The 2014 Annual HEDIS® and Star Ratings Symposium

Implementation Best Practices and Action-able Tips for Payers and Their Providers in Developing a 5-Star Push
November 3-4, 2014
Millennium Maxwell House
Nashville, TN

Conference Details
When it comes to healthcare performance measurement, HEDIS (the Healthcare Effectiveness Data & Information Set) is the industry standard. It required by both public and private purchasers as well as state regulators.

In this hard-hitting conference, we'll cover everything you need to know about HEDIS, from A to Z. Our expert speakers will cover the key metrics required as well as shine a spotlight on some of the tougher measures, like osteoporosis, medication adherence, and diabetes.
Core Curriculum:
  • Extensive Review of the New HEDIS 2013/2014 Measures:
    • General
    • Physician-Specific
    • ACO-Specific
    • CAHPS PCMH-Specific
  • HEDIS 2013/2014 Physician Measures
  • Technical Specifications
  • The NCQA HEDIS Compliance Audit: Standards, Policies, and Procedures
  • Medicare Health Outcomes Survey
  • Behavioral Health Criteria and Process Improvement Spotlight
  • Enhanced Primary Care Potential Bonus Payment Model & Calculation
  • Answers to Commonly Asked HEDIS Questions ~ Provided By Your Peers as well as the Professionals
  • Metrics Definitions
  • Important Dates and Timeframes
  • General Coding Conventions
  • 2013/2014 HEDIS Corrections Process - Permanent Exclusions
  • Practical Spotlight: Improving Screenings for Breast and Colorectal Cancers
Who Will Attend:
This conference has been designed specifically for executives from national Medicare Advantage health plans of every size. The conference will be of specific interest to CMOs, VPs of Operations, VPs of Finance, VPs of Provider Relations - Directors of Medical Management Programs - Clinical Quality Directors - Directors of Quality Improvement.
Audience Demographics:
Hotel Info:


Millennium Maxwell House Nashville
2025 Rosa L. Parks Boulevard
Nashville, TN 37228
Phone: 615 259 4343

We are pleased to announce that the Opal room block is open and we are accepting reservations. Please click on the ONLINE HOTEL RESERVATION link to book your room. The hotel will not accept individual call-ins.

  • Rooms are available only to those participants who are registered conference attendees.
  • Rooms will not be guaranteed without a credit card.
  • Rooms are allocated on a first come first serve basis. Room types/rates are subject to availability.
  • The name on the form will be the name of the guest room.

    Online Hotel Reservation

Please see below for a listing of nearby hotel accomodations

SpringHill Suites Nashville MetroCenter
(.5 miles, 11 minute walk)
250 Athens Way
Nashville, TN 37228
(615) 244-5474

DoubleTree by Hilton Hotel Nashville Downtown
(2.5 miles, 5 minute drive)
315 4th Ave N
Nashville, TN 37219
(615) 244-8200

Courtyard Nashville Downtown
(2.6 miles, 5 minute drive)
170 4th Ave N
Nashville, TN 37219
(615) 256-0900

Sheraton Nashville Downtown Hotel
(2.6 miles, 5 minute drive)
623 Union St
Nashville, TN 37219
(615) 259-2000

Renaissance Nashville Hotel
(2.7 miles, 6 minute drive)
611 Commerce St
Nashville, TN 37203
(615) 255-8400

Hilton Nashville Downtown
(2.8 miles, 7 minute drive)
121 4th Ave S
Nashville, TN 37201
(615) 620-1000

Hutton Hotel
(3 miles, 5 minute drive)
1808 West End Ave
Nashville, TN 37203
(615) 340-9333

Loews Vanderbilt Hotel - Nashville
(3.2 miles, 6 minute drive)
2100 West End Ave
Nashville, TN 37203
(615) 320-1700

Conference Registration Prices:
Early Bird Rate
Standard Rate
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
First 100 Free
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
Service Providers
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
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
Gold Sponsor:
Pharm MD

Exhibitor Sponsor:
eMedical Practice Record Flow Record Flow
Media Partners:
Attest Health EHR IntelligenceGeorgia Bio Health IT AnalyticsHealth IT Security icrunchdata
LabrootsMostly Medicaid  PharmaPhorumPharma VoiceStory of Digital Health

Untitled Document

2014 Attendees & Agenda (current as of 10/29/14)

Business Development Manager, Aetna
Administrative Assistant, Agumet
President Chart Audit & Coding, Altegra Health
MD, Chief Research & Innovation Officer, Ambulatory Care Network, Los Angeles County Department of Health Service
National Sales Manager, American Specialty Health
Practice Consultant, Amerigroup of Tennessee
Quality Management Coordinator, Amerigroup of Tennessee
Quality Management Coordinator, Amerigroup of Tennessee
Senior Director, Quality Management, ArchCare
Principal, Attest Health
RN, Population Health Nurse Consultant, Blanchfield Army Community Hospital
Clinical Consultant, Blue Cross Blue Shield
Manager Clinical Improvement, Blue Cross Blue Shield of TN
Pharmacy director, Goverment Programs, Blue Cross Blue Shield of TN
Accreditation Research Consultant, Blue Cross Blue Shield Tennessee
Clinical Consultant, BlueCare Tennessee
Clinical Consultant, Clinical Improvement, BlueCare Tennessee
QI Director, BlueCare Tennessee
Supervisor, BlueCare Tennessee
Director of Operations, BlueCross BlueShield of Tennessee
Director of STARS, BlueCross BlueShield of Tennessee
Physician, Cardiology Partners
Director Quality Improvement, Centerstone of Tennessee
VP for QI, Centerstone of Tennessee
VP. Medicare Data Quality Operations, Cigna /HealthSpring
Regional Manager, Clinical Pathology Laboratories
Director of Privacy, Community Health Systems
Legal Counsel, Community Health Systems
Vice President and Associate General Counsel, Community Health Systems
HEDIS Specialist, Continucare Corporation
Director of Quality and Disease Management, Cookeville Medical Center
Practice Administrator, Drs. Borders & Associates, P.S.C.
Physician, eMedicalPractice
AVP Quality, First Care Health Plan
HEDIS Manager, First Care Health Plan
Executive Vice President, FloChec
Regional Manager, FloChec
HEDIS Manager, Florida Blue/Blue Cross and Blue Shield of Florida
Billing Coordinator, Grady Health System
Director of Revenue Cycle, Grady Health System
Assistant Vice President, HCA
Manager, HCA
Quality Management Specialist, Health Care Service Corporation
Consultant, Quality Initiatives, Humana
Quality Improvement Team Leader, Humana

RN Quality, Humana
Strategic Consultant, Humana
Quality Improvement Team Leader, Humana, Senior Products -  Quality
RN, Humana/CarePlus Health Plans
Medicare Risk Adjustment Manager, Island Doctors
Board Member, KPN Data Analytics
Director Medicare Performance Management, L.A. Care Health Plan
Medical Director-QI Health Assessment, LA Care Healthplan
HEDIS Strategy Analyst, MCCI Medical Group
National Director of Quality Analytics, HEDIS, STARs and MRA, MCCI Medical Group
Family Health Clinic Chief, McDonald Army Health Center
MAPS Project Manager, McDonald Army Health Center
Provider Consultant, Medcore Health Plan
SVP, MediMedia Managed Markets
Associate Medical Director, Medstar Family Choice
Chief Medical Officer, Molina Healthcare of CA
Manager of Data Integrity, Molina Healthcare of California
CMSRN Patient Care Manager PCMH, Mountain States Medical Group
Assoc. Executive Director, New York City Health and Hospitals
Director of Care Coordination, Novant Health
Value Based Performance Coordinator, Novant Health
Practice Performance Manager, Optum, United Health Group
VP Quality STARS, PharmMD
Clinical Documentation Analyst, Precision Healthcare Systems
Manager, Premier Medical Associates
Regional Vice President, Sales, RecordFlow
Senior Vice President, RecordFlow
Vice President, RecordFlow
Director of Network Development, Regional Medical Associates
Provider Relations Representative, Regional Medical Associates
Sr. Coder/MRA Analyst, Regional Medical Associates
Coding Specialist, Rehabilitation Institute of Chicago
Chief Healthcare Informatics Officer, Sonic Healthcare USA
Director of Business Development, Sonic Healthcare USA
Senior Vice President, Strategy & Implementation, Sonic Healthcare USA
Vice President of Quality Performance Improvement/ CCO, STARUS Medical Group, Inc.
Director of Coding, TN dept of Health
Chief Information Officer, Triple S Advantage
Quality Management and Star Rating Director, Triple SSS Advantage
Director, United Healthcare
Director of Operations, United Healthcare Risk Adjustment and HEDIS Operations
Medical Management Nurse Consultant Pop Health Nurse, United States Army/ Blanchfield Army Community Hospital
Pharmacy Consultant, Universal Care Health Plan
Business Analyst, VIVA Health
RN C4Q, VIVA Health
Sr. Director,  Reporting and Analytics, WellCare
Business Change Director, WellPoint

2014 Agenda (current as of 10/22/14)
Conference Day 1: Monday, November 3, 2014 (HEDIS® Focus)
11:00 am
Chair's Welcome and Audience Demographics

Vice President of Quality Performance Improvement/CCO, Starus Medical Group
11:20 am
Refreshment & Networking Break
Enjoy a cup of coffee while you peruse the exhibit hall. Mingle with your fellow attendees before we kick off the educational sessions
11:50 am
The importance of reporting tools and analytics to achieve quality goals.
Star Rating results are impacted on a 50% by HEDIS measures.Demonstrate improvement in physician groups that follow up this  process.

Director, Quality and Star Rating Department, Triple-S Advantage

12:30 pm
Integrated Progress Improvement Strategies to Improve Medicare CAHPS & HEDIS Scores
  • Integrating CAHPS and HEDIS as tools for identifying organizational gaps/barriers
  • Seeing it through members' eyes: Strategies to streamline and improve internal processes
  • Breaking down organizational silos to affect positive change
  • Working on a tight budget: Using member convenience to increase efficiency and patient satisfaction to improve CAHPS and HEDIS scores
  • Measuring success: Reflecting outcomes in CAHPS, HEDIS and Star Ratings
Pharmacy Consultant, Universal Care Health Plan
1:00 pm
2:00 pm
On Lean Transformation

Associate Executive Director, New York City Health and Hospitals
2:50 pm
Integrating Clinical and Business Intelligence

Director of Translational Ethics and Policy, PEARL, and Chief Clinical and Business Intelligence Officer, KPN Management Partners
Chief Research and Innovation Officer, Los Angeles County, Department of Health Services, Clinical Health Sciences Professor, David Geffen School of Medicine at UCLA 
3:25 pm
Refreshment Break
3:50 pm
Changing culture to improve quality measures

Provider Consultant, Medcore
4:30 pm
HEDIS Audit Best Practices: An Auditor's Perspective
  • Building an effective HEDIS team
  • Maximize your administrative data
  • How to prepare, what to expect in an audit
  • Audit best practices: Good approaches to an audit that make it run smoothly – and make sure you get value out of it as opposed to just meeting a compliance function

Principal & CIO, Attest Health Care Advisors, LLC
5:10 pm
Conference Concludes; Cocktail Reception Immediately to Follow in the Exhibit Hall
Conference Day 2: Monday, November 4, 2014 (Star Ratings Focus)
8:45 am
Networking Continental Breakfast
9:25 am
Chair's Welcome Back
10:05 am

Spotlight Session:
Guarantee a 4 Star for your Part D Star Ratings and Achieve Health Outcomes

Vice President of Quality/Stars, PharmMD 
Pharm MD

9:35 am

Achieving High Scores: A Health Plan & A Physician Group Weigh-In

Vice President of Quality Performance Improvement/ CCO, Starus Medical Group
10:50 am
Mid-Morning Refreshment Break and Networking
11:20 am
Supplemental Data: A Sure-Fire Way to Dramatically Increase Your HEDIS Score
  • How to set yourself up to successfully use supplemental data
  • How to do supplemental data right so that it can be your “secret sauce”
Senior Associate, Mercer CBHS
12:05 pm
Provider member engagement and strategy:
  • Field Support
  • Aligned Incentives
  • Clinical Data and Support
  • Supplemental Data Optimization
  • Provider Portal

Director of Revenue Enhancement Stars - Senior Products, BlueCross BlueShield of Tennessee

12:50 pm
Luncheon and Summit Concludes

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

Service Providers
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
First 100 Free
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Sub-Total: $537.00