INSIDER: May 2024
Health Plan Alliance
05/01/2024
Table of contents
- What's on Members' Minds
- Welcome Shawna Dandridge to the Health Plan Alliance team
- Sponsorship Opportunities Updates
- Q3 Insider Town Hall on Aug. 14
- Tips of the Month
The Medicare Advantage Final Rule for Calendar Year 2025 was top of mind for Alliance members in April, as was the Medicare Prescription Payment Program (M3P). Preparing for Utilization Management audits also emerged as a topic of consideration for our plans. As always, plans are shopping for a number of vendors; jump to the end to see what plans looked for in April.
Centers for Medicare & Medicaid Services (CMS) released its Final Rule in early April, and plans are working overtime to understand the implications to their business and upcoming bids. Changes to Part D payments and marketing spend are top of mind. Being able to provide advisory services as our plans unwind what this new ruling means for them, or services that help them adapt and stay competitive under the new environment, will likely be in high demand among the Alliance membership.
With the new M3P program going into effect January 1, 2025, our plans are looking for ways to operationalize this new drug payment structure and understand what it means for their business’ cash flow. Partnership that makes understanding and implementing this new requirement easier on Alliance member health plans will be beneficial. In addition to the M3P, CMS’ targeted Utilization Management audits also have plans reviewing their compliance with these guidelines and assessing how to best prepare for these audits.
Alliance member plans indicated shopping activity in a number of areas, including the following:
- Risk adjustment
- Dental benefits
- Provider directories
- Subrogation
- Prior Authorization optimization
If these topics align with your organization's capabilities and expertise...
- Add these keywords to your company profile and ensure your company brochure is current. Our members might be searching our vendor directory for support.
- Sponsor a 1-hour spotlight webinar to showcase your organization's capabilities and subject matter expertise to Alliance members. Visit our calendar to see the list of available spots and learn more about this opportunity. Details about this opportunity are on pg. 23 of our 2024 Sponsorship Guide.
- Submit an educational session proposal that addresses our health plans' challenges and highlights your organization's subject matter experts.
Preferred Business Sponsors: Log in to your company dashboard to post a thought leadership piece to the Alliance Knowledge CenterSM and weekly e-digest.
Welcome Shawna Dandridge to the Health Plan Alliance team
Join us in warmly welcoming Shawna Dandridge, Vice President of Program Services, as the newest Health Plan Alliance (HPA) team member. Shawna brings a wealth of experience to her role, having served most recently as Chief Operating Officer at a behavioral health managed care organization with more than 170 providers and 720K eligible members. In previous roles, Shawna supported policy and systems design while working within the PolicyLab at the Children's Hospital of Philadelphia and has consulted nationally on projects of varying scales—from overseeing school health services to funding and policy mechanisms for integrated care.
As Vice President of Program Services, Shawna will play a crucial role in supporting the HPA network by facilitating connections and collaborations for HPA members. Her extensive experience in health plan operations will greatly contribute to maintaining a well-balanced and engaged HPA network.
Shawna holds a Master of Social Work degree from West Chester University of Pennsylvania, is a Licensed Clinical Social Worker, and has continued her education at Stanford University’s Graduate School of Business. Outside of work, she resides in Philadelphia, PA, with her husband and their two cats, Mac and Cheese. Shawna enjoys spending time outdoors and cherishing moments with her niece and nephew.
We are thrilled to have Shawna join our team and look forward to the valuable insights and contributions she will bring to the Health Plan Alliance. Please join us in welcoming her aboard!
Sponsorship Opportunities Updates
Value Visit: Clinical Excellence & Member Experience
September 16 - 18, 2024 | Albuquerque, NM
$15,000, 7 sponsorship spots left
Don't miss this opportunity to connect with Alliance leaders responsible for clinical outcomes, quality measure performance, and experience design for their members, providers, and partners. Sponsors who commit early are able to maximize their brand exposure on the meeting page and can provide input on the agenda. At this year's meeting Alliance members will share learnings and explore the toughest barriers to achieving the quadruple aim of healthcare. Regional payors are placing health equity at the heart of their design efforts, thinking carefully about every opportunity at every touchpoint to ensure all members feel seen, heard, and cared for. Some of the toughest challenges Alliance members are grappling with include integration opportunities – vendor point solutions for chronic care management, providing omnichannel connections to varied modes of care and effectively layering digital health options with knee-to-knee interactions between providers and members. We’re also digging into engagement, satisfaction, and retention, all of which are necessary for strong year-over-year performance. A powerful lever every Alliance member seeks to deploy more effectively—Value Based Care arrangements and whole person care models that align incentives for providers, CBOs, and the members we serve.
Value Visit: Fall Leadership Forum
October 22 - 25, 2024 | Sonoma, CA
$25,000, Waitlist available
Our bi-annual leadership forums are designed specifically to support HPA member plan executive teams as they grapple with far reaching challenges, such as the impact of the big bets from national payers and delivery systems, major trends in physician and provider-led organizations, the shifting digital innovation space, and winners and losers in Government-sponsored care and dynamics at the federal and state levels, as well as the future of commercial for small plans. These executive retreats’ agendas and learning objectives are powered by deep study of Alliance members’ multi-year strategies and feature a lineup of nationally recognized subject matter experts, plus provide exclusive access to proprietary content on the competitive landscape for use in your own environmental scans and strategic planning. Sponsors of our leadership forum enjoy an important opportunity to move beyond superficial discussions with the help of carefully crafted sessions and spaces that connect you with our Alliance executive network.
TOP
Q3 Insider Town Hall is on Aug. 14
All year long, the Alliance leadership conducts strategic listening sessions with our health plan members’ leadership teams, and collects insights from one-on-one calls, in-person meetings, webinars and our discussion forum. During these 90 minute, virtual Insider Town Halls, you'll hear from Joe Lastinger, Alliance president, and have an opportunity to chat with Alliance leaders one-on-one about what they are hearing from our members, what’s trending now and how your organization can support our programming and projects. Anyone from your organization is welcome to attend.
Register now for the remaining 2024 Insider Town Halls:
#1: Review and update your vendor directory listing
Not sure if you're making the most of your vendor directory listing benefit? Check out the "Managing your vendor directory listing" FAQ section to ensure your maximizing this valuable Insider benefit.
Confirm these member-requested RFI questions are complete
Last year, Alliance members requested that we add six questions to vendors' directory listings to assist them when they conduct Requests For Information (RFIs). We strive to provide our members with the most up-to-date and accurate information about our sponsors. Updating your profile not only benefits our members but also enhances your visibility and provides an opportunity to showcase your expertise and capabilities. It also allows our members to make well-informed decisions when considering vendors for their needs. Please take a moment to review and update our company profile on our platform, specifically, these six new RFI questions:
- Corporate Annual Revenue
- Number of Employees
- Accreditations/Certifications
- Are you a certified diverse supplier?
- Does your company offshore any services?
- Are you willing to agree to SLAs or performance guarantees?
How do you update your listing?
Navigate to the "Edit my company profile" section of your online account and select “Edit general information.” Please ensure that you have answered these six questions completely and accurately. If you have already responded or completed these questions, we appreciate your attention to this matter.
#2: Want email alerts about meetings you are sponsoring?
There's a new email subscription option for that! Head to your subscription center and opt in to "Meeting updates." Individuals opted in to meeting updates will receive email reminders and instructions for pass redemption, shipping your collateral and giveaways to the venue, one-time email list use of the registration list and more.
Alliance members in the news
Read the latest news about Alliance members making a difference in the communities they serve.
Quick links
Alliance Business Development Team
Need support? Email howdy@healthplanalliance.org
Jaime G. González,
DrPH, MSSW, MSHA
Chief Business Development Officer
Jessica Boykins
Customer Experience Specialist
Thank you to our
2024 Preferred Business Sponsors
Alliance members sincerely appreciate the generous support of our Preferred Business Sponsor organizations. By uniting more than 45+ regional health plans that don't compete with one another in their markets, we have created a space where leading provider-sponsored health plans can freely and openly work together. Your support helps these organizations deliver better healthcare in the communities where they serve and live.