Monday, July 15, 2024

Registration & Networking Continental Breakfast

Sponsored by


Chairpersons’ Opening Remarks

Thomasina Anane,Director of Market Competitiveness,Alliance of Community Health Plans

Operationalizing Health Equity & Social
Determinants of Health for Scalability & ROI

Activating Equity-Informed Continuous Improvement

  • Review CMS Health Equity Accountability Requirements
  • Examine an Equity-Informed Continuous Quality Improvement case study
  • Discuss strategies to use Reality-based Quality Improvement to activate the organization

Melissa Smith, Founder, Senior Advisor,Newton Smith Group


Panel Discussion: Navigating the Health Equity Index and Addressing SDOH: Strategies for Success in Stars

Join a meaningful discussion exploring the intricacies of the health equity index (HEI) and how health plans are strategically preparing to leverage strengths in addressing social determinants of health to advance health equity as part of MA Stars. Panelists will discuss their unique perspectives of the health equity index and anticipated challenges. Discover insights into the transformative power of addressing social determinants of health and health disparities, leading to positive outcomes for patients and the health care system. Walk away with knowledge and understanding of how initiatives can champion equity and drive sustainable change for greater quality of care.


Thomasina Anane, Director of Market Competitiveness,Alliance of Community Health Plans



Keslie Crichton,Chief Sales Officer, Benelynk

Shelly McCombs, MPH,Sr. Manager Quality Improvement Operations and Accreditation, Health New England

Natalie Pirkola, PharmD, MBA, MASPHM, MSIS,Vice President, Pharmacy and Population Health HAP


Engage with CBOs to Drive Wellness, Build Trust & Retention
to Reach Underserved Members & Prime the Pre-65 Pipeline

Learn how to engage with Community-Based Organizations (CBOs) to drive wellness, build trust, and increase retention among underserved members. By working in partnership with CBOs, we can effectively reach out to those who may not have access to traditional healthcare services and prime the pre-65 pipeline for future enrollment. This session will provide valuable insights and practical tips on collaborating with CBOs to improve health outcomes and strengthen relationships within the community. Don't miss this opportunity to make a positive impact and drive positive change in the lives of underserved individuals.

Simone Brooks, Innovation Strategist, MVP Healthcare

Data Driven Strategies to Meet Members Where They Are

Networking Refreshment Break


Case Study: Using Data to Drive in-Person Member Communications to Address Barriers to Care

  • Adding data sources to identify sub-populations.
    • Enrollment Files
    • Health Risk Assessments
    • Supplemental data sources
  • Review engagement/utilization of populations to identify disparities/opportunities.
    • Race/language
    • Urban/rural
    • Age/sex
    • Product
  • Meet with stakeholder/community groups for including the Voice of the Member
  • Integrate the Voice of the Member findings into the intervention development process

Gregory A. Hanley, MBA, FACHE, CPHQ, Vice President, Health Services Quality and Operations,UCare


Falls are All in Your head: How Improving Brain Health Can Reduce Fall Risk

Most people think about fall risk as an issue involving the body and the environment. But it turns out that the brain has a central role in keeping us on our feet. And that means that brain health - and brain training - can play an important role in fall prevention programs. In this session, we'll talk about the science of brain health and fall risk - and what MA plans can do to reduce falls in their populations with a brain training program.

Henry Mahncke, CEO, Posit Science


Developing Retail Centers to Reach Underserved Populations – The Ground Game to Build Trust and Reach Members Where They Are

Naomi Irvin, Chief of Staff, Government Markets, Blue Cross and Blue Shield of North Carolina


Networking Lunch


Panel Discussion: Meeting Members Where They Are — Increasing Access to Care &
Maximizing Engagement & Satisfaction


Henry W. Osowski, Managing Partner, Strategic Health Group


Jenn Kerfoot, Chief Strategy & Growth Officer, DUOS

Mindi Knebel, CEO, Kaizen Health

Leadership Growth & Operational Innovations
to Balance Potential Revenue Decreases

A Profitable Growth Case Study – Focus on Operational Costs and Margins

  • What matters most…growth or profitable growth?
  • All parts of success are interconnected.
  • The changing landscape means many payers need to go narrow and deep
  • “The” thing that must be done to succeed

Gregg Kimmer PresidentATRIO Health Plans


Implementing a Financial Turnaround: Positioning Your Plan for Financial Success!

With the prospect of lower revenue for the next few years, maintaining plan profitability will be continue to be challenging. For plans looking for a financial turnaround or just to improve their current performance, having a defined strategy will be critical. Come learn some of the best industry practices to define your strategy, including how to benchmark your current performance, identify key areas of opportunity, implement your plan, and monitor the results.

Adam Barnhart, FSA, MAAA, Principal and Consulting Actuary, Milliman


Improve Your Plan’s Competitiveness, Revenue, Sales & Retention & Reduce Costs: 
Understanding the Impacts of Good Benefit Execution & Implementation

  • How, when and who to engage for success
  • Beyond ideation, working with operations to make sure benefits work in your systems smoothly
  • Telling the story: clear communication is key for all stakeholders
  • Creating targeted marketing campaigns to reach members and prospects
  • How can your vendors help
  • Monitoring and adjusting- identifying what, when and how

Christine Leo, Vice President, Senior Products, Cigna


Networking Refreshment Break

STARs Quality, HEDIS® & Risk Collaborations to Increase Performance Scores

Improving Performance in Quality, Stars and Risk Adjustment with a Wholistic Member Approach

  • Understanding all the areas of a health plan that should be included in risk adjustment, Stars, and quality strategies
  • Why a wholistic approach benefits both member and providers
  • What are the benefits of a wholistic approach on the health plan
  • How to create the interconnectivity between different areas of the company

Leah Hannum, Director of Risk Adjustment, Government Funding Operations,Blue Cross of Idaho

Maria Sánchez de Varona, Director, Medicare Stars Program, Blue Cross of Idaho


Managing Vendors for Success in Stars and ROI

  • Share what our process and structure looks like for managing and reviewing vendor partners
  • Getting executive review and buy in on which vendors to use for what needs
  • Creating a system to ensure ROI and continued review of vendors
  • How can your vendors help provide data and ROI?
  • Monitoring and reporting how vendors are helping with your stars strategy

Kena Hahn, MHA, Director, Medicare Stars & Outpatient Care Coordination, Health Alliance

4:50 – 5:50

Networking Reception

Tuesday, July 16, 2024

Networking Continental Breakfast


Chairpersons’ Remarks

Thomasina Anane,Director of Market Competitiveness,Alliance of Community Health Plans

Spotlight on D-SNPS & C-SNPs – Cross-functional Collaborations to Launch & Manage Operations & Grow Market Share

Winning with C-SNPs – A Collaborative and Value-Based Focus on Furthering Your Plan Portfolio with C-SNPs

  • Introduction to Chronic Condition Special Needs Plans (C-SNPs)
  • How, What, and Why C-SNPs belong in your product portfolio
  • Challenges, complexities, and opportunities to launching your C-SNP
  • The role of Value Based Care in managing chronic conditions
  • Achieving profitability, outcomes, and program success within your C-SNP plans

Meg Jordan,SNP SME, Formerly with, Prominence Health


“Please Stay”: Different Approaches to Retaining Dual Eligible-SNP (D-SNP) Members

D-SNP members are increasingly valuable to MA health plans. Retaining these members can be difficult when members are allowed to switch plans every quarter and competitors offer improved benefit packages. This presentation will review several approaches to communicating with Dual-SNP members and keeping them in your health plan. The presentation will cover:

  • Brief profile of membership in Dual-Eligible Special Needs Plans
  • Key retention challenges for D-SNP members and an overview of key reasons for switching D-SNP health plans
  • Different communication messages and channels used to inform and encourage member behaviors that lead to retention

Brian Wilson, Director Medicare Marketing, Cigna Healthcare

Supplemental Benefits – 360 Product Design,
Marketing, Engagement & Service Strategies

Panel Discussion: Supplemental Benefits – From Benefit Design to Member Engagement & Retention – Choosing the Right Benefits Members will Actually Use

As Medicare Advantage plans continue to expand supplemental benefit offerings beyond the table stakes of the industry, it's crucial for payers to stay ahead of the curve in order to better serve their member's needs. This panel will explore strategies for designing attractive supplemental benefits packages that support membership growth and retention. We'll dive into data-driven approaches for selecting the right supplemental benefits in addition to gaining insights to driving engagement through effective communications and utilizing supplemental benefits as a tool for member retention, growth, and Stars improvement. Whether you're looking to enhance your existing supplemental offerings or building a benefits package from scratch, this session will equip you with innovative tactics from within the industry.


Andrew Bell, Medicare Stars Practice Leader, ProspHire


Naomi Irvin, Chief of Staff, Government Markets, Blue Cross and Blue Shield of North Carolina

Rick Gordon, MBA, Senior Director of Operations & Integration, Operations Strategy Development, Business Process Improvement, Sentara Health Plans

Brandi Smith Brunson, Senior Manager Medicare Product, Cigna Healthcare


Networking Refreshment Break

Pharmacy Leadership: Addressing Dramatic Industry-wide Changes

Implementing the Medicare Prescription Payment Plan: Strategies for Smooth Sailing

This session will review how Medicare Advantage plans can successfully navigate the 2025 M3P IRA changes. Tips on how plans can successfully implement & ensure compliance with M3P requirements.

Eileen Murphy, PharmD, Director of Pharmacy Services, Security Health Plan

The Connected Member Experience – Sales, Marketing, Retention & Engagement Tools & Strategies

Empower Service for Retention and Outcomes: Integrating Medicare Advocacy in an Omni-channel Call Center Environment

In today's interconnected world, maintaining strong customer relationships and connecting members to resources become more critical to retaining business and improving outcomes. Learn about how Blue Cross & Blue Shield Rhode Island is pioneering strategies and solutions designed to enhance customer retention and foster health plan engagement with vulnerable and at-risk members within an omni-channel contact center environment. The session will focus on:

  • Key opportunity costs and measures
  • Service stratification
  • Measuring engagement
  • Service as a consultant
  • Application of interventions
  • Enablers to successful omni-channel engagement

Jason Furlan,Director Medicare Concierge, Blue Cross & Blue Shield of Rhode Island


Close of Conference