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Value Visit: ACA & Government Programs

Event Date: 2/28/2023 - 3/3/2023

Event Overview

Regional health plans must compete differently in the ACA individual market and government-sponsored programs

The state of play is rapidly changing across the ACA, Medicaid, SNPs and Medicare. The individual market – particularly subsidized and government-sponsored LOBs – is a critical portfolio play for regional players. The looming end of the PHE, combined with shifting consumer sentiment and a tougher regulatory environment, are creating unique opportunities. But there is also opportunity cost: The double hitter of smart growth and risk capture looms if your strategy doesn’t line up. That’s why HPA member plans need to think differently about how we develop products, position them in our markets, and engage intentionally in member retention efforts.

We’ll dig into critical issues like:

Your portfolio play for the under-65 individual consumers AND the over-65, too
The great debate: The long-term viability of virtual-first product designs
How Alliance member health plans are stretching their resources in creative ways
Driving quality and risk adjustment performance with product design: Is it possible?
The evolving Medicaid landscape and how states are raising the stakes for payer contractors
From the trenches: Real-world efforts to engage your members and impact satisfaction

Work elbow to elbow with Alliance plan leaders in our unique micro-workshop formats and small group discussion opportunities, all incorporated into our case study-driven event format to create a high-trust environment that encourages real relationship building and connection.

What you'll learn:

How regional players can finally leverage all the consumer data we’ve been collecting to drive micro-targeting efforts so we can win market share, capture risk, and deliver on high quality outcomes
Where the ACA is moving: The proposed rule to reduce the quantity of standardized plans and how to think about subsidies near and long term
Moving from hype to hero: What programs are truly making an impact, changing behavior, and bending the cost curve?
How do we treat the whole member as the environment and expectations are changing?
Real-world examples of how Alliance members are focusing on member engagement and satisfaction with an eye on impacting Stars, CAHPS, retention and referral rates, and more.
Exploding SNPs! CSNPs, DSNPs, FIDE SNPs and more. Which is the right path for you? What does it take to be successful and when is the right time to add this to your portfolio?
The Part B buy-back problem: How to differentiate and compete in MA when you can’t go toe-to-toe with national plans’ product and pricing
Are there meaningful strategies you can deploy when submitting your bid that can improve your success in accurately capturing your population’s risk and effecting better health outcomes?
Threading the needle between risk adjustment, experience and VBC arrangements. No matter where you are on the continuum of VBC, continued improvement is challenging. What differentiates the high performers from the organizations still treading water?
Dig into Medicaid national trends and translate authority needs and models into operational practicalities for payers and providers. What elements are more and more states incorporating into their public health strategies and how do the large payers compete so effectively for these contracts?

Session Spotlight

Office hours with Alliance members and topic experts

At top universities and think tanks, Office Hours are when thought leaders connect meaningfully with learners and practitioners to dive deep into sticky issues and explore new possibilities. We’re kicking off day two with a robust, 90-minute session for powerful idea exchanges on critical issues affecting Alliance health plan leaders. Specific Office Hours topics will be chosen and communicated to registered attendees by February 10th so they can RSVP for their preferred topic. Important! Office Hours leaders will ask attendees to prepare some light pre-work to ensure the discussion is focused and impactful. We’ll keep you informed and on-task in the final weeks prior to the event.

Office Hours topics may include:

Sales strategies and tactics
Risk adjustment tactics and managing to RADV
Regulatory compliance
Quality, with emphasis on NCQA and stars

What Alliance members have said after attending this program

“The group size was ideal for sharing tactical ideas and strategies. The candid and open conversations were refreshing, and people took valuable, actionable ideas back home with them. I really enjoyed the fellowship among other health plans and hearing the solutions across the different companies.”

“I enjoy the networking as I will reach out to people I met and ask them questions. I also enjoyed the case studies where the plans shared an initiative they took on and the result. I appreciate that most of the content was provided by plan members rather than vendors.”

“The group size was perfect to allow everyone the opportunity to participate. The ability to share with peers is so valuable to the work we do. The ideas and practices shared will be useful in my day-to-day operations. The HPA staff go above and beyond to offer a warm welcome to both those that have been part of HPA for a long time and those that are brand new.”

Who should attend

This event brings together leaders among your Alliance peer network with responsibility for:

Government-sponsored programs’ product design, sales and marketing, provider contracting, and growth strategy development
Financial leaders with responsibility for population health and value-based design, including issues related to risk adjustment
Leaders in behavioral health, care management, clinical and whole person care outcomes
Stakeholders in achieving quality objectives, including developing and implementing HEDIS, CAHPS, and HOS improvement initiatives, as well as NCQA accreditation
Leaders in your health plan’s health equity strategy, with particular emphasis on the member experience, whole person care, and SDOH
Network management and data analytics teams responsible for provider engagement strategies to drive improved health care quality