Rise

Welcome and Chairperson's Opening Remarks

Kaleb Holt, Director of Medicare Products 
Select Health 

Keynote Address

Year-Round Process Design Strategies to Optimize Your Bid

• Review the bid calendar and consider monthly plans to develop a smooth bid process that results in meeting CMS deadlines and internal goals 
• Design the perfect bid team with players from across the organization and implement strong communications to ensure a smooth process 
• Hear about lessons learned from bid veterans 

Michael O’Malley, Plan Administrator 
AHF/Positive Healthcare 

Kaleb Holt, Director of Medicare Products 
Select Health 

Setting Goals and Defining a Winning Bid Strategy

• Analyze key factors and data about your market to gain an edge on your competition 

• Learn how to gather the necessary data to determine what benefits your current and prospective members want and need 

• Plan your strategy for retention and growth, even when budgets are tight 

Craig Fisher, Director, Product Development & Growth Initiatives 
Jefferson Health Plans 

Laura Cummins, Manager, Product Strategy & Marketing  
Clever Care Health Plan 

Using Supplemental Benefits to Improve Health Equity and Address SDOH

• Discover supplemental benefit trends and how they may be changing under new CMS requirements and tighter health plan budgets 
• Learn techniques for choosing supplemental benefits, pricing and including them in your bid, and using them to improve health equity and address social drivers of health (SDoH) 
• Explore special programs such as Special Supplemental Benefits for the Chronically Ill (SSBCI), Value-Based Insurance Design (VBID), and Uniformity Flexibility 

Monica Pagels, Manager of Product Development 
Emergient 

Ana Handshuh, Principal 
CAT5 Strategies 

Tools & Technology Spotlight

Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization. 

Sharon L. Fletcher, PhD, MBA, President 
Birdsong Hearing Benefits 

Eddie Maria, Head of Sales 
Birdsong Hearing Benefits 

Is a Special Needs Plan Right for Your Market?

• Review recent CMS expansion of types of special needs plans (SNPs) 
• D-SNP, C-SNP, I-SNP, and more: defining the different plans and looking at state and federal requirements for each 
• Get tips on how to analyze the special needs of your members that could be addressed with the appropriate SNP 
• Consider the elements of a competitive SNP, including benefits, provider network, and more 

Nikki Hungate, Principal Product and Quality Strategy Consultant/Owner 
Brightstar Health Solutions 

Supporting Chronic Disease Management through SSBCI Meals and Food Benefits

• Hear how a health plan implemented an innovative healthy food and nutrition program through SSBCI benefits 
• Learn how SSBCI meal and food benefits can be used to power chronic disease management 
• Explore ways to measure the impact of your SSBCI benefits on member experience, SDoH, and clinical outcomes 

Spencer Pratt, Chief Growth Officer 
NourishedRx 

Part D Redesign: Bid Strategies for Success

Explore bid strategies for successfully dealing with the impacts of recent and upcoming Part D changes, including: 

• $2,000 maximum out of pocket,  
• Medicare prescription payment plans (M3P),  
• Medicare drug negotiations, and 
• Part D Premium Stabilization Demonstration 

Omar Daoud, Senior Director of Pharmacy 
Community Health Plan of Washington 

Dan Simenc, Consulting Actuary 
Milliman 

Closing Remarks

Kaleb Holt, Director of Medicare Products 
Select Health 

Welcome and Chairperson's Day One Takeaways

Kaleb Holt, Director of Medicare Products 
Select Health 

The New V28 Risk Adjustment Model’s Impact on Revenues and the Bid

• Discuss how Medicare Advantage organizations’ revenue has already been impacted by the new V28 risk adjustment model  

• Get insight into how V28 is affecting risk score assumptions and revenue modeling for the bid 

• Learn how to build your new risk profile based on current members while appropriately adjusting your bid strategy and design 

Shannon Decker, PhD, MBA, MBA, M.Ed, M.Ed, Founder & CEO
VBC One 

Laura Sheriff, MSN, CPC, CRC 
Industry Expert in Risk Adjustment Operations 

Getting Ahead of Star Ratings Changes

• Get an overview of the changes to the Star ratings program and how they will impact the bid 

• Explore bid strategies to improve Star ratings 

• Take a deep dive into the new Health Equity Index, which measures performance in 2024 and 2025 for the 2027 Star ratings 

Rex Wallace, CEO 
Rex Wallace Consulting, LLC 

Eve Anderson, Assistant Director, Actuarial Services 
Johns Hopkins Health Plans 

Navigating New Requirements for Supplemental Benefits

• Discuss new CMS rules for supplemental benefits, including requirements to report encounter data, create a bibliography of evidence, and notify members mid-year of their benefits usage 

• Understand how these new requirements impact the bid 

• Gain practical strategies for complying with these requirements 

Melissa Smith, Founder 
Newton Smith Group 

Building Successful Partnerships with Supplemental Benefit Vendors

• Get tips for managing vendor cutbacks, vetting vendors, and choosing the vendors that are right for your plan 

• Understand provisions to include in vendor contracts to ensure compliance with new supplemental benefit requirements 

• Learn how to partner with vendors to ensure the best service to your members 

Tina Dueringer, CEO, Principal Advisor 
Dueringer Advisors, Inc. 

Jonathan Cho, Vice President, Medicare Product, Strategy, and Execution 
Healthfirst 

Demystifying the Rebate Reallocation Process

• Prepare for CMS’ announcement on Part D National Average Monthly Bid Amount (NAMBA) and the resulting rebate reallocation and bid resubmission 

• Understand how the direct subsidy is estimated 

• Learn about the CMS requirements and restrictions on making adjustments to the bid 

• Discuss how benefit enhancements can impact medical loss ratio  

Maxwell Hanna, Vice President, Actuarial Services 
Molina Healthcare, Inc. 

Closing Remarks and Conference Concludes

Kaleb Holt, Director of Medicare Products 
Select Health