qualipalooza - enabling enterprise customer engagement...the cahps, hos & member survey forum...
TRANSCRIPT
STAR RATINGS STRATEGIC PLANNING FORUM
HEDIS® FORUM
CAHPS, HOS & MEMBER SURVEY FORUM
Three Co-Located Events Designed to Boost Performance on Star Ratings, HEDIS®, and CAHPS & HOS
JUNE 29-30, 2017 GRAND HYATT HOTEL SAN ANTONIO, TEXAS
Sponsors
TO REGISTER, CALL 866-676-7689 OR VISIT US AT WWW.QUALIPALOOZA.COM
• Build your quality infrastructure to promote optimal performance on your Star Ratings
• Gain insights into how CMS’ most recent changes will impact your organization and what you should be doing now
• Get concrete strategies for improving difficult measures
• Harmonize inter-departmental efforts to improve your performance on the most challenging measures
• Optimize your approach to provider engagement and reporting, as well as member engagement
• Better utilize your data and maximize the functionality of your analytics programs
• Optimize parallel survey programs to enable more effective and targeted intervention strategies
• Maximize the value of your survey data to identify and correct issues hurting your quality performance across the board
• More effectively manage members’ perceptions and experiences
Optimize Your Game Plan for Boosting Your Star Ratings and:
Boost Quality Performance with the Latest Strategies from Industry Innovators and:
Drive Positive Changes in Your Survey Results, Outcomes, and:
Connecting Patients, Providers and Pharmacists
Platinum
Gold
Silver
Bronze
pp3 BH 5/16/17
FEATURED SPEAKER –PAUL COTTON, NCQA
THE 2ND ANNUAL RISE QUALITY LEADERSHIP SUMMITQUALIPALOOZA:
Qualipalooza is the year’s must-attend event for leading-edge quality improvement strategies delivered in an innovative format. Based on extensive research, we have assembled a speaking faculty of pioneers who will share the steps they took to boost their quality scores. You and your team will gain how-to information and concrete takeaways, enriched with insights from healthcare strategists and regulatory officials on what to be prepared for in today’s changing environment. Whether you are a RISE member or not, you are welcome to join this one-of-a-kind discussion.
The structure is unique: three side-by-side conferences, each one a deep-dive examination of a specific aspect of quality improvement. You can choose to attend just one conference, or opt for the all-access pass and design your own event by choosing the sessions from each of the three conferences that most interest you. This is an ideal opportunity to take advantage of our group discounts and bring your entire team! The event consists of the following conferences:
The Star Ratings Strategic Planning Forum begins with a detailed walk-through of the changes in the CMS Final Call Letter and how to determine their implications for your organization. What follows is a slate of intensive two-day presentations featuring ground-breaking methods that plans have used to improve their Star Ratings.
The HEDIS® Forum is a unique opportunity to gain keen insights from quality innovators. Designed to provide attendees with one-of-a-kind insights into real-world programs and initiatives that can be implemented to optimize HEDIS® scores at your organization and boost quality across the board!
The CAHPS, HOS & Member Survey Forum offers techniques and operative strategies to bolster member and provider engagement to better target interventions and positively influence member satisfaction. Find out how industry leaders are utilizing member surveys to maximize data availability and increase opportunities for performance improvement.
Don’t miss this year’s opportunity to get the inside track on the latest quality improvement strategies. Ensure your place by registering today! Call 866-676-7689 or online at www.qualipalooza.com.
Sincerely,
Lance Lysinger, Conference Director
HEALTHCARE EDUCATION ASSOCIATES
Will White, Conference Director
HEALTHCARE EDUCATION ASSOCIATES
VENUE DETAILS
Grand Hyatt San Antonio600 East Market StreetSan Antonio, TX 78205
p: 210-224-1234
We have a block of rooms reserved at a special rate of $219/night. This rate expires on May 31, 2017; although, we expect the block to sell out prior to this date. To receive a room at the negotiated rate book well before the expiration date. To receive a room at the negotiated rate, book well before the expiration date. Mention the “RISE Quality Summit“ when placing your room reservation by phone to receive the negotiated rate. We urge you to book your room early as we expect the block will sell out. Upon sell out of the block, room rate and availability will be at the hotel’s discretion.
Grand Hyatt San Antonio The Grand Hyatt San Antonio is just steps from the city’s magical River Walk, which winds past riverside restaurants, quaint shops and historic landmarks such as the Alamo. Back at the hotel, take a dip in the heated rooftop pool, stick to your routine at the 24-hour fitness center, or dine on delicacies at Ruth’s Chris Steak House. All rooms feature downtown views, natural stone bathrooms, and luxury linens.
TEAM DISCOUNTS
• Three people will receive 10% off • Four people will receive 15% off • Five people or more will receive 20% off
In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For more information, please contact Kathie Eberhard at 704-341-2439 or [email protected]
REFUNDS AND CANCELLATIONSFor information regarding refund, complaint and/or program cancellation policies, please visit our website: https://www.healthcare-conferences.com/thefineprint.aspx
Paul Cotton, Director of Federal AffairsNCQA
Debra Zeh, Director, Provider PerformanceUPMC HEALTH PLAN
Janine Sala, Associate Director, Clinical Quality-HEDIS Operations
UNITED HEALTHCARE
Sara Gardner-Smith, Quality Improvement Coordinator*
PROVIDENCE HEALTH & SERVICES*pending final confirmation
Chris Deimel, Director of AnalyticsBLUE CROSS BLUE SHIELD OF MINNESOTA
Spencer Slade, MHA, MBA, Stars Quality Business Consultant
UNITED HEALTHCARE
Robert T. Gofourth, Vice President, Operational Strategy and Performance
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
Lauren Hampshire, Director, Corporate Clinical Quality
CARESOURCE
Linda Lee, Vice President of Quality Improvement
MEDICAL CARD SYSTEM, INC.
Donna Sutton, Director, Medicare Star QualitySCAN HEALTH PLAN
Frances Johnson, BSN, MBA/HCM, Director, Quality Management
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
Kimberly Swanson, Director of Quality Improvement
NETWORK HEALTH
Jessica Assefa, Medicare Stars Program ManagerUCARE
Michelle Fujii, MHA, PMP, Project Manager, 5 Star
SCAN HEALTH PLAN
Rand Hager, Director, Product DevelopmentALTEGRA HEALTH
Ana Handshuh, Vice President of Managed Care Services
ULTIMATE HEALTH PLANS
Akash Patel, Chief Executive OfficerADVANTMED
Mike Blumental, President and CEO,HEALTH DATA DECISIONS
Kent Holdcroft, Chief Revenue OfficerPHARMMD
Karen W. Connolly, RN, Chief Executive OfficerKW CONNOLLY & ASSOCIATES
Ted Speers, Vice President ENTERTAINMENT HEALTH CARE
Speaker TBDDST HEALTH SOLUTIONS
Neng “Bing” Doh, Chief Executive OfficerHEALTHCROWD
Linda Lynch, M.Ed., PRC, Performance Improvement Consultant
SPH ANALYTICS
Kari Hadley, Senior Director, Medicaid and Quality Products
PULSE8
Kimberly Johnson, MHA, CHC, CPHQ, Director, Quality Improvement
UNITEDHEALTHCARE
Christina Latterell, Vice President, Quality Improvement
ALIGNMENT HEALTHCARE
Nicole Johnson, Director, Performance Outcomes
CARESOURCE
David Larsen, RN, MHA, Directort, Quality Improvement
SELECTHEALTH
David Meyer, Vice President, Risk Adjustment, Encounters, Coding and Audit
SCAN HEALTH PLAN
Rod Kersh, Vice President of Sales & MarketingINCOMM HEALTHCARE & AFFINITY
OUR RENOWNED SPEAKING FACULTY
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
GET ANSWERS TO THESE QUESTIONS
TOP REASONS TO ATTEND
Star Ratings Strategic Planning Forum
• Get in-depth insight on how to prepare for the challenging measure changes on CMS’ Final Call Letter
• Learn what one plan did to move from 3.0 to 4.5 Stars in just three years!
• Hear how you can improve measures using member incentives
• Ensure you are most effectively engaging providers to achieve your quality goals
• Understand the latest methods for utilizing data analytics to improve quality
• Learn how to assign responsibility for quality improvement across departments at your organization
• Hear how to improve your results on the Medication Reconciliation Post-Discharge measure
• Gain innovative strategies for improving the most difficult measures
• Learn how top-rated plans achieve high ratings and stay on top
• Network with leading quality innovators from 4-& 5-Star plans
HEDIS® Forum
• Better understand how to prepare for and succeed on upcoming changes to HEDIS® measures
• Get new perspectives and ideas for capitalizing on your data to drive HEDIS® improvements
• Hear innovative approaches and outside-the-box ways you can optimize your performance on difficult pharmacy measures
• Take away silo-breaking tips and tools to truly optimize your overall quality performance across Stars, HEDIS®, CAHPs and HOS
• Learn how you can enhance your cooperation with your provider network to streamline and enhance provider reporting
• Take away implementable HEDIS®-improving solutions that also will boost your Star Ratings
• Find out what areas NCQA intends to focus on to emphasize improved outcomes moving forward
CAHPS, HOS & Member Survey Forum
• Learn how you can maximize the value of your data to hone in on the issues having the most significant impact on your quality performance
• Get cost-saving tips to help prioritize when and how you use monetary incentives and how you can incorporate parallel survey initiatives
• Better understand how member perceptions are impacting your quality performance overall
• Avoid patient access issues by improving your member feedback mechanisms
• Learn to use member feedback to develop more effective policies, processes and customer service initiatives
• Take away implementable CAHPS and HOS solutions that also will boost your HEDIS® and Stars performance
• Get tips and tools to help diagnose the underlying causes of member dissatisfaction in your CAHPS scores
Star Ratings Strategic Planning Forum
• What strategies will help me boost quality measures across the board?
• How can we prepare for the measure changes on the CMS Call Letter?
• What population health management strategies can our organization employ?
• Which new data analytics methods will most effectively help us increase quality?
• How can we align departments throughout the organization to achieve quality goals?
• Which new techniques and technologies will help our team enhance member engagement?
• How can we create a more effective dialogue to optimize the plan-provider relationship?
• What can we do as an organization to get the most accurate data?
• How do top-rated plans stay on top?• How can our organization anticipate future
measure changes?• How can we optimize results on the
Medication Reconciliation Post-Discharge measure?
HEDIS® Forum
• How do we move beyond the basics of ensuring member compliance on essential measures to make a meaningful difference and truly excel at improving outcomes?
• How are my competitors working to improve on HEDIS® measures and on quality across the board?
• What incentives are leading health plans offering to providers to improve reporting on HEDIS® measures, and how do I prioritize and balance which measures to provide bonuses for?
• How will NCQA be adjusting measures moving forward and what impact will that have on my plan’s performance?
• What strategies and programs can help enhance plan-provider cooperation on the most difficult measures?
• How can we better synchronize quality-improvement projects and initiatives to have a more positive impact while optimizing internal resources?
• What practical steps can we employ to drive big improvements on critical HEDIS® measures?
CAHPS, HOS & Member Survey Forum
• How can we better educate our providers to mutually benefit our member survey performance?
• What member engagement best practices can help ensure our members are educated on the impact of CAHPS and HOS surveys?
• How can we better synchronize quality improvement projects and initiatives to have a broader positive impact while optimizing internal resources?
• What steps can we take to improve on prescription drug measures?
• How should we be evaluating our survey data to better understand areas of need for specialists and improve our approach to network contracting and management?
• How do you engage providers without monetary incentives in an environment with so many competing interests?
• What strategies and programs can help enhance plan-provider cooperation on the most difficult challenges?
The Conference Organizers
Healthcare Education Associates is a division of Financial Research Associates. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to
timely and focused business information and networking opportunities in topical areas. Offering highly targeted conferences, Healthcare Education Associates positions itself as a preferred resource for executives and managers seeking cutting-edge information on the next wave of business opportunities. Backed with over 26 years of combined conference industry experience, the producers of HEA conferences assist healthcare professionals, actuaries, attorneys, consultants, researchers and government representatives in their professional endeavors. For more information on upcoming events, visit us online: www.healthcare-conferences.com
RISE (Resource Initiative & Society for Education) Vision:To build a community and an educational system that promotes successful careers for professionals
who aim to advance the quality, cost and availability of health care.
RISE provides:• A forum to build professional identity and a network of colleagues• A platform to capture and share knowledge and insights• A venue to develop and share benchmarks and document best practices• Career track development support• A channel for building alliances, partnerships and affiliations that fulfill the vision
RISE (Resource Initiative & Society for Education) Mission:RISE is the first national association totally dedicated to enabling healthcare professionals working in organizations and aspiring to meet the challenges of the emerging landscape of accountable care and health care reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development. To learn more about RISE and to join, visit us online: www.risehealth.org
CPE CREDITSFinancial Research Associates is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance
of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: nasbaregistry.org
The recommended CPE credit for this course is up to 13 credits in the following field(s) of study: Specialized Knowledge
For more information, visit our website: https://www.healthcare-conferences.com/thefineprint.aspx
Who Should Attend?
Senior leaders from Medicare Advantage Plans, service providers and consultants with responsibilities in the following areas: • Quality Improvement• Star Ratings • HEDIS®• CAHPS • HOS • Network Management • Physician Outreach & Education• Member Outreach & Engagement • Customer Service• Care Management • Risk Adjustment & HCC Management • Data Management• Performance Management• Analytics• Product Development• Pharmacy Administrator• Health Management• Clinical Audit
FEATURED SPEAKERPaul Cotton is the Director of Federal Affairs at the National Committee for Quality Assurance,
which works to improve the value of health care through measurement, transparency and
accountability. NCQA is the steward of HEDIS - the most widely used set of clinical quality measures,
as well as the nation’s leading Patient-Centered Medical Home and performance-based Health Plan Accreditation programs.
Paul was previously Senior Legislative Representative at AARP, where he lobbied Congress and the Administration on Medicare, Medicaid, CHIP, health reform and quality. He also served as the Center for Medicare & Medicaid Services Office of Legislation Hearings & Policy Presentation Director and Associate News Editor for the Journal of the American Medical Association.
DAY ONE: THURSDAY, JUNE 29, 2017
8:00 - 9:00 Registration sponsored by
Breakfast sponsored by
9:00 - 9:05 Conference Introduction and Kickoff
9:05 - 10:00 Featured Address - Policy Update
• The movement to harmonize measures across programs and payers • NCQA research related to CAHPS measures• NCQA research on new measures, especially behavioral health
Paul CottonDirector, Federal AffairsNCQA
10:00 - 11:00 Featured Panel Discussion: Operationalizing Quality Initiatives in Light of Shifts in Political Tides
• Examining the current state of regulatory changes and projecting the downstream impact
• What is the status of the quality payment bonus and how could financial
incentives for plans change?• What are health plans doing now to be ready for the future?
Moderator:TBA
Panelists:Ana HandshuhVice President of Managed Care ServicesULTIMATE HEALTH PLANS
Kimberly Johnson, MHA, CHC, CPHQ, Director, Quality ImprovementUNITEDHEALTHCARE
David MeyerVice President, Risk Adjustment, Encounters, Coding and AuditSCAN HEALTH PLAN
11:15 - 12:00 Featured Panel Discussion: Harmonizing and Synchronizing Quality Improvement Efforts to Optimize Outcomes
• Why a holistic approach to quality improvement will help you achieve at the highest levels
• Silo-busting best practices to maximize efficiency and quality improvement across the board
• Strategic moves we made to improve collaboration, and how it impacted our quality measures
• What does it look like when teams are effectively working together?
Moderator: TBA Panelists:Robert T. GofourthVice President, Operational Strategy and PerformanceBLUE CROSS BLUE SHIELD NORTH CAROLINA
Deb ZehDirector, Provider PerformanceUPMC HEALTH PLAN
Christina LatterellVice President, Quality ImprovementALIGNMENT HEALTHCARE
Medicare Star RatingsStrategic Planning Forum
1:00 - 1:10CHAIRPERSON’S WELCOME & OPENING ADDRESS
HEDIS® Forum
1:00 - 1:10CHAIRPERSON’S WELCOME & OPENING ADDRESS
CAHPS, HOS & Member Survey Forum
1:00 - 1:10CHAIRPERSON’S WELCOME & OPENING ADDRESS
12:00 - 1:00 Networking Luncheon
11:00 -11:15 Morning Networking Break sponsored by
Medicare Star RatingsStrategic Planning Forum
1:10 – 2:00DEEP-DIVE ANALYSIS: CMS FINAL CALL LETTER
This special presentation features a detailed examination of the key changes mandated in April’s Final Call Letter and an outline of effective strategies for optimizing these measures.
Donna SuttonDirector, Medicare Star QualitySCAN HEALTH PLAN
HEDIS® Forum
1:10 – 2:00HEDIS® INTERACTIVE: LESSONS LEARNED IN AN ADVENTUROUS 2017
In this interactive session, panelists will discuss their critical lessons learned over the past year while engaging the audience via real-time cell-phone polls and surveys to collectively diagnose and avoid common pitfalls looking ahead to 2018.
Janine SalaAssociate Director, Clinical Quality-HEDIS OperationsUNITEDHEALTHCARE
Nicole JohnsonDirector, Performance OutcomesCARESOURCE
Mike BlumentalPresident and Chief Exective Officer,HEALTH DATA DECISIONS
2:00 - 3:00IMPROVING HEDIS PERFORMANCE WITH INNOVATIVE DATA MANAGEMENT AND UTILIZATION PRACTICES• Data management and sharing best practices to
improve physician performance• Reporting gaps in care earlier in the year to get
ahead of issues• The role of data sharing language in pro-vider
agreements
Linda LeeVice President of Quality ImprovementMEDICAL CARD SYSTEM, INC.
Frances Johnson, BSN, MBA/HCMDirector, Quality ManagementBLUE CROSS BLUE SHIELD OF NORTH CAROLINA
CAHPS, HOS & Member Survey Forum
1:10 – 2:00OPTIMIZING THE USE OF YOUR SURVEY DATA TO IDENTIFY AND CORRECT COMMON ISSUES• Data stratification and segmentation best
practices to identify roots of consistent issues• Strategically boosting your data with additional
mini-surveys• How do you store the data and capture the
impact to members to effectively demonstrate issues to specific providers?
Christina LatterellVice President, Quality ImprovementALIGNMENT HEALTHCARE
David Larsen, RN, MHADirector, Quality ImprovementSELECTHEALTH
Linda Lynch, M.Ed., PRC,Performance Improvement ConsultantSPH ANALYTICS
2:00 - 3:00DIAGNOSING THE WHO & WHY BEHIND MEMBER DISSATISFACTION IN CAHPS SCORES• Field your own off-cycle CAHPS Survey• Develop unique and targeted interventions to
improve the satisfaction of sub-populations within product lines
• Analyze results by provider to identify, inform and improve performance of outliers within your network
Jessica AssefaMedicare Stars Program ManagerUCARE
“This is the first conference I’ve been to in a while where I didn’t miss a session.”
Elaine Rosenblatt, UW Medical Foundation
2:00 - 3:00HOW THIS TOP-RATED PLAN STAYS AHEAD OF NEW MEASURES• Creating structures that anticipate the evolution
of quality measures• Closely monitoring advancing medical practice
guidelines• Appointing program owners and measure
owners• Gaining respect from your provider network
Sara Gardner-SmithQuality Improvement Coordinator*PROVIDENCE HEALTH & SERVICES*PENDING FINAL CONFIRMATION
AN INNOVATIVE STRATEGIC APPROACH TO STARS IMPROVEMENT• Taking a practical aim at the next Star• Assessing historical performance• Slice, dice, evaluate• Optimizing and investing• Evaluating progress and predicting performance
Rand HagerDirector, Product DevelopmentALTEGRA HEALTH
3:15 - 4:15CASE STUDY: DATA AND ANALYTICS STRATEGIES FOR SUCCESS FROM BCBS MINNESOTA’S STARS AND ENTERPRISE RISK ADJUSTMENT CENTERS OF EXCELLENCE• Building an executive leadership team dashboard
for Star measures• Organizing reporting data throughout the year• Setting goals and forecasting• Determining the optimum level of detail for the
leadership team as well as day-to-day program managers
Chris DeimelDirector of AnalyticsBLUE CROSS BLUE SHIELD OF MINNESOTA
3:15 - 4:15CASE STUDIES: HOW THESE PLANS HAVE IMPROVED DIFFICULT MEASURES
I. Behavioral Health Measures• Overcoming data availability issues• How do you better manage prescription
adherence?
Neng “Bing” DohChief Executive OfficerHEALTHCROWD
II. Cardiovascular & Diabetes MeasuresAction plans that have been effective in working with both providers and members to improve measures related to diabetes and cardiovascular health, to include:
• Registries• Medical home• Pay performance• Direct member outreach interventions
David LarsenRN, MHA, Director, Quality ImprovementSELECTHEALTH
3:15 - 4:15IMPLEMENTING PROACTIVE ENGAGEMENT INITIATIVES TO MANAGE MEMBER PERCEPTIONS AND EXPERIENCES• Why educating providers on survey questions
and results can help improve your survey outcomes
• Training and customer service initiatives that can improve member experiences
• Using incentives to influence results
Michelle Fujii, MHA, PMPProject Manager, 5 StarSCAN HEALTH PLAN
Rod KershVice President of Sales & MarketingINCOMM HEALTHCARE & AFFINITY
3:00 - 3:15 Afternoon Networking Break sponsored by
4:15 – 5:15CASE STUDIES: MOVING THE NEEDLE ON CHALLENGING STAR MEASURES
I. Medication Adherence • Strategies targeting the Diabetes Blood Sugar
and High Blood Pressure measures• How these improvements impacted Star ratings• Examining 2-year program results and lessons
learned
Ted SpeersVice President ENTERTAINMENT HEALTH CARE
II. ADDITIONAL MEASURES: TBA
4:15 - 5:15SUCCESSFUL AND MEANINGFUL TECHNIQUES FOR INTEGRATING RISK AND QUALITY INTERVENTIONS• Leveraging advanced analytics to determine the
optimal type and timing of each intervention• Integrating supplemental data to improve
efficiency, eliminate overlapping efforts, and reduce program costs
• Keys to increasing retrospective and prospective data capture rates to reduce provider abrasion
• Using integrated reporting and dynamic dashboards to monitor overall performance
Speaker TBAHEALTH PLAN
Kari HadleySenior Director, Medicaid and Quality ProductsPULSE8
4:15 - 5:15CASE STUDIES: EXPERIENCES WITH AND OUTCOMES OF USING PARALLEL SURVEY PROGRAMS
This session will feature an in-depth case studies exploring how leading health plans are using customized surveys to get more actionable information to better identify and address issues impacting their members’ experience.
5:15 - 6:15 Cocktail Reception sponsored by:
9:00 - 10:00 Spotlight Address
DAY TWO: FRIDAY, JUNE 30, 2017
10:00 - 11:00CASE STUDIES: LESSONS LEARNED FROM HIGHLY RATED PLANSI. HOW HEALTHSUN HEALTH PLAN IMPROVED FROM 3.0 TO 4.5 STARS IN JUST THREE YEARS• Strategic development of an internal multi-
disciplinary team• Engagement & empowerment of the primary
care physicians• Enhanced use of data reports & report cards• Identification of best practices & implementation
of P4P incentives
Karen W. Connolly, RNChief Executive OfficerKW CONNOLLY & ASSOCIATES
II.STRUCTURING YOUR STAR RATINGS PROGRAM FOR SUCCESS• Empowering leaders in functional areas • Expediting the decision-making process • Coordinating your Stars strategy with quality
program efforts across products
Jessica AssefaMedicare Stars Program ManagerUCARE
10:00 - 11:00ENHANCING COOPERATION WITH YOUR PROVIDER NETWORK TO STREAMLINE QUALITY IMPROVEMENT• Analyzing your system for incentivizing provider
reporting and improvement efforts• On which measures should you provide financial
incentives?• Understanding how your clinicians can help
provider engagement and quality improvement
Frances Johnson, BSN, MBA/HCMDirector, Quality ManagementBLUECROSS BLUESHIELD OF NORTH CAROLINA
Lauren HampshireDirector, Corporate Clinical QualityCARESOURCE
10:00 - 11:00PREDICTIVE ANALYTICS DEEP DIVE—PATIENT EXPERIENCE MEASURES AS PREDICTORS OF HEDIS® PERFORMANCE• Understanding how access and customer service
relate to clinical care• The cross-section of member experience
measures and how they correlate to HEDIS® clinical measures
• Pinpointing the drivers of member disen-rollment to improve member retention and accrue the benefits of superior care management
Ana HandshuhVice President of Managed Care ServicesULTIMATE HEALTH PLANS
“Well organized, ran on time, great content, and got some good ideas.”
Diana Rodriguez, Cigna HealthSpring
Medicare Star RatingsStrategic Planning Forum HEDIS® Forum CAHPS, HOS & Member Survey Forum
8:00 - 9:00 Breakfast sponsored by
11:15- 12:15STARS AND RISK ADJUSTMENT• Optimally incorporating Stars initiatives into your
Risk Adjustment efforts• When to execute projects to maximize value and
minimize provider abrasion• How to integrate Revenue and Quality functions
in your MCO
Lauren HampshireDirector, Corporate Clinical QualityCARESOURCE
Akash PatelChief Executive OfficerADVANTMED
2:15 – 3:15STRATEGIES FOR IMPROVING THE MEDICATION RECONCILIATION POST-DISCHARGE MEASURE• Establishing a framework for MRPD success• Effectively communicating discharge information• Educating and engaging primary care physicians
Donna SuttonDirector, Medicare Star QualitySCAN HEALTH PLAN
1:15 - 2:15PANEL ANALYSIS: MEMBER ENGAGEMENT STRATEGIES—WHAT HAS WORKED FOR US• Why have some member incentive strategies
been effective, while others have not? • Examining the role of brand development in
engaging members• Determining which demographics to target in
order to optimize results• Taking into account socio-cultural differences in
your target groups
Kent HoldcroftChief Revenue OfficerPHARMMD
Spencer Slade, MHA, MBAStars Quality Business ConsultantUNITED HEALTHCARE
11:15- 12:15THE FUTURE OF HEDIS® AND THE NEED FOR PREDICTIVE MODELING
Health Plan Speaker: TBD
Speaker TBDDST HEALTH SOLUTIONS
“Excellent—experienced andwell-prepared presenters.”
John Achoukian, Matrix Medical Network
2:15 – 3:15THE COMMERCIAL AND GROUP PLAN PERSPECTIVE—PROVIDER & MEMBER ENGAGEMENT• How do you get providers onboard to close gaps
in care when no incentives are in place?• Unique initiatives that can help you address
issues within your commercial population• How can you adjust your survey approach to
drive improvement on the commercial side?
Janine SalaAssociate Director, Clinical Quality-HEDIS OperationsUNITEDHEALTHCARE
1:15 - 2:15KEYS TO OPTIMIZING SUCCESS ON DIFFICULT PHARMACY MEASURES• Best practices for meeting and exceeding
requirements for the medication reconciliation measure
• Which stakeholders provide the best opportunity for connecting with your member
• Strategies and ideas for making your processes more efficient
Kimberly SwansonDirector of Quality ImprovementNETWORK HEALTH
11:15- 12:15UNITEDHEALTHCARE’S INTERVENTION STRATEGIES AND PROGRAMS DESIGNED AROUND CAHPS AND HOS• Addressing access when there is none• Checking in with members prior to CAHPS survey
fielding—a systematic approach• Intervention strategies to boost performance on
Stars
Kimberly Johnson, MHA, CHC, CPHQDirector, Quality ImprovementUNITEDHEALTHCARE
Krisi Bailey, VP Partner SuccessHEALTHTEL
Attendees can choose either Track A or B for this session time period
Attendees can choose either Track A or B for this session time period
“I have learned some interesting solutions to some of our issues, especially how to
approach difficult measure improvements.”Althea Thompson, Universal American
3:15 pm Conference Concludes
12:15 - 1:15 Networking Luncheon
Medicare Star RatingsStrategic Planning Forum HEDIS® Forum CAHPS, HOS & Member Survey Forum
11:00 -11:15 Morning Break sponsored by
SPONSORS
PLATINUM
PLATINUM
SPONSORSHIP AND EXHIBIT OPPORTUNITIES
Enhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event.
To learn more about sponsorship opportunities, please contact Kevin Weigel at 704-341-2448 or [email protected]
Advantmed is a health information management company that helps managed care organizations optimize revenue and improve quality outcomes. Utilizing our Elevate! Healthcare™ platform to deliver and manage integrated products and services, we capture, organize and analyze financial and clinical data so clients can better understand their member populations to improve their quality of care and optimize risk-adjusted revenue. Advantmed delivers the optimal combination of capabilities unique to each client’s objectives, including risk analytics (ELEVATE! Risk Insights™), NCQA-certified HEDIS® Measures software (ELEVATE! Quality Insights™), medical record retrieval, medical record abstraction, risk adjustment coding, compliance and data validation services, member engagement, provider education and professional services. To learn more, please visit: www.advantmed.com
DST Health Solutions, LLC delivers contemporary healthcare technology and service solutions that enable its clients to thrive in a complex, rapidly evolving healthcare market. Supporting commercial, individual, and government-sponsored health plans, health insurance marketplaces, and healthcare providers, DST Health Solutions’ services include enterprise payer platforms, population health management analytics, care management, and business process outsourcing solutions, each designed to assist a company manage the processes, information, and products that directly impact quality outcomes. DST Health Solutions is a wholly-owned subsidiary of DST Systems, Inc. For more information visit www.dsthealthsolutions.com.
PLATINUM
Altegra Health, a Change Healthcare company, provides technology-enabled, next-generation payment solutions using advanced analytics and supporting intervention platforms to enable health plans and other risk-bearing healthcare providers to generate, analyze and submit data needed to successfully manage member care and ensure appropriate reimbursement, allowing them to elevate care quality, optimize financial performance, increase cost transparency, and enhance member experience and engagement.
PLATINUM
Ciox Health facilitates and manages the movement of health information with the industry’s broadest provider network. Through our expertise in release of information, record retrieval, and HIM, we improve the management and exchange of health information by modernizing workflows, facilitating access to clinical data, and improving the accuracy and flow of health information.
PLATINUM
Health Data Decisions provides strategic and analytic consulting related to quality, efficiency and population health. We help health plans, at-risk provider groups and analytics vendors to maximize the use of their data for predictive and retrospective measurement and modeling.
Our team brings decades of experience with measurements including HEDIS, Stars, QRS, AHRQ and P4P in management, analytics, and programming. We can manage your team, your vendors and your data to improve your HEDIS 2017 project. Talk to us about improving the value of your data and your overall measure rates.
GOLD
HealthCrowd is the creator of the first truly unified, end-to-end mobile messaging platform that increases patient engagement for healthcare providers in a wide range of markets. HealthCrowd is dedicated to helping healthcare organizations optimize and scale the delivery of personalized communications across multiple modes. The company’s expertise in the healthcare industry, online advertising and analytics allows it to help healthcare organizations be more strategic -- connecting with patients in a consistent and meaningful way.HealthCrowd’s DH*RMA platform optimizes multimodal communications by allowing health plans to engage their members through text, interactive text response (ITR), online chat, mobile web, email, voice (IVR) and mail while also generating highly personalized, compliant and scalable messaging through their unique Dynamic Persuasion Engine™. HealthCrowd continuously measures the success of individual messages and infuses fresh, creative content into the platform to help organizations keep the attention of their members
PLATINUM
Optum is a leading health services and innovation company dedicated to helping make the health system work better for everyone. With more than 100,000 people worldwide, Optum combines technology, data and expertise to improve the delivery, quality and efficiency of health care. Optum uniquely collaborates with all participants in health care, connecting them with a shared focus on creating a healthier world. Hospitals, doctors, pharmacies, employers, health plans, government agencies and life sciences companies rely on Optum services and solutions to solve their most complex challenges and meet the growing needs of the people and communities they serve.
GOLD
SILVER
SILVER
Since 1990, MedXM has been a national leader in the design and implementation of preventive care technology and in-home health risk assessments for the purpose of care management, quality improvement, and member engagement. MedXM offers a complete network of connections between members, their health plan, and providers. MedXM is focused on delivering Risk Adjustment and Quality Solutions by providing clients with fully customizable healthcare solutions to fulfill specific needs. MEDXM can help develop and implement your preventive care management strategy to help your plan reach better financial and quality outcomes.
• HCC in home Health assessments• Annual wellness visits (AWV)• Star initiatives
• Labs and DEXA• Post Hospital Reduced Re-admissions
Entertainment® Corporate Marketing Solutions helps businesses and organizations grow through incentives and rewards. We create private-labeled digital and print savings programs with high-value discounts, powered by the Entertainment® trusted merchant network. Entertainment® Corporate Marketing Solutions has partnered with dozens of health care plans and providers, demonstrating best business practices to successfully drive member engagement and wellness behaviors through our Healthy Living Rewards programs. Engage and reward your customers, members and employees by providing real value on things they do every day with the highest quality and most trusted discount network in the U.S. and Canada.
InComm Healthcare & Affinity, formerly Medagate, has been a wholly owned subsidiary of InComm since 2012. By combining our point-of-sale and customized-spend payment capabilities with InComm’s wide-reaching distribution and redemption network, InComm Healthcare & Affinity builds innovative and intelligent methods of driving member engagement and brand awareness. Learn more at www.incommhealthcareandaffinity.com
PLATINUM
Pulse8 is the only Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of your Risk Adjustment and Quality Management programs. We enable health plans and at-risk providers to achieve the greatest financial impact in the ACA Commercial, Medicare Advantage, and Medicaid markets. By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment and quality. Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information, please contact Scott Filiault at (732) 570-9095, visit us at www.Pulse8.com, or follow us on Twitter @Pulse8News.
SILVER
SILVER
SILVER
RelayHealth Pharmacy Solutions (RHPS) connects health plans with more than 50,000 retail pharmacies enabling them to utilize a pharmacy’s accessibility to drive member engagement, medication adherence and an overall improvement in quality measures. To learn more, visit relayhealth.com/interventionmessagingrx, call 800.868.1309or email [email protected].
SPH Analytics (SPHA) is a leader in action analytics for provider, payer, member, and health networks. SPHA solutions enable clients to enhance the patient care experience, improve population health, reduce the overall cost of care, and elevate provider performance. SPHA solutions incorporate an engaging social-media style user experience optimized for mobility to measure data, create easy-to-understand analytics, and empower action. For more information, call 1-866-460-5681 or visit www.SPHAnalytics.com.
We’re a technology company that looks at health engagement differently. Healthtel empowers all people who are connected by health (hospitals, doctors, health plans and the people they care for) to take action for healthier lives. We inspire new thinking for bigger results, make easy possible, and help you reimagine what you could do. If you are an innovator or change maker in the health community, let’s talk about reimagining your engagement. Learn more: www.healthtel.net.
BRONZE
SILVER
For Health Plans or Self-Insured Employers that want to measurably improve member and employee health, PharmMD is the proven choice for pharmacy quality solutions. Founded by healthcare and pharmacy innovators, PharmMD’s outcomes-driven reporting, priority on personal touch, and scalable clinical network are backed by performance-based pricing that guarantees fast results for Part D Star Ratings improvement, the most effective Medication Therapy Management, and improved overall health outcomes. For more information visit www.PharmMD.com
Connecting Patients, Providers and Pharmacists
SILVER
NovuHealth is a member engagement and behavior change technology and services company. We partner with health plans to improve performance through quality and risk adjustment. Our solutions combine behavioral analytics and data science with personalized communications and intelligent rewards and incentives to help plans influence high-value member behaviors among their most challenging members–all within the boundaries of regulatory and compliance requirements.
UPCOMING EVENTS
Behavioral Health Integration Best Practices Summit
May 11-12, 2017Wyndham San Diego BaysideSan Diego, CA Your organization has decided
that integrated behavioral health is the future; now what do you do?Get real-time project applications case studies from behavioral health and physical health integration thought leaders to improve and tailor your organization’s integration processes!
Sessions Include:• State of Behavioral Health: Latest Updates on
President Trump’s Healthcare Policies• Case Study: Our Best Practices for Partnering
with Community-Based Services and Supports• Practical Analytics: How to Marry Data
Services to Clinical, Quality, and Network Operations to Streamline and Elevate Your Behavioral Health Operations
• Keys to Implementing a CMS-Approved Behavioral Health Home to Maximize Reimbursements
• Identifying & Analyzing Social Determinates of Health for Whole-Person Health
• BH Contracting Strategies and the Impact to Behavioral and Physical Health Integration
• A Multi-Prong Approach to Mastering Integration & Streamlining Care Between Stakeholders
• Optimizing Behavioral Health Quality Scores through Integration
• Telemedicine’s Scalability & Sustainability in Integration
• Overcoming Barriers on Opioid, Alcohol, and Other Substance Abuse
Proven, Cost-Effective Tools to Enhance Behavioral and Physical Health Outcomes for Payers
Moving BH Integration from Innovation to Practical
Implementation
v2 MS 2.22.17
BEHAVIORAL HEALTH INTEGRATION BEST PRACTICES SUMMITProven, Cost-Effective Tools to Enhance Behavioral and Physical Health Outcomes for PayersMay 11-12, 2017 – San Diego, CA
W H Y E V E R Y H O S P I TA L N E E D S T O AT T E N DNEEDS TO AT TEND
Join us at the only conference focused exclusively on concrete methods you can use for improving quality scores at your organization. Replete with case studies and including an address from a leading CMS official, this is the must-attend event for hospital quality and safety professionals who want to acquire the latest tools and strategies to make a difference now.
Learn what you need to:• Determine which measures to target for maximum impact• Improve scores on the most challenging key measures• Be ready for upcoming CMS measure changes and new programs• Ensure you have an effective quality and safety dashboard to
monitor and optimize results• Align departments across your organization in the achievement
of quality goals• Boost HCAHPS scores• Engage patients to optimize participation in their own care• Improve outcomes using the “High Reliability Organization” framework• Understand and optimize CMS Hospital Star Ratings• Learn how top innovators are successfully reducing hospital-acquired
infections
OPTIMIZING HOSPITAL QUALITY & SAFETY MEASURES
Proven Strategies for Targeting and Improving Key Measures
May 18-19, 2017 - Holiday Inn Express Nashville Downtown
Hear directly from CMS!
T O R E G I S T E R : C A L L 8 6 6 - 6 7 6 - 7 6 8 9 O R V I S I T W W W. H E A LT H C A R E - C O N F E R E N C E S . C O M
Earn CEUs! go to healthcare-conferences.com
for more information OPTIMIZING HOSPITAL QUALITY & SAFETY MEASURESProven Strategies for Targeting and Improving Key MeasuresMay 18-19, 2017 – Nashville, TN
MAY 22-23, 2017 - FAIRMONT GRAND DEL MAR - SAN DIEGO, CA
2017 SUMMIT HIGHLIGHTS:
AND BACK BY POPULAR DEMAND WITH A NEW AND UPDATED TWIST:
• NEW THIS YEAR – Select between two pre-conference workshops, RADV or Prospective Assessment
• NEW THIS YEAR – Customize your learning experience by selecting between our two tracks
• NEW THIS YEAR – Hear case studies on RADV by the people who actually survived it
• NEW THIS YEAR – Hear the latest on repeal vs. replace• NEW THIS YEAR – Get industry results on RAPS-EDS
data collaboration and its impact on the industry• NEW THIS YEAR – Find out the lessons learned from
the IVA pilot results
• A two-part plan-provider collaboration for improving coding errors and capturing the money you have been leaving behind
• A comprehensive look at capturing, measuring, interpreting, and implementing data analytics
• Best practices for aligning quality and risk adjustment• Tactical strategies to ensure a smooth RAPS-EDS
transition
T O R E G I S T E R : C A L L 8 6 6 - 6 7 6 - 7 6 8 9 O R V I S I T U S A T W W W . H E A L T H C A R E - C O N F E R E N C E S . C O M
THE 10TH ANNUAL RISK ADJUSTMENT FORUM
Two New Additional Pre
Workshops Available this
year!
H E A LT H C A R E E D U C AT I O N A S S O C I AT E S A N D R I S E P R E S E N T
For Medicare Advantage, Medicaid, and Commercial Plans
SPONSORSPlatinum Gold Silver
THE 10th ANNUAL RISK ADJUSTMENT FORUMFor Medicare Advantage, Medicaid and Commercial PlansMay 22-23, 2017 – San Diego, CA
REACHING AND RETAINING DIVERSE MEMBERS FOR HEALTH PLANS SUMMIT
Implementing culturally competent marketing, outreach, and retention strategies to reduce health disparities and gain a competitive edge
June 26-27, 2017Hotel ColonnadeCoral Gables, FL
Learning Objectives Include:
• How to produce communications that speak to your target audience in their language and vernacular
• Identifying and addressing the unique needs of various ethnically, culturally, and socially diverse consumers
• Building a network of clinicians and health professionals who reflect diversity and understand cultural nuances of a community
• How to improve performance on HEDIS quality measures for your diverse populations
• Strategies to provide equitable care to lesbian, gay, bisexual, and transgender (LGBT) members
• How to partner with community leaders and organizations who understand your target communities
• Improving the level of cultural-competence in staff members
Find out how health plans can attract and serve diverse consumers and gain a competitive edge in the marketplace through:
• Culturally competent marketing strategies
• Outreach and retention initiatives that engage diverse consumers
• Services and supports that understand and meet the needs of diverse communities
• Building trust within the communities you serve
V.4 SS 3/1/2017
REACHING & RETAINING DIVERSE MEMBERS FOR HEALTH PLANS SUMMITImplementing Culturally Competent Marketing, Outreach, and Retention Strategies to Reduce Health Disparities and Gain a Competitive EdgeJune 26-27, 2017 - Coral Gables, FL
2017 Special Needs PlanLeadership Summit
June 21-23, 2017The Princeton ClubNew York, NY
Ensure Your Plan Stands Out From the CrowdSNP members present unique and difficult challenges, as well as meaningful rewards. Join us for a one-of-a-kind opportunity to learn from industry leaders and engage with your peers to learn proven strategies and innovative programs that will improve your financial success, as well as the quality and outcomes of your members’ care.
Gain Best Practices and Practical Takeaways from Industry LeadersMove beyond the basics to truly optimize your operations that have a significant impact on your business processes and members. Gain unprecedented insight into best practices on issues and processes at the core of a successful SNP.
Top Reasons to Attend
V.5 MS 3/16/17
• Gain best practices and strategies to more effectively design your Model of Care (MOC) to get CMS 3-year approval• Learn how industry-leading plans are meeting compliance requirements for Health Risk Assessments (HRA) and Individual
Care Plans (ICP)• Optimize your revenue by ensuring your reimbursements are commensurate with the medical bills you pay for your most
expensive members• Find out innovative tools and programs you can implement to overcome unique quality-score measures you face as a SNP• Gain strategies to boost member retention to drive more stable long-term income• Find out how to better utilize community partnerships as a marketing tool to help grow your membership• Learn best practices from industry-leading plans on how you can better work with members to overcome socioeconomic
barriers inhibiting their health• Get actionable strategies for improving partnerships with your provider networks with more appropriate risk-sharing
agreements• Improve the care management strategies you employ for your members with the most challenging healthcare needs• Optimize your benefit by improving how you analyze your market, bolster provider networks and ensure you have the
right supplemental benefits
R E G I S T E R TO D AY ! C A L L 8 6 6 - 6 7 6 - 7 6 8 9 O R O N L I N E AT W W W. H E A LT H C A R E - CO N F E R E N C E S . CO M
SILVER SPONSOR
2017 SPECIAL NEEDS PLAN LEADERSHIP SUMMITEnsure Your Plan Stands Out from the CrowdJune 21-23, 2017 – New York, NY
7th ANNUAL RISE WEST SUMMIT Essential Risk Revenue Optimization, Quality Performance, and Data Maximization StrategiesSeptember 17-19, 2017 – Scottsdale, AZ
SILVER
Indegene Healthcare delivers next generation solutions for payers and providers across Risk Adjustment, Quality Improvement, Population Health Management And Member/Provider Engagement. Indegene Healthcare leverages its significant capabilities across Analytics, Technology, Operational Scale and Medical Expertise to help payers and providers drive better health and business outcomes. Indegene Healthcare has a strong focus on IP and innovation, with a full portfolio of next generation platforms including HEDIS Pro and STARMAX for Quality Improvement, RiskOptimizer and ProspectiveEnhance for Risk Adjustment, iClinEngager and Ngage for Provider and Member Engagement, and SmartCare, an integrated enterprise analytics platform for population health management.
HEALTHCARE EDUCATION ASSOCIATES200 WASHINGTON ST. SUITE 201SANTA CRUZ, CA 95060
ATTENTION MAILROOM:If undeliverable, please forward to theDirector of Quality and Performance Improvement
INCORRECT MAILING INFORMATION: If you are receiving multiple mailings, have updated information or would like to be removed from our database, please fax our database team at 704-341-2641 or call 704-341-2387. Please keep in mind that amendments can take up to 8 weeks.
Conference Code:
Name
Company
Address
City
Phone
State
Zip
Title
Payments must be received no later than June 19, 2017
Please bill my: MC VISA AMEX DISCOVER
Card Holder’s Name:
Signature:
Check enclosed: Please bill me later:
Exp. Date:
Payment Method:
Four Ways to Register
704-341-2641 866-676-7689 www.qualipalooza.comHEALTHCARE EDUCATION ASSOCIATES
129 Portland St., 6th FlBoston, MA 02114
Fax Call Web Mail
Make checks payable to Wilmington Financial Research Associates, and write ___________ on your check.H415
H415
Qualipalooza: The 2nd Annual RISE Quality Leadership Summit
Please Mention This Priority Code When Registering
JUNE 29-30, 2017 GRAND HYATT HOTEL SAN ANTONIO, TEXAS
STAR RATINGS STRATEGIC PLANNING FORUM
CAHPS, HOS & MEMBER SURVEY FORUM
HEDIS® FORUM
$1595Early Bird:
Plan/Provider Rate* Service Provider/Consultant Rate
*Subject to HEA approval
Single Conference:
Plan/Provider Rate* Service Provider/Consultant Rate
All-Access Pass: Single Conference: All-Access Pass:
Early Bird Pricing Ends 5/19/17
Standard: $1795
$1795Early Bird:
Standard: $1995
$2195Early Bird:
Standard: $2395
$2395Early Bird:
Standard: $2595
FEATURED SPEAKER –PAUL COTTON, NCQA
TO REGISTER, CALL 866-676-7689 OR VISIT US AT WWW.QUALIPALOOZA.COM
Three Co-Located Events Designed to Boost Performance on Star Ratings, HEDIS®, and CAHPS & HOS
THE 2ND ANNUAL RISE QUALITY LEADERSHIP SUMMITQUALIPALOOZA: