Pre-Conference Workshop-Examine the Critical Connections Between Product Design, Quality Measures, and Risk Adjustment
Sep 21, 2020 9:10am ‐ Sep 21, 2020 10:45am
Identification: MON02
- Comprehend the importance of member engagement, social influence, and member satisfaction in relation to product design and improving quality measures
- Assess how to improve your current operations to abide by new CMS guidelines related to Stars ratings, specifically in a virtual environment, including CMS’s shift away from clinical outcomes as a main criterion
- Identify the impact of CMS’s hold on Stars data and utilizing last year’s data on your plans revenue
- Calculate how behavioral health during time of isolation can impact member health, satisfaction, and quality measures and how to overcome this issue
- Examine how risk adjustment coding will change due to the necessity for the majority of member interactions being virtual
- Discuss new CMS guidelines on virtual healthcare and supplemental benefits and how they could manipulate your future product offerings
- Interpret the impact of SDoH on quality measures and how they will be determined
Deep Dive into CMS CY 2021 Final Rule for Part C and Part D
Sep 21, 2020 11:05am ‐ Sep 21, 2020 11:50am
Identification: MON04
- Discuss CMS Policy regulation revisions related in response to COVID-19 and how it can a catalyst for future changes to MA
- Examine changes to Stars, HEDIS, CAHPs and HOS regulations that may influence product design
- Analyze relaxed regulations for providing hospital services outside of the hospital itself and adaptations to the CMS requirements for telehealth
- · Evaluate the likely impact of the CY 2021 and 2022 MA and Part D Proposed Rule on product design and member benefits
- Assess potential influence of 2021 MA Capitation Rates and Part C and Part D Payment Policies
Star Ratings Considerations for Plan Design
Sep 21, 2020 12:00pm ‐ Sep 21, 2020 12:45pm
Identification: MON05
- Get Star Rating updates from the interim final rule
- Understand the quality measures that impact a contract’s Star Rating
- Leverage benefit design to improve challenging Stars measures
- Maximize provider engagement to improve measure performance
Panel Discussion: The Impact of COVID-19- Adaptation of Product Design
Sep 21, 2020 1:15pm ‐ Sep 21, 2020 2:00pm
Identification: MON06
- Examine the changes in delivery of healthcare that need to be accounted for in future product design
- Re-imagine the way that you market to members, and service your current members in this new era with remote monitoring and virtual healthcare
- Assess how others have adapted successfully to borrow from their success and remain competitive within your market
- Overcome fear of change with your members and providers by implementing support and education exercises
Differentiate your Organization Through Advanced Supplemental Benefit Selection
Sep 21, 2020 2:15pm ‐ Sep 21, 2020 3:00pm
Identification: MON07
- Utilize data and trends to identify what your benefits are mast valuable to your membership and potential members
- Calculate what zero-dollar co pay offerings will increase enrollment and identify what competitor plans are offering to stay ahead of the game
- Tailor your benefits to meet the needs of low-income membership to improve healthcare outcomes and reduce cost of care
Strategies to Maximize Flexible Benefits while Targeting the Right Customers with the Most Relevant Benefits
Sep 21, 2020 3:15pm ‐ Sep 21, 2020 4:00pm
Identification: MON08
- Customize and optimize SDoH benefits based on certain member population needs to improve healthcare outcomes
- Analyze the impact of the benefits offered to drive shopping decisions
- Gather feedback from membership on what the most essential benefits are to them to improve product offering for future years
