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Two Co-Located Events: Quality and Medicare Value Visit 2017

Event Date: 7/18/2017 - 7/21/2017

Event Overview
Visit the documents tab to access the archived event presentations and podcasts.


People networking at conference

Two events in one, tackling the biggest challenges facing Medicare plans and quality departments

Hosted by Physician's Plus and Quartz Health Solutions

Download the event presentations and podcasts for in-depth information on:

  • Everything from quality improvement to provider contracting to operational excellence and product stability
  • How to ensure your organization is in lock-step with NCQA and CMS Stars expectations
  • Re-energizing your efforts to engage providers in quality, Stars and risk adjustment initiatives
  • How other health plans are tackling provider directory requirements
  • Growth strategies and product design approaches that take into account VBID and MACRA

 


Member Testimonials


What a great week! I learned so much and loved the engaged and interactive format of the meeting.

Amy Sepko
Health New England
Great conference. I hope to return each year. I got some amazing information.

Star Christensen
SelectHealth
Appreciate the opportunity to network with other like professionals on quality. Learned much! Have lots of ideas and contacts!

Mary Alice Brosseau
CommunityCare
I appreciate the Case Studies and practical application shared to move the quality needle. I always walk away with new ideas and motivation to implement.

Lisa Johnston
Alliant Health Plans


ABOUT THE EVENT

Achieving your organization's quality goals
July 18 - 19*

Leaders in health plan Quality management programs came together July 18-19 for education and networking on key issues related to quality management program structure, shifting accreditation requirements and Stars improvement strategies.

 

Audience:

  • Leaders in your plans' quality management programs including program directors and managers.
  • Provider partner representatives, i.e., medical group and/or health system with an interest in quality improvement efforts of the health plan.
  • Stakeholders involved with NCQA accreditation activities
  • Individual with responsibility for developing and implementing HEDIS, CAHPS, HOS improvement initiatives
  • Network management and data analytics teams responsible for provider engagement strategies to drive improved health care quality 

Operationalizing your Medicare Advantage strategy
July 19* - 21 

Medicare Advantage leaders and stakeholders convened July 19 - 21 to discuss challenges in MA product design, operationalizing growth strategies, and keeping pace with the shifting regulatory environment.

Shared MA marketing materials

Each year, attendees from member health plans across the country bring their Medicare marketing materials samples to the Medicare Advantage value visit. Throughout the year you can continue to share your samples with your Alliance peers by adding your samples to the knowledge center.

 

Audience:

  • Leaders of your organization's MA Product Line, including MA program managers and MA program directors
  • Leaders in MA product design, sales and marketing, provider contracting, and growth strategy development
  • Financial leaders with responsibility for revenue cycle optimization, including issues related to MSP and risk adjustment
  • Stakeholders in the member experience, including MA collateral and communications, member surveys, and engagement in Stars
  • Individuals with responsibility for provider directory management

 


Thank you to our event sponsors


SILVER SPONSORS

       

 
 
 
 
 
 
 
 

 

 BRONZE SPONSORS

 

                        

 

 OTHER SPONSORS

                           

 
 
 
 
 
 
 
 

 

 

Agenda

A detailed draft agenda is available for download via the documents tab noted above 

This Agenda at a Glance was last updated May 31, 2017

• Quality Management Value Visit

• Medicare Advantage Value Visit

 

TUESDAY, JULY 18th

8:00am

Breakfast

8:30 – 9:00am

Welcome and introductions

9:00 – 10:30am

Organizational structures for quality activities

10:30 – 10:45am

Break

10:45 – 12:00pm

Creating a culture of quality improvement and effectively integrating quality initiatives across your plan/system

12:00 – 1:00pm

Lunch

1:00 – 2:00pm

Review of proposed NCQA health plan accreditation standards for 2018

2:00 – 3:00pm

Navigating key NCQA 2017 and 2018 health plan standards changes, part 1

 

3:00 – 3:30pm

Break

3:30 – 4:15pm

Navigating key NCQA 2017 and 2018 health plan standards changes, part 2

 

4:15 – 4:45pm

Tools and resources to manage the NCQA workflow process

4:45 – 5:15pm

Review of quality survey results and next steps for quality programming

6:00pm

Reception

 

WEDNESDAY, JULY 19th

7:30am

Breakfast

 

 

8:00 – 8:30am

Welcome and Introductions

 

8:30 – 9:30am

Government programs and quality program synergies: Leveraging your investments across product lines

9:30 –9:45am

Break

9:45 – 11:00am

Emerging trends in Star ratings to improve 2018 scores

11:00 – 12:30pm

Peoples Health Case study: Developing provider partnerships that align stars, risk adjustment and outcomes

12:30 – 1:30pm

Lunch

1:30 – 3:00pm

CommunityCare Case study: Provider engagement strategies to support both Star ratings and risk adjustment initiatives

3:00 –3:30pm

Break

3:30 – 4:45pm

Quartz Case study: A collaborative quality improvement model

6:30pm

Dinner

 

 

THURSDAY, JULY 20th

7:30 – 8:00am

Breakfast

 

8:00 – 9:15am

Paramount Case study: Their multi-pronged approach to improving the financial performance of their MA product

9:15 – 9:30am

Break

 

9:30 – 10:45am

Understanding and operationalizing provider directory regulations

10:45 – 12:00pm

Johns Hopkins Case study: Infrastructure investments critical to positioning for the next generation of MA

12:00 – 1:00pm

Lunch

 

1:00 – 2:15pm

Closing the time gap between diagnosis and risk forecasting: Empowering providers to manage risk

2:15 – 2:45pm

Break

 

2:45 – 3:45pm

Case study: Making member communications management work better, for you AND your MA members

3:45 – 4:45pm

Innovation session: Blending enrollment with onboarding and care management phases

4:45 – 5:00pm

Wrap up

 

6:30pm

Dinner

 

 

FRIDAY, JULY 21st

8:00 – 8:30am

Breakfast and MA Collateral show and tell – Open Discussion

8:30 – 10:00am

Quartz case study: Thinking beyond the sale -- Training your sales team to get the member connected to the health plan right from the start

10:00 – 10:15am

Break

 

10:15 – 11:45am

Case study: A new approach to member acquisition that brings internal stakeholders to the table

11:45 – 12:45pm

Lunch

 

12:45 – 2:00pm

Maximizing your Medicare Portfolio

2:00 – 2:30pm

Open discussion and wrap up

 

2:30pm

Event adjourns

 

Venue

edgewater

The Edgewater Hotel
1001 Wisconsin Place
Madison, WI 53703
608.535.8200

Our room rate is $195 plus taxes/fees. Internet access in the guest rooms is complimentary. This rate may be available three days prior and three days after our meeting dates, depending on the hotel's availability. You should call the reservations department at 608.535.8200 and ask for the Health Plan Alliance (HPA) room rate.  You must call the hotel by Monday, June 26, 2017 in order to receive our group room rate. Should you call after this deadline, you will not be guaranteed to receive our group room rate or the hotel may be sold out. Please note that the group block could sell out before this date.

DRESS
Business casual attire is appropriate for the meeting. Remember that the hotel meeting room temperatures vary, so we recommend that you layer clothing to be comfortable in case the room becomes either hot or cold.

GROUND TRANSPORTATION
The hotel is about 3 miles from Dane County Regional Airport (DCRA) and is approximately a 10 minute drive. Taxi service is available for an estimated $20 one way.  Self parking is $18. Valet parking is $25 includes in/out privileges. For more transportation information click here.

MADISON WEATHER
Click here for the latest weather forecast.


Special Events

MA Marketing Materials: Show and tell

Share your member materials!

Each year, attendees from member health plans across the country bring their Medicare marketing materials samples to the Medicare Advantage value visit.  Plan on bringing examples of your own plan’s good work!  See below for details, or reach out to Kristin Rodriguez with any questions.  

The WHO:
All value visit attendees are invited to bring copies of your health plan’s member communication materials to Madison.  
Even if you’re not directly responsible for sales and marketing development at your plan, we encourage you to coordinate with your organization’s stakeholders to arrange for sharing 50 copies of your samples (enough for 1 sample per attending health plan).  Thank you in advance for participating! We can all learn from each other. 

The WHAT:
Any member-facing piece is encouraged! Direct mail, advertising slicks, brochures of course – and don’t forget Postcards reminding your members to get flu shots, or any other campaign you’ve built to support Stars objectives.  If the piece is seen by your members, we’d love you to share it with your Health Plan Alliance colleagues.

The HOW:
Ship your materials directly to the Edgewater Hotel with an arrival date of July 17th.  
Your package label should read:

ATTN: Patrice Snowden
Health Plan Alliance meeting
The Edgewater Hotel
1001 Wisconsin Place
Madison, WI 53703

The WHEN:
All contributed materials will be placed on a table in the meeting room July 19-21 and FedEx boxes will be provided for interested attendees to fill and ship, heavy with ideas and samples, back to their offices.

 

Documents
8/13/2017

Audio: Navigating Key NCQA 2017 and 2018 Health Plan Standards Changes PT 2
Carol Delage, President of Tashidy Corporation led a workshop with the attendees at the 2017 Quality Value Visit to help us understand key updates to the 2017 Health Plan standards and identify operational impacts, including NCQA’s reverting to the historical medical necessity denial decision definition and impact on file review; plans for 2017 surveys on UM 4H and the appropriate classification of decisions and key areas of surveyor emphasis outlined in 2017 NCQA Surveyor Training. Carol also discussed the implications of the draft 2018 Health Plan standards changes, with a main focus on the new Population Health Management requirements and what types of actions are needed to demonstrate compliance

8/13/2017

Audio: Tools and resources to manage the NCQA workflow process
At the 2017 Quality Value Visit, Sheryl Pierce with Quartz Health Plan shared her plans to improve the efficiency and effectiveness of monitoring the NCQA workflow process within Quartz and then spearheaded a discussion with the attendees around the use of tools and resources used by other plans.

8/13/2017

Audio: Government programs and quality program synergies: Leveraging your investments across product lines
In this session from the 2017 Medicare Advantage Value Visit, Gorman Health Group founder and executive chairman John Gorman shares his insights on the policy agenda and how the translation of that policy into regulatory oversight, quality programs expectation, and payment model evolutions are going to shape your organization’s decision making over the next 3 years.

8/13/2017

Audio: Emerging trends in Star ratings to improve 2018 scores
At the 2017 Medicare Advantage Value Visit, Gorman Health Group Senior Consultant Melissa Smith dives deep into Stars with Alliance member organizations, offering insights on how health plans already committed to Stars performance must continue to evolve to maintain performance levels. She focuses on critical elements of success and engages attendees in discussion regarding lessons learned, best practices, and emerging innovations plans should consider embracing.

8/13/2017

Audio: Peoples Health Case Study: Developing provider partnerships that align stars, risk adjustment and outcomes
In this case study from Peoples Health, SVP Health Services Barbara Guerard walks through the health plan’s multi-pronged approach to weaving efforts related to Stars and care coordination into what the staff is already doing. From their integrated advanced care coordination model to provider and member engagement efforts, their approach to dashboard development and how they use these tools to further strategically significant conversations, PeoplesHealth has elevated the refinement of their care coordination model into the culture of the organization.

8/13/2017

Audio: CommunityCare Case Study: Provider engagement strategies to support both Star ratings and risk adjustment initiatives
In this case study at the 2017 Medicare Advantage Value Visit, CommunityCare leaders share their strategy for engaging physicians and achieve alignment around Stars and risk adjustment efforts. Powered by thoughtful data analytics and supported with meaningful conversations from medical leadership, their provider dashboards are tools to support the efforts they ask their physicians to make. In this session, they share their best practices, lessons learned along the way, and advice for other health plans seeking to share data in meaningful ways with their providers, with an eye on driving outcomes.

8/13/2017

Audio: Quartz Case study: A collaborative quality improvement model
In this case study presentation t the 2017 Medicare Value Visit from Quartz, VP of Managed Care and Large Group Brian Collien shares details on the Unity health plan regional provider quality incentive program.

8/13/2017

Audio: Understanding and operationalizing provider directory regulations
With tough regulations and more rigorous oversight than ever before, Alliance members continue struggling to meet CMS expectations. In this session at the 2017 Medicare Advantage Value Visit, Shelley Stevenson of Change Healthcare leads a discussion of the regulatory environment and how plans are working within it to meet requirements related to provider directories

8/10/2017

Medicare Advantage Diagnostic
During the 2017 Medicare Value Visit, HealthScape shared its experience working with Paramount Healthcare to enhance the performance of its Medicare Advantage (MA) line of business. This brochure outlines how HealthScape can support other plans in achieving similar results and outlines the value add services HealthScape is offering Alliance plan members.

8/1/2017

Presentation: Innovation Session: Blending enrollment with onboarding and care management phases
Many beneficiaries newly enrolling in MA do not participate in important Care Management programs, due primarily to the limited success of costly health plan engagement efforts. This session explores how process, technology and focused public/private collaboration can quickly address this shortcoming, beginning at the Point of Sale. In a new pilot approved by CMS for the 2018 AEP, Bloom Insurance Agency is testing the theory that gathering health status (HRA) and a complete provider and Rx profile in conjunction with the enrollment, will result in more seamless, efficient and effective care and a more loyal member from day one. In this session, Bloom shares details about the program?s goals, feedback from CMS thus far, and how they see sales, compliance, and quality all coming together for a better member experience and more efficient use of health plan resources.

Attendees

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

  • Aubrie Augustus
  • ALLIANCE GUEST
  • Director of Accreditation at Peoples Health
  • Barbara Guerard
  • ALLIANCE GUEST
  • Senior Vice President - Health Services at Peoples Health
  • Crystal Harry
  • ALLIANCE GUEST
  • Director of Quality/Stars Program at Peoples Health
  • Deanna Homer
  • ALLIANCE GUEST
  • Chief Operations Officer at HealthTeam Advantage
  • Thomas Wilson
  • ALLIANCE GUEST
  • Medicare Compliance Officer at Kelsey-Seabold Clinic | KelseyCare Advantage
  • Amy Bachhuber
  • ALLIANCE MEMBER
  • Director, Provider Affairs at Quartz Health Solutions
  • Richard Berg
  • ALLIANCE MEMBER
  • Account Manager at Mission Health
  • Brian Collien
  • ALLIANCE MEMBER
  • VP Product Development at Quartz Health Solutions
  • Raven Crum
  • ALLIANCE MEMBER
  • Healthcare Informatics Analyst at Quartz Health Solutions
  • Trevor DaRin
  • ALLIANCE MEMBER
  • Senior Director, Sg2 at Vizient Inc.
  • Rita Datko
  • ALLIANCE MEMBER
  • Chief Financial Officer at Sharp Health Plan
  • Carol Dornbush
  • ALLIANCE MEMBER
  • Credentialing Coordinator at Medical Associates Health Plans
  • Daniel Ecklund
  • ALLIANCE MEMBER
  • Associate Medical Director at Quartz Health Solutions
  • Jeremy Fejfar
  • ALLIANCE MEMBER
  • Pharmacy Director Government Programs at Quartz Health Solutions
  • Jessica Fischer
  • ALLIANCE MEMBER
  • Director of Communications at Network Health
  • Alice Frank
  • ALLIANCE MEMBER
  • Sr Healthcare Informatics Analyst at Quartz Health Solutions
  • Elizabeth Goff
  • ALLIANCE MEMBER
  • Manager - Medicare Project Management at IU Health Plans
  • Brisa Guajardo
  • ALLIANCE MEMBER
  • Manager, Business Development at Community Health Plan of Washington
  • Andrea Hale
  • ALLIANCE MEMBER
  • Vendor Management Analyst at Quartz Health Solutions
  • Erin Heckethorn
  • ALLIANCE MEMBER
  • Director of Operations and Program Management at FirstCarolinaCare Insurance Company
  • Kaleb Holt
  • ALLIANCE MEMBER
  • Director of Medicare Programs at SelectHealth
  • Angela Keenan
  • ALLIANCE MEMBER
  • Compliance Officer at Network Health
  • Anita Landino
  • ALLIANCE MEMBER
  • Medicare SR. Marketing Specialist at Health Alliance Plan (HAP)
  • Luce Lohier
  • ALLIANCE MEMBER
  • Director, Government Programs Reimbursement at AvMed
  • Jonathan Moody
  • ALLIANCE MEMBER
  • Director of ACA Products and Government Affairs at Quartz Health Solutions
  • Romi Norton
  • ALLIANCE MEMBER
  • Strategic Marketing and Communications Manager at Network Health
  • Kari Pace
  • ALLIANCE MEMBER
  • Clinical Documentation Improvement Nurse-Risk Adjustment/Quality Management at Medical Associates Health Plans
  • Jerri Pearson
  • ALLIANCE MEMBER
  • Director, Marketing Operations at CommunityCare
  • Penny Ransom
  • ALLIANCE MEMBER
  • Chief Administrative Officer at Network Health
  • christina salm
  • ALLIANCE MEMBER
  • Vice President of Medical Management Operations at Quartz Health Solutions
  • Maggie Traastad
  • ALLIANCE MEMBER
  • Manager, Consulting Analytics - Production Support at Quartz Health Solutions
  • Josh Weisbrod
  • ALLIANCE MEMBER
  • VP Risk Adjustment at Network Health
  • Jim Corbett
  • SPEAKER
  • Founder and Chief Strategy Officer at Reveleer
  • Alexis Levy
  • SPEAKER
  • Managing Director at HealthScape Advisors, LLC
  • Brad Piper
  • SPEAKER
  • Principal and Consulting Actuary at Milliman
  • Mohammed Vaid
  • SPEAKER
  • Founder & Chief Solution Architect at Simplify Healthcare
  • Becky Erbe
  • SPONSOR
  • Chief Business Development Officer at hunterAI
  • Judith Nelson
  • SPONSOR
  • Director, Medicare Advantage Strategy at DST Health Solutions
  • Dennis Nelson
  • SPONSOR
  • Vice President Business Development at eviCore healthcare
  • Diana Sonbay-Benli
  • SPONSOR
  • Chief Product Officer, TriZetto Healthcare Products Group at Cognizant
  • Jacqueline Crews
  • VIRTUAL ATTENDEE - MEMBER
  • Director, Public Policy & Benefit Contracts at AvMed
  • Jodi Digmann
  • VIRTUAL ATTENDEE - MEMBER
  • Medicare Compliance Analyst at Medical Associates Health Plans
  • Melanie Draheim
  • VIRTUAL ATTENDEE - MEMBER
  • Vice President of Marketing and Strategy at Network Health
  • Alison Dunton
  • VIRTUAL ATTENDEE - MEMBER
  • Director of Practice Enhancement & Analytics at Aspire Health Plan
  • Krista Schonrock
  • VIRTUAL ATTENDEE - MEMBER
  • AVP, Senior Medical Director Physician Review at SelectHealth
Speakers