Rise

Networking Breakfast

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

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

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

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 

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

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