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Fly-in: Medicare Advantage VBID 2.0

Event Date: 8/6/2019 - 8/7/2019

Event Overview


 

VBID 2.0: New perks available for payers that enroll in the latest CMS model

Since CMS reinterpreted the statutes underlying its uniformity regulations, Medicare Advantage plans can enjoy many of the opportunities provided by the original VBID test, without having to take on the additional administrative burden that's part and parcel of participation in a pilot program.  But now CMS has introduced VBID 2.0, and is encouraging participation nationwide by offering even greater flexibilities to model participants:

  • Benefit offerings based on an enrollee's low-income status and benefits that directly address SDOH, without the requirement to link the benefit to a medical need, or award it based on medical necessity.
  • Rewards programs associated with VBID 2.0 participation may have higher values than ever before
  • VBID participants may use telehealth providers as a limited substitute for physical providers to meet network adequacy requirements in a given county.
  • More plan types can participate, including Regional Preferred Provider Organizations and all Special Needs Plans
  • Beginning in 2021, a test of a hospice benefit in 2021 will likely give beneficiaries an option to remain in MA and receive all benefits through their plan, rather than traditional Medicare

This fly-in and workshop, organized in cooperation with the Center for Value-Based Insurance Design, brings both the "vision" and the "real world experience" into a single conversation and will arm Medicare Advantage and Special Needs Plans with the insight they need to better evaluate the opportunities VBID 2.0 present for their health plan.  For more information on V-BID in MA, visit the V-BID Center event page  

 


 
Brought to you by the Health Plan Alliance and the Center for Value-Based Insurance Design





The Health Plan Alliance is a national organization that brings provider-sponsored and independently-owned health plans together with their health system and provider group leaders for unparalleled peer-to-peer collaboration. For more than 20 years, Health Plan Alliance members have leveraged the collective knowledge of our community to enhance their business acumen and advance the quality of health care delivery in their communities.

University of Michigan faculty first conceptualized and coined the V-BID concept and have guided this approach from early principles to adoption in the private and public sectors. Since its inception in 2005, the University of Michigan Center for Value-Based Insurance Design has led efforts to promote the development, implementation, and evaluation of innovative health benefit designs that improve quality and lower costs - the primary goals of health care reform. 




Event highlights

Visit the agenda tab to see the entire agenda 
 

  • CMMI's Mark Atalla joins our faculty for a townhall style Q&A with Alliance member health plans
  • The VBID center convenes an expert panel to provide context and background of the VBID model, and what we anticipate from policy makers and regulators in the future when it comes to support for clinically nuanced benefit design
  • We'll look under the hood of real-world VBID programs managed by a provider-sponsored health plan today: The case study from UPMC will cover the decision-making process, implementation experience, and the road ahead.  Following the case study presentation, we will host peer-group break outs for more technical details related to product design, medical management, and financial management


Who should attend

This meeting is limited to Health Plan Alliance members and invited guests.

We encourage organizations offering a Medicare Advantage plan to send a team of delegates, to take full advantage of the break out sessions designed to offer technical guidance and deeper dives into role-specific issues in these key areas: Medical, Financial, and Product design and strategy.  

This meeting is designed for inter-disciplinary teams with responsibilities for:

  • Medical management
  • Product design and market intelligence
  • Financial performance of your Medicare Advantage product
  • MA bid development
  • Network development and contracting
  • Provider partnership strategies, risk sharing arrangements and advanced payment model development


Alliance member health system and/or provider groups are also invited attend.


Thank you to our event sponsors


Bronze


Sponsor

 
Agenda

AGENDA  (updated July 30, 2019)

AGENDA | Tuesday, August 6, 2019

 

2:30pm

Welcome and Kick Off (4th floor, Conf room 4506)


Kristin B. Rodriguez, Chief Knowledge Officer

Health Plan Alliance


2:40 – 3:10pm

Background and Motivation for VBID in MA



A. Mark Fendrick, Director, V-BID Center

3:10 – 4:00pm

Expert Panel: VBID’s evolution and current role in MA

VBID’s CMMI architects consider the early experience and current role of VBID in MA, including a discussion of the amendment of the Uniformity Rule and the MA VBID model evaluation report


Steve Jenkins, LMI


Adam Finkelstein, Manatt

4:00 – 5:00pm

Reverse Case Studies

Alliance members workshop their specific sticking points when it comes to making any progress on VBID. Reverse case study presenters will leverage the group’s collective knowledge and receive feedback on the specific analyses, workflow, or executive communication challenges they face today.


SelectHealth: How do you make the numbers demonstrate what you know intuitively?

It makes sense that removing barriers will increase compliance in patient populations with chronic diseases. But when creating a model for clinically-nuanced benefit enhancements it can be difficult to translate expectations (from intuition to published studies) into cost savings you can rely on. In this reverse case study, SelectHealth’s MA program manager shares the roadblocks they’ve hit so far in modeling clinically-nuanced benefits. They seek to learn from workshop participants how others are sharpening their pencils to design enhancements that actuaries can get behind, and how they are measuring success once the benefits are implemented. Specific examples will include benefits to reduce falls risk and avoid surgery for lower back pain.


Health Alliance Plan: The challenges of perception and process

In any value based or condition specific product design approach at HAP, the cross functional team responsible has a careful process of selecting the conditions, modeling the potential opportunity and makes a recommendation to move forward based on the analytics. For the VBID model, the initiative has never been able to move past this step. The barriers for decision makers could include concerns about too much risk, or a perception that there are not enough proven results, or perhaps that it will be too hard to administer. Our reverse case study presenter shares her experience with internal dialogue regarding VBID and wants to know from workshop participants how other plans been able to overcome the hurdles to move initiatives like these forward? What advice or recommendations do plans have to approach differently?


Interested in workshopping your health plan’s reverse case study? Contact Kristin Rodriguez to learn more.


Kaleb Holt, Medicare Advantage Program Manager, SelectHealth

 

Lori Rund, VP-Product Mgt & Mkt Intelligence, Health Alliance Plan



5:30 – 8:00pm

Happy Hour/Networking Dinner


All attendees

 


 

AGENDA | Wednesday, August 7, 2019

7:30 – 8:00am

Breakfast

Alliance Offices (4th floor, Conf Rm 4505 & 4506)



8:00 – 8:30am

Welcome Back! Attendee introductions


Kristin B. Rodriguez, Chief Knowledge Officer

Health Plan Alliance


8:30 – 10:00am

Case Study: UPMC’s journey with the VBID demo

Hear firsthand how UPMC implemented VBID design in their Medicare Advantage product. They provide an overview of the journey from beginning to today, and highlight successes, failures, learnings, and results to date.


Hazem Alsahlani, UPMC Health Plan


10:00 – 10:30am

Break



10:30 – 11:30am

Technical Break Out Workshops

The UPMC case study provides a high level framework of the health plan journey – now attendees take that discussion deeper into the strategies and tactics that make an initiative like this possible. Three break out groups, one each for Financial decision-makers, Product owners, and Medical leaders, dive into specific challenges such as:

  • How the financial analysis of a VBID design incorporates less tangible factors like impact on Stars and member retention
  • How the VBID program is implemented operationally, and how it is administered
  • How the clinically nuanced care approach impacts care management teams, physicians and patients directly


All attendees


11:30 – 12:00pm

Technical break out workshop debrief

The group discussion continues as we uncover the decision-making processes plans have used when it comes to VBID. We explore sticking points such as the financial analysis, securing buy-in from leadership, and the disconnect between medical case studies and claims analyses.


All attendees

12:00 – 1:00pm


Networking Lunch


1:00 – 2:00pm

CMMI Town Hall

Attendees engage in an open discussion of the VBID 2.0 model. Learn how CMMI views the transformative updates, and why today’s architects believe they will increase choice, lower cost, and improve the quality of health care for Medicare beneficiaries.


Mark Atalla, VBID design lead, the Center for Medicare and Medicaid Innovation (CMMI), CMS

2:00 – 3:00pm

To Demo, or not to Demo? Open Discussion

The group reflects on the workshop’s content and engages in ideation on additional resources, workshops, and tools which will continue to support health plans as they work through these models and decisions.

All attendees

 

Venue

Las Colinas, TX

Health Plan Alliance Headquarters

290 E. John Carpenter Freeway, Bldg 1
Irving, TX 75062


Hotels that offer shuttles to our headquarters

Omni Mandalay Hotel
221 E Las Colinas Blvd

Irving, TX 75039
972.556.0800
Website

Homewood Suites
4300 Wingren Dr
Irving, TX 75039
972.556.0665
Website

Aloft Las Colinas
122 E John Carpenter Fwy
Irving, TX 75062
972.717.6100
Website

Holiday Inn Express & Suites Irving Convention Center
333 W John Carpenter Fwy
Irving, TX 75039
972.910.0302
Website

Need more recommendations send an email to the Alliance. 

 

Attire

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

Taxi from the Dallas/Ft Worth International airport and Love Field airport is approximately $25 one-way.  UberX is $17-20.  The hotels above provide a shuttle to the Alliance office at 290 E John Carpenter Fwy, Bldg 1, which is where the meeting will be held.



Dallas weather

View the latest weather forecast.
Documents
  • 8/7/2019
  • Presentation: Background and Motivation for VBID in MA
  • A. Mark Fendrick, MD of the University of Michigan Center for Value-Based Insurance Design lays the groundwork for the MA VBID 2.0 session by providing a history of VBID and motivation for implementing it at health plans.
  • 8/7/2019
  • Presentation: VBID's Evolution and Current Role in MA
  • Manatt, Phelps and Phillips, presents and leads a discussion of the amendment of the Uniformity Rule and the MA VBID model evaluation report during the Medicare Advantage VBID 2.0 fly-in held in Irving, TX, August 6, 2019.
  • 8/6/2019
  • Presentation: Advantage Reverse Case Study
  • SelectHealth shares specific examples of benefits to reduce falls risk and avoid surgery for lower back pain. This presentation took place on August 6, 2019 during the Medicare Advantage VBID 2.0 fly-in held in Irving, TX.
  • 7/31/2019
  • Agenda: Medicare Advantage VBID 2.0
  • This fly-in and workshop brings both the "vision" of VBID and the "real world experience" into a single conversation and will arm Medicare Advantage and Special Needs Plans with the insight they need to better evaluate the opportunities VBID 2.0 presents for their health plan.
Attendees

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

  • Jordyn Clark
  • ALLIANCE GUEST
  • Project Manager at University of Michigan Center for Value-Based Insurance Design
  • Benjamin Aragon
  • ALLIANCE MEMBER
  • Manager, Product Development at Sharp Health Plan
  • Tiffany Berry
  • ALLIANCE MEMBER
  • Chief Medical Officer, Baylor Scott & White Quality Alliance at Baylor Scott & White Health
  • JoAnn DeBeer
  • ALLIANCE MEMBER
  • Director of Financial Planning & Analysis at Avera Health Plans (DAKOTACARE)
  • Jean Detwiler
  • ALLIANCE MEMBER
  • Director Medicare Product Oversight at Health Alliance Plan (HAP)
  • Mike Dooley
  • ALLIANCE MEMBER
  • Director of Provider Contracting & Engagement at Avera Health Plans (DAKOTACARE)
  • Jordan Erp
  • ALLIANCE MEMBER
  • SVP, Chief Integration Officer at Presbyterian Health Plan
  • Trent Hadley
  • ALLIANCE MEMBER
  • VP & CFO at Baylor Scott & White Health
  • Scott Hancock
  • ALLIANCE MEMBER
  • VP of Sales and Operations at Care N' Care Insurance Company, Inc.
  • Kaleb Holt
  • ALLIANCE MEMBER
  • Medicare Advantage Program Manager at SelectHealth
  • Jeff Ingrum
  • ALLIANCE MEMBER
  • President and CEO at Scott & White Health Plan
  • Keith Johnson
  • ALLIANCE MEMBER
  • Executive Director, Employer & Value Based Contracting at Prisma Health
  • Wendy Karsten
  • ALLIANCE MEMBER
  • CEO at Care N' Care Insurance Company, Inc.
  • Melissa Kinzel
  • ALLIANCE MEMBER
  • Product Development Coordinator at Health First Health Plans
  • Christine Lounsbery
  • ALLIANCE MEMBER
  • Director of Population Health Services Operations at Avera Health Plans (DAKOTACARE)
  • Matt Miles
  • ALLIANCE MEMBER
  • Director of Marketing/Sales at CHRISTUS Health Plan
  • Hilairee Mosier
  • ALLIANCE MEMBER
  • Marketing Manager at Avera Health Plans (DAKOTACARE)
  • Falon Owen
  • ALLIANCE MEMBER
  • Director, Product Management at Mount Carmel Health Plan (MediGold)
  • Kate Parker
  • ALLIANCE MEMBER
  • Director, Consumer & Government Products at Avera Health Plans (DAKOTACARE)
  • Jenny Reed
  • ALLIANCE MEMBER
  • VP of Comprehensive Care Management at Baylor Scott & White Health
  • Stephanie Rogers
  • ALLIANCE MEMBER
  • VP, Government Programs at Scott & White Health Plan
  • Lori Rund
  • ALLIANCE MEMBER
  • Vice President-Product Mgt & Mkt Intelligence at Health Alliance Plan (HAP)
  • David Sand
  • ALLIANCE MEMBER
  • Chief Medical Officer at Care N' Care Insurance Company, Inc.
  • Margaret Solma
  • ALLIANCE MEMBER
  • Director of Plan Structure & Integrity at Avera Health Plans (DAKOTACARE)
  • Katie Studer
  • ALLIANCE MEMBER
  • Director, Customer Experience at Avera Health Plans (DAKOTACARE)
  • JT Walker
  • ALLIANCE MEMBER
  • Sr Actuarial Analyst at SelectHealth
  • Mark Atalla
  • SPEAKER
  • MA-VBID Model Lead at Center for Medicare and Medicaid Innovation (CMMI)
  • A. Mark Fendrick
  • SPEAKER
  • Director, University of Michigan Center for Value-Based Insurance Design (V-BID) at Center for Value-Based Insurance Design
  • Stephen Jenkins
  • SPEAKER
  • Program Manager at Logistics Management Institute
  • Sarah Clark
  • SPONSOR
  • Market Insights Manager at American Well
  • Brian Goetsch
  • SPONSOR
  • Sr. Director - New Business Development at EyeMed Vision Care
  • Liz Kelliher
  • SPONSOR
  • Senior Event Manager at American Well
  • Alicia Kutil
  • SPONSOR
  • Business Development at American Well
Speakers
  • A. Mark Fendrick
    Director, University of Michigan Center for Value-Based Insurance Design (V-BID) at Center for Value-Based Insurance Design
    click here for full people profile