Aging and Disabilities (NASUAD)
  • Michael Nardone, Director of the Disabled and Elderly Health Programs Group, CMS
  • Jerry Mulcahy, Director, Medicare Parts C and D Oversight and Enforcement Group, CMS
  • Cindy Chiou, Director, Division of Issuer Compliance and Monitoring, Marketplace Plan Management Group, CMS/CCIIO
     
     

Who should attend?

Plan leadership team members with responsibility for Government programs, including Medicare Advantage, SNP populations, Medicaid, and the marketplace.  In addition, individuals with specific oversight over operational compliance, regulatory compliance, STARs, sales and marketing, and product development will find this event helpful.

Functions

Tuesday, August 2, 2016

6:30 - 8:00 pm Networking dinner for event delegates.  Cazbar at 316 N. Charles St

 

Wednesday, August 3, 2016

6:30 - 8:00 pm Networking dinner for event delegates.  Phillips Seafood at 601 E. Pratt St

​

 
Agenda

For a printable, detailed agenda, visit the Documents tab noted above.  Or check out the agenda-at-a-glance below 

AGENDA AT A GLANCE  

Tues, Aug 2

 

7:30am

Breakfast and Registration

8:00am

Welcome and Introductions

9:00am

The political environment: What to expect for Government programs in 2017 and beyond

9:45am

BREAK

10:00am

The Medicaid Mega Rule: Translating policy and regulations into operational reality

11:00am

The State Perspective: National trends as States seek to transform their Medicaid programs

12:00pm

LUNCH

1:00pm

The Medicare-Medicaid Financial Alignment initiative: An update from CMS

2:00pm

FITNESS BREAK

2:30pm

The Medicare-Medicaid Plans and the financial alignment demo: Innovations and lessons learned

3:15pm

Meeting the operational challenges of serving the Duals population: From SNPs to demos

4:00pm

Panel Discussion: Managed Care Organizations’ role in addressing the Long Term Care crisis

5:00pm

Day Adjourns

6:30pm

Dinner

Wed, Aug 3

 

7:30am

Breakfast

8:00am

Johns Hopkins case study on community-coordinated care: The J-CHiP program

9:00am

BREAK

9:15am

Flash Case Studies: Incentivizing members to engage in their care

10:15am

Game your health: How do video games increase engagement to improve health outcomes?

11:00am

Town hall meeting: CMS Oversight and Enforcement Group leader discusses audit trends and CMS priorities

12:00pm

LUNCH

1:00pm

Regulatory compliance in government programs: The hot button issues worth your leadership’s attention all the time

2:00pm

FITNESS BREAK

2:30pm

CMS/CCIIO addresses QHP Issuer oversight and enforcement

3:30pm

Hot topic: provider data management and synergies to achieve admin cost goals

4:30pm

Day adjourns

6:30pm

Dinner

Thurs, Aug 4

 

7:30am

Breakfast

8:00am

Making the most of your Stars efforts: How members are using dashboards to inform decision making

9:30am

BREAK

10:00am

Panel Discussion: Ensuring long-term profitability of your Medicare Advantage product

12:00pm

Box Lunch and Open Discussion

1:00pm

Event Adjourns
Documents
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8/5/2016

Presentation: Retention Strategies
John Burich, VP, Strategy and Growth, of Passport Health Plan, shares the strategy and approach for the Duals, and leads a conversation about retention strategies in Kentucky Medicaid

8/4/2016

Presentation: Medicare Advantage Stars Improvement Monitor, Measure, Discuss and Refine
Dave Neiman, Sr. Consulting Actuary with Wakely Consulting, shares the math behind the stars, and provides great visuals and explanations that answer the questions executives have most often when it comes to Stars. He also shares Stars Dashboard examples, and experiences gained from working with clients across the industry on moving the Stars needle.

8/4/2016

Audio: Your MA Product's Place in the Portfolio: Assessing Profitability
HealthScape Advisors focuses on your MA product's place in the portfolio, and how you assess profitability.

8/4/2016

Presentation: Building the Bid - The Evolution of the MA Bid Process
Eric Goetsch from Milliman review the then and now: how the process and team involved has changed in the last three years, and the implications for your plan. Alliance member trends: what questions are brought to the table and where a commonalities in the answers from the Alliance member plans Product development and lifecycle - emerging trends.

8/4/2016

Presentation: Differentiating Your Product - Can You More Effectively Leverage Supplemental Benefits
Ryan Baum of TruHearing shares an Industry update - latest trends on prevailing supplemental benefits. An example of a competitive analysis that examines the opportunities of leveraging supplemental benefits. Alliance member trends - which benefits are making the difference in our markets.

8/4/2016

Document: Medicare Star Descriptions 2016
Medicare Star descriptions, measures are included in CMS Star Ratings

8/4/2016

Document: Explanation of the Star Estimate 2016 Report
This report from Presbyterian gives the viewer an up to date estimate of several star measures. An overall weighted star level is also provided. The measures included are those measures that be tracked on a monthly basis throughout the year. The measures in this report account for ~53% of the overall weighted star. Measures captured only once a year: CAHPS, HOS, Foreign Language/TTY response and the calculated Quality measures are not included.

8/4/2016

Document: Presbyterian Star Estimate 2016
Stars Dashboard tool shared by Presbyterian Health Plan. Estimated Star level.

8/4/2016

Presentation: Presbyterian Health Plan Stars Dashboard
This session combines the industry view of Wakely's experts with the real-world experience of Presbyterian Health Plan when it comes to monitoring Stars efforts. We discuss the KPIs plans use to inform decision-making, plus share suggestions to improve Star dashboard development and use.

8/4/2016

Presentation: Your MA Product's Place in the Portfolio: Assessing Profitability
HealthScape Advisors focuses on your MA product's place in the portfolio, and how you assess profitability.

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Attendees

Below is a list of all delegates registered to date for this event

  • Beth Marootian
  • ALLIANCE GUEST
  • Director of Business Development at Neighborhood Health Plan of Rhode Island
  • Jodi Digmann
  • ALLIANCE MEMBER
  • Medicare Compliance Analyst at Medical Associates Health Plans
  • Kaleb Holt
  • ALLIANCE MEMBER
  • Director of Medicare Programs at SelectHealth
  • Anita Landino
  • ALLIANCE MEMBER
  • Medicare SR. Marketing Specialist at Health Alliance Plan (HAP)
  • Susan O'Connor
  • ALLIANCE MEMBER
  • Vice President & General Counsel at Health New England
  • Greg Pugh
  • ALLIANCE MEMBER
  • Sr. Director, Service Development & Chief of Staff at Passport Health Plan
  • Sinead Rice Madigan
  • ALLIANCE MEMBER
  • President and Chief Executive Officer at Health Alliance Medical Plans
  • Cara Techlin
  • ALLIANCE MEMBER
  • Director of Operations at Network Health
  • Cynthia Weiss
  • ALLIANCE MEMBER
  • Director, Quality, Accreditation and Wellness at AvMed
  • Todd Wood
  • ALLIANCE MEMBER
  • Medicaid Program Director at SelectHealth
  • Marissa Lawson
  • HEALTH SYSTEM/MEDICAL GROUP (ALLIANCE MEMBER OWNER/PARTNER)
  • Director, Product Marketing at Evolent Health
  • Molly Smith
  • PROFESSIONAL
  • Vice President, Coverage at American Hospital Association (AHA)
  • Christine Aguiar
  • SPEAKER
  • Vice President for Medicare and Managed Long-term Care at Association for Community Affiliated Plans
  • Lauren Gavin
  • SPEAKER
  • Health Insurance Specialist at Centers for Medicare & Medicaid Services (CMS)
  • Eric Goetsch
  • SPEAKER
  • Principal & Consulting Actuary at Milliman
  • Zain Jafri
  • SPEAKER
  • Consultant at HealthScape Advisors, LLC
  • Julia Lambert
  • SPEAKER
  • Principal & Senior Consulting Actuary at Wakely Consulting Group
  • Sandra Leal
  • SPEAKER
  • Chief Executive Officer at SinfoníaRx
  • Jeff Myers
  • SPEAKER
  • President and CEO at Medicaid Health Plans of America
  • Michael Nardone
  • SPEAKER
  • Director, Disabled and Elderly Health Programs Group at Centers for Medicare & Medicaid Services (CMS)
  • Dave Neiman
  • SPEAKER
  • Senior Consulting Actuary at Wakely Consulting Group
  • Jennifer Smith
  • SPEAKER
  • Director of the Division of Analysis, Policy & Strategy at Centers for Medicare & Medicaid Services (CMS)
  • Damon Terzaghi
  • SPEAKER
  • Sr Director of Medicaid and LTSS Programming at NASUAD
  • Hemi Tewarson
  • SPEAKER
  • Program Director, Health Division at National Governors Association
  • Cindy Yen Chiou
  • SPEAKER
  • Director, Division of Issuer Compliance and Monitoring at Centers for Medicare and Medicaid Services
  • Becky Erbe
  • SPONSOR
  • Chief Business Development Officer at hunterAI
  • Brooke Ivey
  • SPONSOR
  • VP – Sales at Bloom Insurance Agency
  • Kyle Moll
  • SPONSOR
  • Senior Sales Executive at Sagility
  • Judith Nelson
  • SPONSOR
  • Director, Medicare Advantage Strategy at DST Health Solutions
  • Richard Popper
  • SPONSOR
  • Director, Medicaid & Duals Strategy at DST Health Solutions
  • Diana Sonbay-Benli
  • SPONSOR
  • Chief Product Officer, TriZetto Healthcare Products Group at Cognizant
  • Anne Armao
  • VIRTUAL ATTENDEE - MEMBER
  • VP, Member Experience and Product Development at SummaCare
  • Alissa Beattie
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President, Operations & Compliance at New West Health Services
  • Janet Bylow
  • VIRTUAL ATTENDEE - MEMBER
  • Senior FWA Investigator at Paramount Health Care
  • Lisa Denney
  • VIRTUAL ATTENDEE - MEMBER
  • FWA Supervisor at Johns Hopkins Health Plans
  • Erin Heckethorn
  • VIRTUAL ATTENDEE - MEMBER
  • Director of Operations and Program Management at FirstCarolinaCare Insurance Company
  • Kelli Limbach
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Marketing Officer at Baptist Health Plan
  • Roger Milliner
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Growth Officer at MetroPlusHealth
  • Daniel Quan
  • VIRTUAL ATTENDEE - MEMBER
  • Compliance Officer at Santa Clara Family Health Plan
  • Todd Rau
  • VIRTUAL ATTENDEE - MEMBER
  • Dir Medicare Markets at IU Health Plans
  • Caresse Sakagawa
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Marketing and Product Officer at Providence Health Plan
  • Irina Shikin
  • VIRTUAL ATTENDEE - MEMBER
  • Sr. Regulatory Auditor at Health Alliance Plan (HAP)
  • Mary Tournoux
  • VIRTUAL ATTENDEE - MEMBER
  • Chief Commercial Officer at Solera
  • Marja Wilson
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President, Medicare Advantage at Johns Hopkins Health Plans
Speakers