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Star Ratings Symposium


Action-able Tips for Payers and Their Providers in Developing a 5-Star Push
February 2014
Anaheim, CA

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Conference Details:
How would your rank your strategy for optimizing CMS's 5-Star Quality Rating System? Were you a top-rated plan in 2013?

If not, the Star Ratings Symposium is a must-attend conference for you. The information will be high-level, but very practical. You'll learn valuable strategies from the nations top health plans for improving your rating, including how to get buy-in from your providers - as well as intervention strategies.
Core Curriculum:
  • CMS Star Ratings Requirements
  • Member/Prescriber Engagement Strategies
  • Best Practices from Top Rated Plans AND the Nation's Top Physician Groups
  • Techniques For – and Examples of – True Payer/Provider Integration Toward Higher Ratings
  • Health Plan & Physician Group Perspectives on:
  • Achieving High Preventative Services Scores
  • Achieving High Treatment Scores
  • Achieving High Consumer Satisfaction Scores
  • Part D Spotlight
  • Integrating Stars, Revenue, and Medical Expense Management
  • Member Engagement Strategies
  • Integrating P4P, HEDIS and Stars
  • Strategies for Developing a Chronic Condition Improvement Program
Who Will Attend:
This practical business conference is designed for executives from national Medicare  Advantage health plans of every size, along with their network providers. The symposium will be of specific interest to:
  • VPs of Operations
  • VPs of Finance
  • VPs of Provider  Relations
  • Directors of Medical Management Programs
  • Clinical Quality Directors
  • Directors of Quality Improve
  • and any other Stars Stakeholder in your plan.
Audience Demographics:
Hotel Info:
TBA
Conference Registration Prices:
Earlybird Rate
Standard Rate
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
FIRST 100 FREE
$995
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995
Service Providers
$1895

Register Now!

Group Discounts:
Register 3 people and receive 10% off ***
Register 4 people and receive 15% off ***
Register 5 people or more and receive 20% off ***

If you'd like to be invoiced, please submit your contact details on the registration page and select "Please invoice me" at the bottom of the page.

If you are interested in sponsorship, exhibiting, or speaking opportunities, please call 212-532-9898 or email information@opalevents.org
* TERMS & CONDITIONS
Subject to approval. To qualify you must be currently employed by a non-vendor company. Eligibility will be verified by conference producer. Opal reserves the right to allocate places and to refuse applications.

*Health plans must be CMS approved as Medicare, Medicare Advantage or Medicaid health plans

***
Registrations must be made online on the same date. Discount will be applied after all registrants have been received.


Registration price reflects $100 online discount
Media Partners:
Advantar LaboratoriesKong Push
Untitled Document
2013 Attendees & Agenda
Director of Medicare, INLAND EMPIRE HEALTH PLAN
ABLHEALTHCARE
Medical Director, ACCESS HEALTH CARE PHYSICIANS
Chief Compliance Officer, ACCESS HEALTH CARE PHYSICIANS
Care/ Case Management Director, ACCESS HEALTH CARE PHYSICIANS
MED Director, ACCESS HEALTH CARE PHYSICIANS
CEO, ACCESS HEALTH CARE PHYSICIANS
President & CEO, ACCESS MEDICAL GROUP
HCC Coding Specialist, ACCESS MEDICAL GROUP, INC.
HCC Coding Specialist, ACCESS MEDICAL GROUP, INC.
Account Executive, AETNA
General Manager, AETNA
General  Agent Manager, AETNA
Director, Business Development, AETNA
Manager Business Development, AETNA
Head, Medicare Clinical Quality, AETNA
Market Head of Sales, AETNA MEDICARE
Medical Director, Innovation, ALTAMED
Chief Financial Officer, AMANECER COMMUNITY COUNSELING SERVICE, INC.
Director of IPA Operations, AMERICAN FAMILY IPA
HEDIS Asst., AMERICAN FAMILY IPA
Provider Relations, AMERICAN FAMILY IPA
VP, CLinical Pharmacy - Medicare/Medicaid, AMERIGROUP
Director IT, Projects Delivery, APRIA HEALTHCARE
HCC Dept. Supervisor, BAKERSFIELD FAMILY MEDICAL
Director of Quality Management, BAKERSFIELD FAMILY MEDICAL CENTER
Administrative Director, BLESSING HEALTH SYSTEM
Government Pharmacy Operations Manager, BLUE CROSS BLUE SHIELD OF ALABAMA
Spec IIlb - Business Support, BLUE CROSS BLUE SHIELD OF FLORIDA / FLORIDA BLUE
Consultant Network Design, BLUE CROSS BLUE SHIELD OF FLORIDA/ FLORIDA BLUE
Director Medicare Revenue Management, BLUE CROSS BLUE SHIELD OF FLORIDA/ FLORIDA BLUE
Manager, BLUE CROSS BLUE SHIELD OF MICHIGAN
VP, Quality, Population Management & Behavior Health, BLUE SHIELD OF CALIFORNIA
Medicare Revenue Analyst, BLUE SHIELD OF CALIFORNIA
Medical and Regional Medical Director, BLUE SHIELD OF CALIFORNIA
Institutional Account Executive Director, BOEHRINGER INGELHEIM
Quality Improvement Manager, BRAND NEW DAY / HMO CA, AFFILIATED DOCTORS OF ORANGE COUNTY
Chief Medical Officer, CALIFORNIA HOUSE CALL DOCTORS
Director of Clinical Operations, CALIFORNIA HOUSE CALL DOCTORS
Executive Faculty, CALIFORNIA STATE UNIVERSITY, DEPT HCA
Senior Manager, CALIFORNIA QUALITY COLLABORATIVE
Assistant Professor, CALIFORNIA STATE - LONG BEACH
Compliance Director, CARE 1ST HEALTH PLAN
Director of Medicare Services - RAF / Star Ratings, CARE 1ST HEALTH PLAN
RAF-Star Rating, CARE 1ST HEALTH PLAN
CIO, CAREMORE HEALTH PLAN
Director of Quality Management, CAREMORE HEALTH PLAN
General Management, Stars, CAREMORE HEALTH PLAN
Associate Medical Director, CENTRAL HEALTH PLAN OF CALIFORNIA
Data Analyst, CENTRAL HEALTH PLAN OF CALIFORNIA
Star Program Manager, CENTRAL HEALTH PLAN OF CALIFORNIA
Quality Director, CENTRAL HEALTH PLAN OF CALIFORNIA
Star Program Coordinator, CENTRAL HEALTH PLAN OF CALIFORNIA
IPA Administrator, CHOICE PHYSICIANS NETWORK
Project Manager, Process Improvement, CITIZEN CHOICE HEALTH PLAN
Coordinator, Process Improvement, CITIZENS CHOICE HEALTHPLAN HMO
Director, Process Improvement, CITIZENS CHOICE HEALTHPLAN HMO
Quality Incentive Program Coordinator, COAST HEALTHCARE MANAGEMENT
Manager, Healthcare, COGNIZANT HEALTHCARE BUSINESS CONSULTING
Vice President, COGNIZANT HEALTHCARE BUSINESS CONSULTING
Medical Director, DENVER HEALTH MEDICAL PLAN, INC./DHHA
QI Manager, DENVER HEALTH MEDICAL PLAN, INC./DHHA
Vice President, DESERT OASIS HEALTHCARE
Vice President Quality Services, DESERT OASIS HEALTHCARE
Director of Coding Services, DESERT OASIS HEALTHCARE
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Director, DIGNITY HEALTH
Quality Program Coordinator, EASY CHOICE HEALTH PLAN
QI/CM Manager, EASY CHOICE HEALTH PLAN
President, EDGAR CONSULTING GROUP
IPA Administrator, FAMILY CARE SPECIALISTS, IPA
Consultant Network Design, FLORIDA BLUE
Founder and Chairman, GORMAN HEALTH GROUP
VP of Finance, HARDEN HEALTHCARE
Vice President, HARDEN HEALTHCARE
Director, QI Medicare     , HEALTH NET
Senior QIS, HEALTH NET
Senior QIS, HEALTH NET
Senior QIS, HEALTHNET
QI Manager, Medicare, HEALTHNET
Senior QI Specialist, HEALTHNET
Regional Medical Director, HEALTHNET
Health Care Analysis – Medicare, HEALTHNET
Director, QI, HEALTHNET
Program Manager SNP, HEALTHNET
President, HELP, INC.
HERITAGE VICTOR VALLEY MEDICAL GROUP
Health Center Supervisor, HERITAGE VICTOR VALLEY MEDICAL GROUP
Care Management and Clinical Innovations, HILL PHYSICIANS MEDICAL GROUP
Director, Government Programs, HILLS PHYSICIANS MEDICAL GROUP
Business Analyst, HUMANA
Field, VP, HUMANA
Stars Director, HUMANA
Vice President and Division Leader, HUMANA
Project Manager, HUMANA
Strategic Consultant, HUMANA
VP Network Management, HUMANA
Director, HUMANA
Director of Medicare, HUMANA
PMO Manager   , HUMANA
Medical Director, HUMANA
Chief Marketing Officer, INLAND EMPIRE HEALTH PLAN
Director of Quality Management, INLAND EMPIRE HEALTH PLAN
Senior Medical Director, INLAND EMPIRE HEALTH PLAN
Decision Support Manager, INTER VALLEY HEALTH PLAN
Vice President of Plan Operations, INTER VALLEY HEALTH PLAN
Executive Director, KEY PHYSICIANS
Director of Utilization/Case Management, KINDRED HEALTHCARE
Senior Director, Medical Management, L.A. CARE HEALTH PLAN
Director, Medicare Operations, L.A. CARE HEALTH PLAN
Pharmacist, L.A. CARE HEALTH PLAN
Executive Associate, L.A. CARE HEALTH PLAN
Risk Adjustment Analyst, L.A. CARE HEALTH PLAN
Senior Medicare Operations Specialist, L.A. CARE HEALTH PLAN
Director, Quality Improvement, L.A. CARE HEALTH PLAN
Health Services Coordinator, L.A. CARE HEALTH PLAN
Medicare Operations Specialist, L.A. CARE HEALTH PLAN
QI Manager, L.A. CARE HEALTH PLAN
Senior Biostatistician, L.A. CARE HEALTH PLAN
Medicare Operations Specialist, L.A. CARE HEALTH PLAN
Manager, Quality Improvement, L.A. CARE HEALTH PLAN
Medicare Operations Specialist, L.A. CARE HEALTH PLAN
Assistant Risk Management, LAC USC MEDICAL CENTER
Information Systems Coordinator, LOS ANGELES COUNTY
AVP, Quality, LOVELACE HEALTH PLAN
Associate Chief Medical Officer, LOVELACE HEALTH PLAN
Chief Programs Officer, LOVELACE HEALTH PLAN
Program Manager, Star Ratings, MEDICA
Senior Vice President, MENTAL HEALTH SYSTEMS
Director of Training and Novata, MENTAL HEALTH SYSTEMS
Director of Contracting & Members, METROHEALTH / GERIATRIC MANAGEMENT, LLC
Medical Drug Officer, METROHEALTH / GERIATRIC MANAGEMENT, LLC
MRA Specialist, METROHEALTH / GERIATRIC MANAGEMENT, LLC
Corporate VP Quality, MOLINA HEALTHCARE
Medicare QI Specialist, MOLINA HEALTHCARE
AVP Quality Monitoring, MOLINA HEALTHCARE
Chief Medical Officer, MOLINA HEALTHCARE OF CA
Director, Performance Improvement, MONARCH HEALTHCARE
Performance Improvement, MONARCH HEALTHCARE
Administrator, MY FAMILY MEDICAL GROUP
Director of Federal Affairs, NATIONAL COMMITTEE FOR QUALITY ASSURANCE
Account Executive, NOVO NORDISK
National Sr. Medical Director, OPTUM
VP Strategy and Business Development, PARTNERS IN CARE FOUNDATION
Quality Data Coordinator, RIVERSIDE PNSYICIAN NETWORK
Medical Director, RIVERSIDE PHYSICIAN NETWORK
HEDIS Analysis, RIVERSIDE PHYSICIAN NETWORK
Risk Adjustment Manager, RIVERSIDE PHYSICIAN NETWORK
Quality Data Coordinator, RIVERSIDE PHYSICIAN NETWORK
IT Liaison, SAN BERNADINO MEDICAL GROUP
Director of QM and Clinical Operations, SAN BERNADINO MEDICAL GROUP
QM Assistant, SAN BERNADINO MEDICAL GROUP
IT, SAN BERNADINO MEDICAL GROUP
VP/Medical Director, SCAN HEALTH PLAN
Health Education Specialist, SCAN HEALTH PLAN
Quality Initiatives Project Manager, SCAN HEALTH PLAN
Director, Project Management, SCAN HEALTH PLAN
Provider Services Specialist, SCAN HEALTH PLAN
VP, Medical Director, SCAN HEALTH PLAN
RN, SCAN HEALTH PLAN
Strategic Initiatives, Network Management, SCAN HEALTH PLAN
Quality/ 5 Star Initiative Developer, SCAN HEALTH PLAN
Specialist, Network Management, SCAN HEALTH PLAN
VP, Medical Director, SCAN HEALTH PLAN
Provider Services Specialist, SCAN HEALTH PLAN
Specialist, Network Management, SCAN HEALTH PLAN
VP, Health Care Informatics, SCAN HEALTH PLAN
Specialist, Network Management, SCAN HEALTH PLAN
Director, HCC Coding, SCAN HEALTH PLAN
Executive Assistant, SCAN HEALTH PLAN
Manager, Network Management, SCAN HEALTH PLAN
Strategic Project Professional, SCAN HEALTH PLAN
Director Clinical Education and Training, SCAN HEALTH PLAN
VP, Network Management, SCAN HEALTH PLAN
Sr. Provider Relations Specialist, SCRIPPS HEALTH
Supervisor Quality Improvement, SCRIPPS HEALTH PLAN SERVICES
Manager, UM & QI, SCRIPPS HEALTH PLAN SERVICES
Medicare Part D Manager, SELECTHEALTH
Director, Quality Improvement, SELECTHEALTH
Director, Quality Management, SENIOR WHOLE HEALTH
Director, SIMPLY HEALTHCARE PLANS
Quality Reporting  Analyst, SIMPLY HEALTHCARE PLANS
Director of Client Operations, SOLSTICE BENEFITS
Director of Project Management, SOLSTICE BENEFITS
Director of Marketing, SOLSTICE BENEFITS
Chief Operations Officer, SOLSTICE BENEFITS
Director of Performance & Improvement, ST. JOSEPH HOSPITAL AFFILIATED PHYSICIANS
Plan Administrator, STAYWELL HEALTH PLAN
Manager Quality Improvement, SUMMACARE HEALTH PLAN
CIO, TOUCHSTONE
Compliance Officer, TRANSAMERICA/STONEBRIDGE LIFE
Medical Director, Senior Products, TUFTS HEALTH PLAN
Vice President, Stars Initiative, UNITED HEALTH CARE
RVP, UNITED HEALTHCARE
West Region Medical Director, UNITED HEALTHCARE MEDICARE & RETIREMENT
Director, Medical Management, UNIVERSAL AMERICAN
Sr. Director of Technology, UNIVERSAL HEALTHCARE
Manager, Care Coordination, UNIVERSITY OF CALIFORNIA SAN DIEGO MEDICAL CENTER
Executive Director, UW MEDICINE NEIGHBORHOOD CLINICS UNIV. OF WASHINGTON
Clinical Director, Geriatrics, VA GREATER LOS ANGELES
Geriatric Nurse Practitioner, HSR, VA GREATER LOS ANGELES
Clinical Manager, VA GREATER LOS ANGELES
Geriatric Fellow, VA GREATER LOS ANGELES
Vice President, BUSINESS DEVELOPMENT, VERISK HEALTH
Sr. Product Manager, VERISK HEALTH
National Medical Director, WALGREENS
Program Director, WELLPOINT
Program Manager, WELLPOINT
Managed Care Medical Director, WENATCHEE VALLEY MEDICAL CENTER
Director of Managed Care, WENATCHEE VALLEY MEDICAL CENTER
CEO, WHITTIER HOSPITAL MEDICAL CENTER
Marketing Assistant, YOUR HOME ADVANTAGE
COO, YOUR HOME ADVANTAGE
Marketing Manager, YOUR HOME ADVANTAGE
CEO, YOUR HOME ADVANTAGE
Regional Vice President, Operations, YOUR HOME ADVANTAGE
CMO, YOUR HOME ADVANTAGE
YOUR HOME ADVANTAGE
2013 Agenda (current as of 1/15/13)
Past Conference Day One: Monday, February 25, 2013
8:30 am
Registration & Continental Breakfast
9:30 am
Opal Events' Welcome
9:35 am

Chair's Welcome
Trying to Hit a Moving Target: What We Know Will Drive Your Score

  • How Medicare Advantage and Part D are the playbook for all things to come

Founder and Chairman, GORMAN HEALTH GROUP

10:00 am
Spotlight Session:
STAR PERFORMERS
Hear from the 2012 top-rated plans on bonus payments and other competitive advantages as well as lessons learned.

Senior Director, Medical Products, TUFTS HEALTH PLAN

10:35 am
Mid-Morning Refreshment & Networking Break
11:05 am
Spotlight Session:
Physician Group Panel Discussion
Hear from  2012 leading physician groups on health plan collaboration and lessons learned along he Stars journey. 

ABL HEALTHCARE SOLUTIONS, LLC, former Chief Medical Officer, ARIZONA INTEGRATED PHYSICIANS
Medical Director, ACCESS HEALTH CARE

11:50 am
Luncheon
1:05 pm
Achieving High Preventative ServicesScores: A Health Plan & A Physician Group Weigh-In
  • Breast cancer screening
  • Colorectal cancer screenings
  • Glycoma screening
  • Evaluating mental health status
  • Evaluating physical health status
  • Flu shots
  • Pneumonia shots
  • Adult MBI assessment
ABL HEALTHCARE SOLUTIONS, LLC, former Chief Medical Officer, ARIZONA INTEGRATED PHYSICIANS
IPA Administrator, CHOICE PHYSICIANS NETWORK
1:50 pm
Mid-Afternoon Refreshment & Networking Break
2:20 pm
Achieving High Treatment Scores: A Health Plan & A Physician Group Weigh-In
  • Diabetes
  • Heart Disease
  • Mental & behavioral health
  • Other treatment measures
CEO, ACCESS HEALTH CARE
Medical Director, ACCESS HEALTH CARE
3:05 pm
The Cost of Quality Improvement: Selecting Measures and Software to Drive Cost Savings and Increase Quality

Each year organizations make a resolution to improve their HEDIS scores or perform 'better' on a measure. By the time reports are due they often realize they still have not developed a quality improvement strategy that identifies targeted areas for cost savings or metrics with potential for improvement. Organizations need a simple place to start:

  • Simplifying measure reporting (e.g., HEDIS, P4P, PQRS, CHIPRA) - With whom should you partner?
  • Missed opportunities - How will you improve population management and identify, analyze and prioritize STAR ratings gaps?
  • Quality management and health care reform - How will upcoming regulations impact drive your strategy and your costs?
VP, COGNIZANT HEALTHCARE BUSINESS CONSULTING
Manager, COGNIZANT HEALTHCARE BUSINESS CONSULTING
3:55 pm
Drug Adherence in Part D
  • Best Practices in Drug Adherence in the elderly
President, EDGAR CONSULTING GROUP
VP Strategy and Business Development, PARTNERS IN CARE FOUNDATION
4:40 pm
Integrating Stars, Revenue, and Medical Expense Management

VP, Quality, Population Management & Behavior Health, BLUE SHIELD OF CA
5:25 pm
Day One Adjourns; Cocktail Reception Immediately to Follow
Past Conference Day Two: Tuesday, February 26, 2013
8:30 am
Registration and Breakfast
9:15 am
Low Rated Plans: Maintain CMS Coverage
  • Short and long term strategies to becoming a high rated plan
  • Steps executive management must take - right now
  • Manage your relationship with CMS
Founder and Chairman, GORMAN HEALTH GROUP
9:30 am
Incentives for Groups to Improve Star Ratings: A Case Study from Tufts Health Plan
  • Where is left to go?
  • P4P incentives
  • Appealing to professional pride
  • Leveraging the overlap between Star, Medicare ACO, and other Health Plan quality measures
  • Challenges in rewarding improved Star performance
Senior Director, Medical Products, TUFTS HEALTH PLAN
10:15 am
Mid-Morning Refreshment Break; Hotel Check-Out
10:45 am
Outside the box: Leveraging a national pharmacy network to improve STAR scores

National Medical Director, WALGREENS
Representative, OUTCOMESMTM
11:45 am
Creating a Well-Rounded Quality Improvement Program: P4P, HEDIS, Stars

Senior Manager, CALIFORNIA QUALITY COLLABORATIVE
Senior Product Manager, VERISK HEALTH
Director of Performance and Improvement, ST JOSEPH HOSPITAL AFFILIATED PHYSICIANS
12:30 pm
Luncheon
1:30 pm
Tools to Improve Your Star Ratings
  • How Star Ratings work
  • Updates for 2013
  • How Patient-Centered Medical Homes, ACOs, Integrating Care for Dual Eligibles and Multicultural Healthcare impact the measures that go into star ratings.
Director of Federal Affairs, NATIONAL COMMITTEE FOR QUALITY ASSURANCE
2:15 pm
Strategies for Developing a Chronic Condition Improvement Program

Reducing hospitalizations & readmissions through chronic care management

VP/Medical Director, SCAN HEALTH PLAN
3:00 pm
Symposium Adjourns
Register:
Service Providers
$1,895.00
:
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995.00
:
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
$995.00
:
Pending Registrations
You have 1 registration pending.
Sub-Total: $537.00
    register now
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