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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, Part D premium requirements, M3P, and GLP-1 proposed price changes, IRA negotiated drugs lists and its impact to manufacturer rebates
  • PD Bid benefits: formulary changes and benefit design considerations related to trend in moving to coinsurance for T3/4 and impact of VBID removal
  • Part D trends: Costs, utilization, blockbuster drugs, generic launches, GLP-1s, induced utilization, and other impacts to point-of-sale Part D drug costs
  • Part D risk adjustment: continued need to focus on RxHCCs, normalization factor spread between PDPs and MAPDs, and potential CY2027 model change due to continued IRA impacts.
  • 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

  • Carrie Alles
  • ALLIANCE MEMBER
  • Director of Consumer and Specialty Products at Providence Health Plan
  • Julie Boutwell
  • ALLIANCE MEMBER
  • Medicare Audit Analyst - Compliance at Providence 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
  • Megan Do
  • ALLIANCE MEMBER
  • Manager Product Development at Health First Health Plans
  • Jeremy Fejfar
  • ALLIANCE MEMBER
  • Pharmacy Director Government Programs at Quartz Health Solutions
  • Rasheeda Flesch
  • ALLIANCE MEMBER
  • Medication Adherence Specialist at CommunityCare
  • Jessica Griffin
  • ALLIANCE MEMBER
  • Medicare Product Manager at Quartz Health Solutions
  • Anthony Hansen
  • ALLIANCE MEMBER
  • Sr. Pharmacy Compliance Product Management Coordinator at Providence Health Plan
  • Patricia Henderson
  • ALLIANCE MEMBER
  • Director, Compliance at Health Partners Plans / Jefferson Health Plans (HPP/JHP)
  • Kaleb Holt
  • ALLIANCE MEMBER
  • Director of Medicare Programs at Select Health
  • LaShunda Hooks
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment at Santa Clara Family Health Plan
  • Jamie Johnson
  • ALLIANCE MEMBER
  • QI Stars Specialist at CommunityCare
  • Alicia Kelley
  • ALLIANCE MEMBER
  • Vice President, Government Program 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
  • Isela Martinez
  • ALLIANCE MEMBER
  • Clinical Program Manager at Baylor Scott and White Health Plan
  • Brandon Mauck
  • ALLIANCE MEMBER
  • Director of Product Management and Business Development at MediGold
  • Tracey McCloy
  • ALLIANCE MEMBER
  • Director, Strategic Growth & Product Development at HealthTeam Advantage
  • James Moses
  • ALLIANCE MEMBER
  • Sales Manager at Denver Health Medical Plan
  • Phu Nguyen
  • ALLIANCE MEMBER
  • Pharmacy Executive at Vizient Inc.
  • Veronica Palma
  • ALLIANCE MEMBER
  • Product Development Manager at Select Health
  • Charles Perez
  • ALLIANCE MEMBER
  • Pharmacy Benefits Administrator at CommunityCare
  • Noelle Plumlee
  • ALLIANCE MEMBER
  • Compliance Consultant at Providence Health Plan
  • Amanda Scholze
  • ALLIANCE MEMBER
  • Sr. Director, Medicare & Individual Products at Quartz Health Solutions
  • Ray Shackelford
  • ALLIANCE MEMBER
  • Medicare Product Advisor at Select Health
  • 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
  • Deb Sterner
  • ALLIANCE MEMBER
  • Clinical Auditor, FWA at Geisinger Health Plan
  • Mike Treash
  • ALLIANCE MEMBER
  • President at Health New England
  • Andy Wheaton
  • ALLIANCE MEMBER
  • Director-Pharmacy Benefits at Network Health
  • Ann Xiao
  • ALLIANCE MEMBER
  • Product Manager at CCHP
  • Elaine Zettel
  • ALLIANCE MEMBER
  • Product Manager, Medicare at Health Alliance Plan (HAP)