CMS Bid Boot Camp

Jan 21, 2021 ‐ Jan 22, 2021

Standard: $500.00


Changes and Unknowns in 2022: Regulatory and Legislative Actions to the Medicare Program During a Pandemic

Jan 21, 2021 10:10am ‐ Jan 21, 2021 11:00am

Identification: THUR02

  • Understand the impact of COVID-19 fallout on bids and how it can inform bid strategy for 2022
  • Prepare for rulemaking changes and their downstream impacts on 2022 bids
  • Get up to speed on legislative proposals to reform Medicare Advantage and Part D and the new Administration goals

  • Deana Bell, FSA, MAAA, Principal and Consulting Actuary, Milliman
  • Kathryn Qin, FSA, MAAA, Vice President of Pricing, Blue Shield of California

A Bird’s Eye View of the Bid Cycle and Requisite Project Management

Jan 21, 2021 11:15am ‐ Jan 21, 2021 12:00pm

Identification: THUR03

•    Discover how various health plans construct their timelines to coordinate inputs from a multitude of functional areas for optimal bid build
•    Create a successful project management structure with C-suite buy-in, a multi-disciplinary review, and a CMS deadline-driven project schedule for a smooth annual bid process


Expanding Medicare Advantage Market Share

Jan 21, 2021 12:15pm ‐ Jan 21, 2021 1:00pm

Identification: THUR04

• Understand marketing and operational requirements for successful implementation in a new-to-you region
• Assess models that optimize the creation of a Medicare Advantage plan with financial and operational efficiency
•    Review startup experiences with product, price, channels, advertising and how these wove into the bid planning process


Master Plan Revenue: Part 1 - CMS Bid Variables 101

Jan 21, 2021 1:45pm ‐ Jan 21, 2021 2:30pm

Identification: THUR05

• Discover how base bids, benchmark rates, risk scores and other bid variables in CMS bid calculation affect health plan revenue
•    Compare CMS tools and tests – and their dependencies – that determine pricing
•    Optimize the financial mechanics behind lower rebates and higher provider group payouts, rebates versus adjusting your product offering, base bids and benchmarks, and other bid relationships
•    Understand the importance of risk scores on your plan revenue


Master Plan Revenue: Part 2 - Risk Score Mechanics for Accurate Modeling

Jan 21, 2021 2:45pm ‐ Jan 21, 2021 3:30pm

Identification: THUR06

•    Gain best practices for building up a risk profile for your bid, based on current members
•    Learn how risk adjustment assumptions dial into your revenue modeling for the CMS bid
•    Discover how ongoing retrospective and prospective risk adjustment activities contribute to revenue projections
•    Understand the calendar of CMS mid-year adjustments, “sweeps” activities, and assumptions that factor into your bid cycle milestones


Competitive Analysis: Define Your Strategy for Your Most Impactful Bid and Day One Summary Remarks

Jan 21, 2021 3:45pm ‐ Jan 21, 2021 4:45pm

Identification: THUR007

Processes for Completing the ANOC and EOC Submission

Jan 21, 2021 4:45pm ‐ Jan 21, 2021 5:30pm

Identification: THUR09RT3

  • Monica Pagels, Senior Product Manager Medicare Product Oversight, Health Alliance Plan

Tactics to Financially Manage a Product After It’s Released

Jan 21, 2021 4:45pm ‐ Jan 21, 2021 5:30pm

Identification: THUR09RT4

  • Learn what key member-level data to collect after your Medicare Advantage product is launched
  • Understand which cross-functional departments need to be involved in managing the financial impact
  • Discuss tactics to engage other departments to help build dashboards, analyze the data, and develop action plans to financially manage your Medicare Advantage product

  • Lisa Franklin, Market Portfolio Manager, CareFirst BlueCross BlueShield

Trends to consider for 2022 In Supplemental Benefits

Jan 21, 2021 4:45pm ‐ Jan 21, 2021 5:30pm

Identification: THUR09RT5

  • Tom Pelegrin, Senior Vice President & Chief Revenue Officer, Convey Health Solutions
  • Brian Goetsch, Managing Director, HealthScape Advisors

Part D – Point of Service Rebates and How to Use Them for Your Formulary Strategy

Jan 21, 2021 4:45pm ‐ Jan 21, 2021 5:30pm

Identification: THUR09RT6

  • Explore and understand potential impacts of Point-of-Sale rebates on the Part D marketplace.
  • Discover how health plans can take advantage of the opportunities this policy change would present.

  • Casey Gardner, ASA, MAAA, Consulting Actuary, Wakely Consulting Group, LLC