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Medicare Product Design Master Class
August 5-6, 2024
Orlando, FL
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Monday - August 5, 2024
Registration Desk Open
Networking Breakfast
Exhibit Hall Open
Welcome and Opening Remarks
Nick DiMauro, Director of Business Development
Medline
Fireside Chat: Medicare Advantage at a Crossroads
- Get a behind-the-scenes look at how CMS creates policies and regulations
- Unravel industry trends and headwind shifts that are redefining the Medicare Advantage market
- Navigate the evolving turbulence of the Medicare Advantage industry to get a vision for the future
Moderator:
Sion Hughes, Senior Consultant
Wakely, an HMA Company
Amy Bassano, Managing Director, Medicare
Health Management Associates
Former Deputy Director, CMS Innovation Center
Tim Murray, Principal
Wakely, an HMA Company
Andy Higgins, Vice President, Product Development
Clever Care Health Plan
10:10 AM 11:00 AM
CMS Final Rule: Overview of Key Provisions
- Learn about the key provisions impacting product design, including changes related to supplemental benefits
- Explore how to adjust your benefit strategy to comply with new requirements
- Understand potential financial impacts
Melissa Smith, Founder
Newton Smith Group
Shannon Decker, PhD, MBA, MBA, M.Ed, M.Ed, Principal
VBC One
11:00 AM 11:20 AM
10:00 AM 10:20 AM
Networking Break
11:20 AM 12:20 PM
10:20 AM 11:20 AM
Part D Changes and Challenges Impacting Product Design
- Discuss recent and upcoming Part D changes under the Inflation Reduction Act, including the lowered maximum out of pocket cost, prescription payment plans, and Medicare drug negotiations, and their impact on product design
- Analyze how the changes could affect member behavior
- Take away product design ideas that will help balance your Part D budget
- Understand utilization trends of certain drug classes, such as GLP-1s
Omar Daoud, Senior Director of Pharmacy
Community Health Plan of Washington
Gary Melis, Clinical Pharmacist
Network Health
James Cooper, Consulting Actuary
Milliman
11:20 AM 12:20 PM
10:20 AM 11:20 AM
Networking Lunch
11:20 AM 12:10 PM
10:20 AM 11:10 AM
Product Design Strategies to Boost Your Star Rating
- Understand the intersection between product design and Stars
- Review the new Health Equity Index and consider whether pursuing that reward is right for your plan, especially if you don’t currently have a large high-need population
- Get tips for implementing elements to your product design that could result in a higher Star rating
Moderator:
Rebecca Ballou, Senior Business Development Executive
Amplifon Hearing Health Care
Lisa Franklin, MS, Director of Individual Medicare Business and Product & Marketing Strategy (Government Programs)
CareFirst BlueCross BlueShield
Rex Wallace, CEO
Rex Wallace Consulting, LLC
11:10 AM 12:00 PM
Benefits Analysis: What to Keep and What to Cut to Optimize ROI and Health Outcomes
- Get strategies for making the right product decisions when facing revenue headwinds
- Learn how to analyze your market to determine the supplemental benefits that not only attract members but truly add value, address social drivers of health (SDoH), and improve outcomes
- Analyze whether monetary benefits, like Part B buybacks and zero-dollar premiums, work for your market over the long term
- Understand how to calculate the return on investment (ROI) of supplemental benefits
Danica (Dani) Holliston, Manager of Medicare Product
Regence Blue Cross Blue Shield
Jenn Kerfoot, Chief Strategy & Growth Officer
DUOS
12:00 PM 12:20 PM
Networking Break
Medicare Advantage Supplemental Benefits: Where Do We Go from Here?
- Explore the growth of supplemental benefits in the Medicare Advantage program, as well as questions around how to validate benefit value
- Understand the changing regulatory environment related to supplemental benefits
- Review the opportunities and challenges MA plans face in administering supplemental benefits
Monica Pagels, Manager of Product Development
Emergient
Andy Friedell, Chief Operating Officer
The Helper Bees
Real-Life Experiences with VBID
- Get insights into effective use of the CMS Value-Based Insurance Design (VBID) model to improve health outcomes and health equity while containing costs
- Review the new application process and requirements for participating in VBID
- Discuss the hospice benefit under VBID and how plans will be impacted by the discontinuation of that component
- Hear about offering supplemental benefits and Part D rewards and incentives through VBID to address SDoH and improve outcomes
Omar Daoud, Senior Director of Pharmacy
Community Health Plan of Washington
Heather Adams, Senior Product Line Manager, Medicare
Blue Cross and Blue Shield of North Carolina
Leveraging AI to Modernize Medicare Advantage Plan Design
Developing differentiated and financially viable Medicare Advantage products is key to winning in a market that is becoming increasingly competitive and facing financial headwinds. Learn how generative and traditional artificial intelligence (AI) capabilities can assist in:
- Understanding the impact of different benefit choices on enrollment
- Pulling competitive insights buried within PBP files and EOC documents
- Comparing product strength at a county level to understand competitive positioning
- Providing product insights to downstream stakeholders (including sales)
Harbinder Raina, Principal
ZS
Danica (Dani) Holliston, Manager of Medicare Product
Regence Blue Cross Blue Shield
Closing Remarks
Nick DiMauro, Director of Business Development
Medline
Networking Cocktail Reception
Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.
Tuesday - August 6, 2024
Registration Desk Open
Networking Breakfast
Exhibit Hall Open
Welcome Remarks and Day One Takeaways
Melissa Smith, Founder
Newton Smith Group
Deep Dive: Special Supplemental Benefits for the Chronically Ill (SSBCI)
- Analyze your market to determine whether offering supplemental benefits through SSBCI is right for your population
- Understand how to calculate the ROI of SSBCI
- Review the new SSBCI reporting requirements, including creating a bibliography of evidence
Paul Cain, Product Strategy Lead
Cigna
Ana Handshuh, Principal
Cat5 Strategies
Andy Higgins, Vice President, Product Development
Clever Care Health Plan
10:00 AM 10:45 AM
Responding to New Reporting Requirements for Supplemental Benefits
- Review the requirements, with a focus on the most cumbersome areas
- Gain strategies for efficiently tracking and reporting the required data
- Understand provisions to include in vendor contracts to help with compliance
- Get insights into the strategic advantages that collecting more data will bring to your health plan
Moderator
Nick DiMauro, Director of Business Development
Medline
Abby Katabaro, Managing Director, Medicare Product
Blue Cross Blue Shield of Michigan
Ana Handshuh, Principal
Cat5 Strategies
10:45 AM 11:05 AM
Networking Break
11:05 AM 11:50 AM
10:05 AM 10:50 AM
Focus on the Growing D-SNP Market
- Discuss the different types of Dual Eligible Special Needs Plans (D-SNPs) and recent market trends
- Review CMS’ plan to transition all dual-eligible Medicare beneficiaries to D-SNPs
- Gain insights into the special needs of the dual-eligible population
- Get tips for launching a new D-SNP or improving an existing one
Kelsey McNamara, MPH, Head of Research and Impact
Papa
Jenna Corbly, Director of Medicare
CareOregon
Matt Kranovich, Principal and Consulting Actuary
Milliman
