Agenda
Explore the full schedule of sessions at The RISE Medicare Product and Pharmacy Strategy Summit
Thursday - June 11, 2026
8:00 AM
8:00 AM – 6:00 PM
Exhibit Hall Open
8:00 AM
8:00 AM – 4:00 PM
Help Desk Open
8:00 AM
8:00 AM – 9:15 AM
Networking Breakfast
9:15 AM
9:15 AM – 9:20 AM
Welcome and Opening Remarks
Chairperson, Speaker
Abby Katabaro
Founder & Principal at Katabaro & Co
Chairperson, Speaker
Kaleb Holt
Medicare Advantage Program Design Expert
9:20 AM
9:20 AM – 10:10 AM
Keynote Address
From Policy to Practice: What CMS Drug Innovation Models Mean for Your Pharmacy Strategy
Abigale R. Sanft, Director of the Division of Drug Innovation at CMS's Center for Medicare and Medicaid Innovation (CMMI), offers health plan leaders an inside look at how federal drug innovation models are reshaping pharmacy strategy across Medicare Part D and Medicaid. Drawing on her work designing and overseeing alternative payment models at the intersection of drug pricing, payment policy, and healthcare delivery reform, she will explore how CMMI's initiatives translate into real-world implications for formulary design, drug affordability, and value-based care in the pharmaceutical space. Attendees will leave with a clearer understanding of how emerging CMS policy signals should inform their pharmacy and benefit strategy decisions heading into 2027.
Speaker
Abigale R. Sanft
Director of the Division of Drug Innovation (DDI), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI)
10:10 AM
10:10 AM – 10:15 AM
Session Transition
10:15 AM
10:15 AM – 11:00 AM
Track 1
Making the MA Math Work: Product Strategy in a Tight Funding Environment
- Understand how Advance Notice payment signals and IRA drug costs are shaping product decisions
- Understand the financial pressures shaping MA product decisions, including rate changes, rising utilization, and pharmacy cost trends
- Explore how plans are adjusting benefits, service areas, and cost-sharing to maintain sustainability
- Walk through practical strategies product teams are using to balance member value, Star performance, and financial viability
Moderator
Abby Katabaro
Founder & Principal at Katabaro & Co
Speaker
Chemu Lang’at
Senior Vice President and General Manager at Best Buy Health
Speaker
Tina Dueringer
CEO, Principal Advisor at Dueringer Advisors
Speaker
Leon Lead
Founder at Leon Lead Consulting, LLC
10:15 AM – 11:00 AM
Track 2
Part D After the IRA: Managing the New Economics of Drug Spending
- Examine how catastrophic liability, specialty drug growth, and IRA changes are reshaping the economics of the Part D benefit
- Explore how plans are responding through formulary tightening, deductible changes, tier restructuring, and utilization management
- Understand how pharmacy cost pressure is influencing benefit design, member affordability, and plan competitiveness
- Discuss how plans are adapting their pharmacy strategy to balance cost control, access, and Stars performance
- Understand why IRA-driven changes represent a permanent shift in Part D economics, not a temporary disruption
Speaker
Debjani Mukherjee
Principal Research Scientist, Health Care Evaluation at NORC
11:00 AM
11:00 AM – 11:30 AM
Networking Break
11:30 AM
11:30 AM – 12:15 PM
Track 1
Supplemental Benefits That Deliver ROI
- Identify which supplemental benefits are being reduced or eliminated as plans prioritize measurable clinical and financial outcomes
- Learn how leading plans target benefits to specific populations and clinical needs to drive impact
- Explore how plans measure utilization, outcomes, and engagement to justify ongoing investment
- Understand how CMS oversight and evolving SSBCI guidance are reshaping benefit design decisions
Moderator
Heather Adams
Sr. Product Manager, D-SNP Lead at Blue Cross and Blue Shield of North Carolina
Speaker
Carrie Meyer
Director of Clinical Programs at Amplifon Hearing Health Care
Speaker
Jason Hellinger
Sr. Strategic Product Manager, Medicare Solutions at Health Care Service Corporation (HCSC)
11:30 AM – 12:15 PM
Track 2
Pharmacy Stars Strategy: Winning the Measures That Matter
- Review the major changes in Part D Star measures, adherence metrics, and quality scoring methodology
- Examine operational challenges plans face with measures such as medication adherence, COB, and polypharmacy indicators
- Explore strategies plans are deploying across pharmacy operations, care management, and provider engagement to improve Stars performance
Speaker
Jimmy WuRohe
Chief Product Officer at Clarest Health
Speaker
Jennifer Wirick
VP, Pharmacy at Essence Healthcare
12:15 PM
12:15 PM – 1:15 PM
Networking Lunch
1:15 PM
1:15 PM – 2:00 PM
Track 1
SNP Strategy: Choosing the Right Specialized Product
- Evaluating when a C-SNP, D-SNP, or I-SNP makes sense
- Examine how plans assess population fit, provider alignment, and enrollment potential before launching SNPs
- Understand operational and clinical requirements needed to support specialized populations successfully
- Disucss how tighter margins and higher care complexity are reshaping the financial viability of SNP expansion
Speaker
Tina Dueringer
CEO, Principal Advisor at Dueringer Advisors
Speaker
Heather Adams
Sr. Product Manager, D-SNP Lead at Blue Cross and Blue Shield of North Carolina
Speaker
Kaitlin Mayhew
Senior Director, Product Development at Curana Health
1:15 PM – 2:00 PM
Track 2
PBM Oversight and Transparency: Navigating a Changing Pharmacy Landscape
- Understand how growing scrutiny and transparency requirements are reshaping plan, PBM relationships and shifting control back to plans
- Evaluate rebate structures, formulary control, and utilization management strategies under increasing cost pressure
- Assess how changes in pharmacy distribution—including mail-order growth, PBM-owned pharmacies, and retail closures—are impacting network design and member access
- Identify how plans are restructuring PBM partnerships to balance cost control, access, and member experience
Speaker
Debjani Mukherjee
Principal Research Scientist, Health Care Evaluation at NORC
2:00 PM
2:00 PM – 2:05 PM
Session Transition
2:05 PM
2:05 PM – 2:55 PM
Risk Adjustment in the Next Era of Medicare Advantage
- Understand how V28 and ongoing payment updates are reducing RAF opportunity and reshaping plan revenue
- Examine how CMS expectations are shifting from diagnosis capture to documented treatment, proactive care, and clinical engagement
- Identify how declining RAF combined with flat rates is forcing product, network, and care model redesign
- Explore how plans are aligning benefit design, provider incentives, and care management to support both risk performance and member outcomes
Speaker
Colleen Gianatasio
Value Based Care expert
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Speaker
Gabrielena (Gaby) Alcalá
Founder and CEO at MAPA Healthcare
2:55 PM
2:55 PM – 3:30 PM
Networking Break
3:30 PM
3:30 PM – 4:15 PM
Keynote Address
Measuring What Matters: Quality, Pharmacy, and the Path to Value-Based Care
As Medicare Advantage and Part D plans and partners navigate unprecedented financial and regulatory disruption, the medication-related quality measures guiding performance have never been more consequential. This keynote explores how PQA is advancing person-centered measures that align medication use quality with value-based care goals. Following the presentation, attendees will gain insights into how medication management services can be translated into data that is structured, shareable, interoperable, and usable across the healthcare system. Quality medication use — grounded in data, collaboration, and outcomes — helps plans, pharmacies, and partners meet the demands of a rapidly evolving healthcare landscape.
Speaker
Micah Cost
Chief Executive Officer at Pharmacy Quality Alliance
4:15 PM
4:15 PM – 4:55 PM
Reacting to the Clover Ruling: Adapting and Reshaping Your Part D Stars Strategy
- Understand the impact of the ruling on Part D Star Ratings
- Organize your response plan
- Understand the implications on the Star Ratings program
- Adapt Part D Stars strategies during the period of uncertainty
Speaker
Melissa Newton Smith
Founder, Senior Advisor at Newton Smith Group
4:55 PM
4:55 PM – 5:00 PM
Closing Remarks
Chairperson
Abby Katabaro
Founder & Principal at Katabaro & Co
Chairperson
Kaleb Holt
Medicare Advantage Program Design Expert
5:00 PM
5:00 PM – 6:00 PM
Networking Cocktail Reception
Friday - June 12, 2026
8:00 AM
8:00 AM – 11:05 AM
Exhibit Hall Open
8:00 AM
8:00 AM – 11:00 AM
Help Desk Open
8:00 AM
8:00 AM – 9:00 AM
Networking Breakfast
9:00 AM
9:00 AM – 9:10 AM
Welcome Remarks and Day One Takeaways
Chairperson
Abby Katabaro
Founder & Principal at Katabaro & Co
Chairperson
Kaleb Holt
Medicare Advantage Program Design Expert
9:10 AM
9:10 AM – 10:00 AM
The New Drug Landscape: What Every MA Leader Needs to Know. A practical update on drug policy, GLP-1s, and Part D disruption
- Understand how GLP-1 drugs, negotiated pricing, and new payment models are changing pharmacy economics
- Explore the ripple effects on benefit design, risk adjustment, and member selection
- Understand the financial and clinical implications of GLP-1 drugs across diabetes, cardiovascular disease, and weight management
- Discuss potential impacts on adherence measures, Star Ratings, eligibility criteria, and long-term cost offsets
Speaker
Leslie Rodriguez
Consultant at BCBSAZ Health Choice
10:00 AM
10:00 AM – 10:45 AM
Vendor Strategy: Building Partnerships That Drive Outcomes
- Explore how plans are rethinking vendor partnerships as financial pressure and regulatory scrutiny increase
- Understand how plans measure vendor performance across member experience, quality metrics, and operational results
- Identify governance practices that help ensure vendor partnerships support product strategy rather than creating unnecessary complexity
- Discuss how plans are consolidating vendors and tying contracts to measurable financial and clinical outcomes under tighter margins
Moderator
Colleen Gianatasio
Value Based Care expert
Speaker
Tina Dueringer
CEO, Principal Advisor at Dueringer Advisors
Speaker
Shannon Decker
CEO at VBC One
10:45 AM
10:45 AM – 11:05 AM
Networking Break
11:05 AM
11:05 AM – 11:50 AM
The Future of the Medicare Advantage Member Experience
- Designing smarter plans in an increasingly complex benefit environment
- Explore how the growing complexity of MA benefits, across medical, pharmacy, and supplemental programs, is reshaping member expectations and engagement
- Identify emerging strategies for the next generation of MA plans, including simplified benefit structures, proactive member support, and integrated service models
- Discuss how plans are simplifying benefits and member touchpoints as complexity, cost pressure, and regulatory scrutiny increase
Speaker
Leon Lead
Founder at Leon Lead Consulting, LLC
Speaker
Shannon Decker
CEO at VBC One
11:50 AM
11:50 AM – 12:00 PM
Closing Remarks
Chairperson
Abby Katabaro
Founder & Principal at Katabaro & Co
Chairperson
Kaleb Holt
Medicare Advantage Program Design Expert
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