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Workgroup: Medicare Advantage

Event Date: 1/13/2026

Event Overview

1/13/2026
1:00 PM – 2:00 PM CT (60 minutes)
Webinar // Zoom Meeting

Explore advanced strategies for 2027 Part D bid preparation, including regulatory updates, risks, trends, and key considerations to strengthen your plan’s Part D performance.

Key areas include: 

  • Regulatory Updates: Review of critical CMS and BPT changes, including new documentation requirements, increased scrutiny of the national average bid estimate, CMMI models, and potential additional legislative or rule changes.
  • Advanced Part D specific bid preparation strategies, focusing on regulatory changes and optimizing Part D performance.
  • Benefit trends and considerations as drug negotiation expands, VBID closure starts CY2026, and SSBCI scrutiny increases.
  • A challenging revenue environment and what other data sources tell us about possible 2027 implications.
  • Rebate/Subsidy Strategies: Discussion of rebate reallocation and direct subsidy complexities related to the proposed BPT and documentation changes.
     

Medicare Advantage plans are navigating tighter margins, shifting regulations, and growing performance expectations. In this workgroup, leaders come together to focus on key topics across Stars, quality, risk adjustment, compliance, and bid strategy. Through open dialogue and peer exchange, you’ll gain practical solutions and fresh ideas to strengthen your plan’s performance.

 

Your perspective strengthens the conversation.

This call is part of an ongoing workgroup series. Visit the event search to register for more like it.

 

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Attendees

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

  • Laura Adams
  • ALLIANCE MEMBER
  • Director, Medicare Stars at Medical Mutual
  • Sheila Albeke
  • ALLIANCE MEMBER
  • Director of Pharmacy Services at Samaritan Health Plans
  • Carrie Alles
  • ALLIANCE MEMBER
  • Director of Consumer and Specialty Products at Providence Health Plan
  • Benjamin Aragon
  • ALLIANCE MEMBER
  • Manager of Product Development at Sharp Health Plan
  • Julie Boutwell
  • ALLIANCE MEMBER
  • Medicare Audit Analyst - Compliance at Providence Health Plan
  • Xenas Bradfield
  • ALLIANCE MEMBER
  • Delegation Vendor Oversight Auditor at Health Alliance Plan (HAP)
  • Heather Brooks
  • ALLIANCE MEMBER
  • Marketing Compliance at Community Health Plan of Washington
  • George Burleton
  • ALLIANCE MEMBER
  • Director of Product Development at Network Health
  • Maria Capretta
  • ALLIANCE MEMBER
  • Sr. Clinical Operations and Compliance Specialist at Medical Mutual
  • Amy Carl
  • ALLIANCE MEMBER
  • Manager Quality Improvement at Providence Health Plan
  • Irem Conery
  • ALLIANCE MEMBER
  • Manager, Customer Experience & Performance Improvement at Sharp Health Plan
  • Deb Curry
  • ALLIANCE MEMBER
  • Mgr, Risk Adjustment Coding Quality & Operations at Medical Mutual
  • Cassie Dahl
  • ALLIANCE MEMBER
  • Clinical Program Manager at Baylor Scott and White Health Plan
  • Joslyn Dechant
  • ALLIANCE MEMBER
  • Manager of Medicare Product Development at Johns Hopkins Health Plans
  • Jena Deschler
  • ALLIANCE MEMBER
  • Managed Care Pharmacist at Health Alliance Medical Plans
  • Megan Do
  • ALLIANCE MEMBER
  • Manager Product Development at Health First Health Plans
  • Juanita Dowell
  • ALLIANCE MEMBER
  • Manager Health Plans Compliance at CHRISTUS Health Plan
  • Misty Dunphy
  • ALLIANCE MEMBER
  • Sr. Compliance Director - Medicare Compliance Officer at Providence Health Plan
  • Mike Eaton
  • ALLIANCE MEMBER
  • Director of Pharmacy Government Programs at Select Health
  • Shelby Esposito
  • ALLIANCE MEMBER
  • Stars and Accreditation Program Manager at Health First Health Plans
  • Jeremy Fejfar
  • ALLIANCE MEMBER
  • Pharmacy Director Government Programs at Quartz Health Solutions
  • Miranda Flango
  • ALLIANCE MEMBER
  • Coding Program Trainer at Geisinger Health Plan
  • Rasheeda Flesch
  • ALLIANCE MEMBER
  • Medication Adherence Specialist at CommunityCare
  • Keishaun Goldmas
  • ALLIANCE MEMBER
  • Government Programs, Regulatory Affairs Manager at Providence Health Plan
  • Jessica Griffin
  • ALLIANCE MEMBER
  • Medicare Product Manager at Quartz Health Solutions
  • Elizabeth Gross
  • ALLIANCE MEMBER
  • Manager Quality Improvement at CommunityCare
  • Mardelle Gustilo
  • ALLIANCE MEMBER
  • Quality Program Coordinator, Medicare Advantage at Sharp Health Plan
  • Michael Haaga
  • ALLIANCE MEMBER
  • Market Intelligence Research Analyst at SummaCare
  • Robin Haehlke
  • ALLIANCE MEMBER
  • RN Clinical Quality Assurance Specialist at Quartz Health Solutions
  • Anthony Hansen
  • ALLIANCE MEMBER
  • Sr. Pharmacy Compliance Product Management Coordinator at Providence Health Plan
  • Amber Harris
  • ALLIANCE MEMBER
  • Director Risk Adjustment at MediGold
  • Veronica Hawkins
  • ALLIANCE MEMBER
  • VP, Individual & Retiree Health Solutions at Medical Mutual
  • Heather Heard
  • ALLIANCE MEMBER
  • Quality Care Coordinator - Community at Network Health
  • Patricia Henderson
  • ALLIANCE MEMBER
  • Director, Compliance at Health Partners Plans / Jefferson Health Plans (HPP/JHP)
  • Eva Hoffman
  • ALLIANCE MEMBER
  • Director of Marketing & Communications at CCHP
  • Abby Hoffman
  • ALLIANCE MEMBER
  • Director of Quality & Stars at HealthTeam Advantage
  • Kaleb Holt
  • ALLIANCE MEMBER
  • Director of Medicare Programs at Select Health
  • LaShunda Hooks
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment at Santa Clara Family Health Plan
  • Jeniffer Horn
  • ALLIANCE MEMBER
  • Director - Health Plans Call Center Operations at CHRISTUS Health Plan
  • Nathan Hui
  • ALLIANCE MEMBER
  • Vice President, Product Line Leader at Medical Mutual
  • Danielle Jaber
  • ALLIANCE MEMBER
  • Director, Government Programs at Baylor Scott and White Health Plan
  • Brooke Johnson
  • ALLIANCE MEMBER
  • Pharmacy Benefit Services Strategy Specialist at CHRISTUS Health Plan
  • Jamie Johnson
  • ALLIANCE MEMBER
  • QI Stars Specialist at CommunityCare
  • Betty Jones
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Specialist at Johns Hopkins Health Plans
  • Lemane Kaba
  • ALLIANCE MEMBER
  • Coding Compliance Specialist at Johns Hopkins Health Plans
  • Alicia Kelley
  • ALLIANCE MEMBER
  • Vice President, Government Program at Capital District Physicians' Health Plan (CDPHP)
  • Stephanie Kozak
  • ALLIANCE MEMBER
  • Director, Government Programs Performance at Capital District Physicians' Health Plan (CDPHP)
  • Ed Lee
  • ALLIANCE MEMBER
  • VP Medicare Products at Baylor Scott and White Health Plan
  • Timothy Leech
  • ALLIANCE MEMBER
  • Product Development Benefit Specialist at Health First Health Plans
  • Janis Lehrer
  • ALLIANCE MEMBER
  • Director at Health Alliance Plan (HAP)
  • Karina Li
  • ALLIANCE MEMBER
  • Government Programs Manager at CCHP
  • Gregory Limon
  • ALLIANCE MEMBER
  • Vice President and Chief Administrative Officer at Sharp Health Plan
  • Terry Malett
  • ALLIANCE MEMBER
  • Director, Federal Government Programs Operations at Geisinger Health Plan
  • Deborah Marine
  • ALLIANCE MEMBER
  • Compliance Director at Geisinger Health Plan
  • Isela Martinez
  • ALLIANCE MEMBER
  • Clinical Program Manager at Baylor Scott and White Health Plan
  • Aaron Masini
  • ALLIANCE MEMBER
  • Senior Director of Pharmacy at Providence Health Plan
  • Brandon Mauck
  • ALLIANCE MEMBER
  • Director of Product Management and Business Development at MediGold
  • Hannah McCaffrey
  • ALLIANCE MEMBER
  • Manager, Pharmacy Regulations and Implementations at Health Partners Plans / Jefferson Health Plans (HPP/JHP)
  • Tracey McCloy
  • ALLIANCE MEMBER
  • Director, Strategic Growth & Product Development at HealthTeam Advantage
  • Angela McGregor
  • ALLIANCE MEMBER
  • Sr Risk Adjustment Coding Specialist at Community Health Plan of Washington
  • Eric McKeeman
  • ALLIANCE MEMBER
  • Director, Analytics & Risk Adjustment at Santa Clara Family Health Plan
  • Zach Meluch
  • ALLIANCE MEMBER
  • Sr Health Plan Quality Program Manager at Medical Mutual
  • Maria Menendez
  • ALLIANCE MEMBER
  • RN/CPC/CRC/CPMA -clinical reviewer at Sentara Health Plans
  • Matt Mitchell
  • ALLIANCE MEMBER
  • Chief Pharmacy Officer Select Health and Scripius at Select Health
  • James Moses
  • ALLIANCE MEMBER
  • Sales Manager at Denver Health Medical Plan
  • Alex Newell
  • ALLIANCE MEMBER
  • Senior Actuary at Health Alliance Plan (HAP)
  • Phu Nguyen
  • ALLIANCE MEMBER
  • Pharmacy Executive at Vizient Inc.
  • Tina Nguyen
  • ALLIANCE MEMBER
  • Manager Pharmacy Benefits and Services at CHRISTUS Health Plan
  • Veronica Palma
  • ALLIANCE MEMBER
  • Product Development Manager at Select Health
  • Laura Paull
  • ALLIANCE MEMBER
  • Medicare Product & Vendor Relationship Manager at HealthTeam Advantage
  • Jana Pennington
  • ALLIANCE MEMBER
  • Risk Adjustment Analytics Manager-Coding at Select Health
  • Charles Perez
  • ALLIANCE MEMBER
  • Pharmacy Benefits Administrator at CommunityCare
  • Donna Piko
  • ALLIANCE MEMBER
  • Director, Group Contracts & Benefit Compliance at Medical Mutual
  • Natalie Pirkola
  • ALLIANCE MEMBER
  • Vice President, Clinical Strategy and Population Health at Health Alliance Plan (HAP)
  • Noelle Plumlee
  • ALLIANCE MEMBER
  • Compliance Consultant at Providence Health Plan
  • Deb Rainha
  • ALLIANCE MEMBER
  • Director of Stars Strategy at Neighborhood Health Plan of Rhode Island
  • Sarah Reynolds
  • ALLIANCE MEMBER
  • Senior Program Manager at Johns Hopkins Health Plans
  • Lori Rund
  • ALLIANCE MEMBER
  • VP, Medicare Advantage at Johns Hopkins Health Plans
  • Shelly Rutledge
  • ALLIANCE MEMBER
  • Manager Clinical Pharmacy and Clinical Quality at Providence Health Plan
  • Ivis Salgado
  • ALLIANCE MEMBER
  • RN,CPMA,CDEO,CRC,Clinical Reviewer at AvMed
  • Janice Sawyer
  • ALLIANCE MEMBER
  • Senior Regulatory Auditor at Health Alliance Plan (HAP)
  • Amanda Scholze
  • ALLIANCE MEMBER
  • Sr. Director, Medicare & Individual Products at Quartz Health Solutions
  • Kim Schoon
  • ALLIANCE MEMBER
  • Manager Risk Adjustment at CommunityCare
  • Ray Shackelford
  • ALLIANCE MEMBER
  • Medicare Product Advisor at Select Health
  • Riley Shagena
  • ALLIANCE MEMBER
  • Sr. Analyst at Health Alliance Plan (HAP)
  • Himani Sharma
  • ALLIANCE MEMBER
  • Risk Adjustment Analyst at MetroPlusHealth
  • Jennifer Shermo Volm
  • ALLIANCE MEMBER
  • VP of Medicare and Commercial Markets at Health Partners Plans / Jefferson Health Plans (HPP/JHP)
  • Michiru Shibata
  • ALLIANCE MEMBER
  • Consulting Actuary at Health First Health Plans
  • Jennie Simerau
  • ALLIANCE MEMBER
  • Director, Medicare Product at Health Alliance Plan (HAP)
  • Gerri Smith
  • ALLIANCE MEMBER
  • Director, Compliance at CHRISTUS Health Plan
  • Jessica Soriano
  • ALLIANCE MEMBER
  • UM Director at Santa Clara Family Health Plan
  • Taylor Spence
  • ALLIANCE MEMBER
  • Manager, Market Strategy at Health Alliance Plan (HAP)
  • Deb Sterner
  • ALLIANCE MEMBER
  • Clinical Auditor, FWA at Geisinger Health Plan
  • Sheila Symm
  • ALLIANCE MEMBER
  • Pharmacy Operations Manager at Baylor Scott and White Health Plan
  • Kerri Towsley
  • ALLIANCE MEMBER
  • Director, Product Development & Market Intelligence at SummaCare
  • Mike Treash
  • ALLIANCE MEMBER
  • President at Health New England
  • Karla Tull
  • ALLIANCE MEMBER
  • Director Underwriting at CommunityCare
  • Jules Vasquez
  • ALLIANCE MEMBER
  • Director, Stars & Accreditation at Health First Health Plans
  • Cecelia Vergara
  • ALLIANCE MEMBER
  • Market Strategy Analyst at Health Alliance Plan (HAP)
  • Andy Wheaton
  • ALLIANCE MEMBER
  • Director-Pharmacy Benefits at Network Health
  • MK Williams
  • ALLIANCE MEMBER
  • Actuary at Health Alliance Plan (HAP)
  • John Willis
  • ALLIANCE MEMBER
  • Vice President Quality and Clinical Integration at Network Health
  • Ruie Winters
  • ALLIANCE MEMBER
  • Sr. Director, Health Outcomes and Pharmacy at Denver Health Medical Plan
  • Jessica Woods
  • ALLIANCE MEMBER
  • STARS Member Engagement Program Manager at Health First Health Plans
  • Sam Wu
  • ALLIANCE MEMBER
  • Actuary at Denver Health Medical Plan
  • Ann Xiao
  • ALLIANCE MEMBER
  • Product Manager at CCHP
  • David Young
  • ALLIANCE MEMBER
  • Pharmacist at Denver Health Medical Plan
  • Elaine Zettel
  • ALLIANCE MEMBER
  • Product Manager, Medicare at Health Alliance Plan (HAP)