CMS Bidding From Process to Strategy-August 24-25 2015-Paradise Point Resort & Spa

AUGUST 24-25, 2015 PARADISE POINT RESORT & SPA SAN DIEGO, CALIFORNIA

TAKING YOUR BID TO THE NEXT LEVEL REQUIRES PLANNING AND PATIENCE. LOTS OF PATIENCE. GET IT RIGHT AND YOU’RE LOOKING AT UNRIVALED ACCESS TO NEW MARKETS, MEMBERS, AND REVENUE. GETTING IT WRONG… WELL, THAT’S NOT AN OPTION.

The long-term objectives of your Medicare Advantage plan ride on the shoulders of your team’s assumptions and projections. Using this information in a constructive way requires careful governance. This unique forum brings together national and regional plans for a step-by-step evaluation of the opportunities, obstacles, and competitive advantages available throughout the development of your bid.• Expand your bidding toolbox to include new approaches to narrow networks, Part D design, and member engagement• Understand the roadmap of your bid timeline—where do you encounter problems along the way and how can you avoid the traditional pitfalls?• Hear creative solutions for expanding into new markets— learn new ways to evaluate the competitive landscape

OPTIMIZE YOUR BID!

SPONSORS

GO

LD

SILV

ER

T O R E G I S T E R : C A L L ( 8 6 6 ) 6 7 6 - 7 6 8 9 O R V I S I T U S A T W W W . H E A L T H C A R E - C O N F E R E N C E S . C O M

CMS BIDDING: FROM PROCESS TO STRATEGYLeveraging Your Bid for Competitive Medicare Advantage Outcomes

The only Medicare Advantage bid event is back! Learn best

practices and all-new advanced strategy

topics in an interactive

setting!

H E A L T H C A R E E D U C A T I O N A S S O C I A T E S P R E S E N T S

We’re going to make the bid process easier to attain new benefits along the way.

There are tons of moving parts—we get it. That’s why we’ve brought together Medicare Advantage experts from across the country to help paint you a clearer picture of the bid submission process. Product development, network expansion, best-and-worst case scenario planning, and strategic Part D design—we’ve got executives from Humana, Innovacare, Affinity Health Plan, Milliman, Tufts Health Plan, and more to help you navigate the complex system of crafting an optimized bid. Our comprehensive program offers health plans an opportunity to interact with other plans to share best practices and unlock new possibilities within their Medicare Advantage plans.

CMS Bidding: From Process to Strategy offers attendees from Medicare Advantage plans an intensive two-day learning experience. Built as an interactive classroom, sessions spotlight specific practices for building advanced programs into your annual bid. Our expert speaking faculty will guide you through the intricacies of governing inputs from different sources so that you can extract the most from your submission! Learn how successful Medicare Advantage plans create more efficient access to outcomes, revenue, and market share through the meticulous application of the bid!

What’s the best approach to managing and assembling the best Medicare Advantage product possible? Join us August 24th and 25th at the Paradise Point Resort & Spa to discover new avenues of success with your annual bid!

Register today! Call (866) 676-7689 or online at www.healthcare-conferences.com.

Sincerely,

Josh Krenz, Conference DirectorHEALTHCARE EDUCATION ASSOCIATES

IMPORTANT INFORMATION

VENUE DETAILS

Paradise Point Resort & Spa1404 Vacation RoadSan Diego, CA 92109(858) 274-4630

We have a limited number of hotel rooms reserved for the conference. The negotiated room rate of $189 per night will expire on August 3, 2015. We expect the block to sell out prior to this date. To ensure you receive a room at the negotiated rate book well before the expiration date. Upon sell out of the block room rate and availability will be at the hotel’s discretion.

Tucked away on gentle Mission Bay in the heart of San Diego, Paradise Point Resort & Spa features comfortable bungalow-style rooms amidst lush, tropical gardens, tranquil lagoons, and one mile of sandy beach next door to SeaWorld. Scattered across our 44-acre island, you’ll find plenty of room to roam and relax with five swimming pools, beach bonfire pits, a marina, five dining venues, an award-winning spa and endless recreation options.

Paradise Point and its amenities offer a unique San Diego vacation experience for both families and couples with a location that is secluded, yet centrally situated; the airport, downtown San Diego and top attractions including Old Town, the San Diego Zoo, and Balboa Park are all just minutes away from our shores.

TEAM DISCOUNTS

• Three people will receive 10% off• Four people will receive 15% off• Five people or more will receive 20% off

In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For more information, please contact Kathie Eberhard at (704) 341-2439 or [email protected].

REFUNDS AND CANCELLATIONSFor information regarding refund, complaint and/or program cancellation policies, please visit our website: healthcare-conferences.com/thefineprint.aspx

TOP TEN REASON TO ATTEND• Witness top-notch bid professionals showcase their insight as they break down how a successful bid team should operate• New to the bid? This is your one-stop-shop for an all-inclusive educational experience!• Seasoned bidder? Explore new opportunities, receive and share insight, and network with the best of the best!• See how other plans operationalize, maintain, and implement strategic bids!• Dissect CMS regulations in order to predict next year’s trend• Know what to look for in your network; should you go narrow or wide? Learn how the bid affects your expansion strategy!• Unlock revenue by doing what your competition is afraid to• Learn how to mitigate attrition while gaining access to new members through the bid!• Discover ways to improve your Star ratings with advanced Part D design!

WHO WILL ATTEND?This conference is designed for Medicare Advantage professionals including (but not limited to):• Product Management and Development• Medicare Advantage and Senior Products • Government Programs /Special Needs Plans /Medicare Part D Plans• Quality / Compliance• Operations• Risk Adjustment

• Revenue Management and Analysis • Finance and Actuaries• Marketing and Sales Departments• Network Development• Care Management• Consultants

“It was a great overview of the bid process and I was able to connect the dots that I was missing in this process, specifically the actuarial/ financial piece.”

Caro Ruiz, Tufts Health Plan

Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas. Offering highly targeted conferences, Healthcare Education Associates positions itself as a preferred resource for executives and managers seeking cutting-edge information on the next wave of business opportunities. Backed with over 26 years of combined conference industry experience, the producers of HEA conferences assist healthcare professionals, actuaries, attorneys, consultants, researchers and government representatives in their professional endeavors. For more information on upcoming events, visit us online: www.healthcare-conferences.com

RISE (Resource Initiative & Society for Education) Vision:To build a community and an educational system that promotes successful careers for professionals who aim to advance the quality, cost and availability of health care. RISE provides:• A forum to build professional identity and a network of colleagues• A platform to capture and share knowledge and insights• A venue to develop and share benchmarks and document best practices• Career track development support• A channel for building alliances, partnerships and affiliations that fulfill the vision

RISE (Resource Initiative & Society for Education) Mission:RISE is the first national association totally dedicated to enabling healthcare professionals working in organizations and aspiring to meet the challenges of the emerging landscape of accountable care and health care reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development. To learn more about RISE and to join, visit us online: www.risehealth.org

THE CONFERENCE ORGANIZERS OUR RENOWNED SPEAKING FACULTYKyle Raeder, COMMUNITY CARE, INC.Osato Chitou, AMIDA CAREDavid Neiman, WAKELY CONSULTING GROUPMatt Chamblee, MILLIMANAlex Cires, MILLIMANKimberly Kauffman, SUMMIT HEALTHCAREBrenda Stubblefield, AFFINITY HEALTH PLANDebbi Greer, HEARING CARE SOLUTIONSMatt Kranovich, MILLIMANKevin Mowll, RISEJarem Hallows, TRUHEARINGKat Gesh-Wilson, BLUE CROSS BLUE SHIELD NORTH CAROLINAMichelle Hoffner, BOLTON HEALTH ACTUARIALLinda Borths, QUEST ANALYTICS

SPONSORS

GOLD GOLD SILVER SILVER

CPE CREDITSHealthcare Education Associates is registered with the National Association of State Boards of Accountancy (NASBA)

as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.learningmarket.org.

The recommended CPE credit for this course is 11 credits in the following field(s) of study: • Specialized Knowledge and Application

For more information, visit our website: healthcare-conferences.com/thefineprint.aspx

SPONSORSHIP AND EXHIBIT OPPORTUNITIESEnhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event.To learn more about sponsorship opportunities, please contact Jennifer Clemence at (704) 341-2438 or [email protected].

TruHearing is a hearing aid savings program that offers

your health plan members exclusive pricing on the industry’s best hearing aids and services. We partner with top hearing aid manufacturers to save your members thousands of dollars off the retail price of hearing aids. Because our prices are exclusive, TruHearing helps differentiate your health plan from the competition. In fact, 90% of TruHearing customers report having an improved opinion of their health plan after using our program.TruHearing offers both embedded hearing aid benefit programs tailored to Medicare audiences as well as VAIS programs that are free to the health plan and come at no additional cost to members. For more information about how TruHearing can enhance your benefit offering, contact Jarem Hallows, VP of Business Development, [email protected]

With over 60 combined years of healthcare experience,

Bolton Health Actuarial consists of senior consultants with comprehensive knowledge of pricing and reviewing commercial rate filings, Medicare Advantage, Managed Medicaid and development of risk-based contracting. Bolton has some of the best actuarial minds in the country and realizes the challenges the ever-changing regulatory landscape poses to competitively pricing successful health plans. Our high consultant-to-client ratio allows us to focus on work products that meet your goals.

As the industry-leader and

standard for Network Adequacy Analysis, Quest Analytics offer a full range of solutions to meet Network Adequacy challenges. Because the Quest Analytics Suite™ is utilized at the Federal level, Quest Analytics is at the forefront of understanding the complexities of Network Adequacy requirements. Learn how your peer companies are leveraging Quest Analytics to position themselves for success.

For additional information, please visit us at www.questanalytics.com or call us at 920.739.4552.

Hearing Care Solutions was founded in response to the changing

landscape for managed care plans. HCS is unique within the industry. Our prices are fixed, based on the level of technology. Our strong relationships with manufacturers and hearing care providers allow us to offer low prices, without sacrificing quality. In 2014, HCS saved members of our managed care plans an average of $1,929 per hearing aid.Our executive team brings over 35 years of combined experience in hearing healthcare management. We will design a program around your benefit, making the benefit more meaningful to the member.HCS will also work well as a value-added service. We will offer your members a valuable hearing care program, at no charge to the plan or members.For more information on how HCS can add value and quality to your offering, contact Debbi Greer, VP of Client Services & Communications [email protected]

8:00 - 8:45 REGISTRATION & CONTINENTAL BREAKFAST

8:45 - 9:00 CHAIR’S WELCOME AND ORIENTATIONKevin Mowll, Executive DirectorRISE

9:00 – 9:30 BID DEVELOPMENT PROJECT MANAGEMENT AND BEST PRACTICESWhat are the key dates of bid season and why do they the dictate the need for early planning?• Breaking down the bid timeline—critical dates for decision -making and submission• Resolving typical issues through bid development best practices, project management, and early alignment of process• Organizing your cross-functional team for successful bid oversight, communications, and governance• Creating year-over-year momentum with bid developmentKyle Raeder, Director of Reimbursement & Financial PlanningCOMMUNITY CARE, INC.

9:30 - 10:00 CONSEQUENCES OF THE BID ON THE FUTURE OF YOUR PLAN• So… why’s the bid such a big deal?• What’s the impact of the bid on your Star ratings?• How does the bid shape the direction of your Medicare Advantage programs and vice versa?• What happens when it all goes wrong?Osato Chitou, Esq, MPH, Director of Medicare ComplianceAMIDA CARE

10:00 - 10:15 MORNING BREAK sponsored by

10:15 – 11:00 PRE-JANUARY: LOOKING AT THE EARLY PARTICIPANTS IN THE BID PROCESSIn order to unlock and implement key strategies, our panel will evaluate and deconstruct the roles, responsibilities, and challenges initial players face in assembling early bid inputs. • Evaluating the outcomes and objectives of last year’s bid• Key strategies, obstacles, assumptions, and decisions regarding: - Pharmacy management and formulary development - How to catch up if your pre-January work is incompleteDavid Neiman, Senior Consulting ActuaryWAKELY CONSULTING GROUP

PART 2: HOW TO STRATEGIZE THE NABA DECISION IN YOUR INITIAL BID• How, why, and where does it go wrong?• What opportunities are available to you?• Aligning premiums and bids to be in-line with projections and NABADavid Neiman, Senior Consulting ActuaryWAKELY CONSULTING GROUP

DAY ONE: MONDAY, AUGUST 24, 2015

11:00 - 12:00 PRE-JANUARY: POST-MORTEM OF LAST YEAR FROM AN ACTUARY’S PERSPECTIVE• How to do a post mortem – getting at the truth - What are the typical things that go wrong - How to make the things that go wrong go right - What should the plan do and what should the bid actuary do• Looking at the landscape next year and what to do now and what to plan for - Financial analysis of next year - Your plans experience and what it means - How to look at risk scores of your plan and what it means for next year - What opportunities are you missing• Looking at your contracting and how it impacts your bids and financial results - Medicare and Rx contracting– how should you look at the terms of the contracting and what it means - Part C capitated contracts – making sure you are optimizing your contracts - Global risk – how to look at these and making sure you are aware of the pitfalls Matt Chamblee, FSA, MAAA, Principal and Consulting ActuaryMILLIMAN

12:00 - 1:00 LUNCHEON sponsored by

1:00 - 2:00 JANUARY: ANALYZING THE STRATEGIC ENVIRONMENT FOR NETWORK DEVELOPMENT• Network management service area expansion—stratifying markets based on relative attractiveness• Network adequacy tests— - Tips for submitting exception requests - Filing with CMS - How does this process inform the bid? Linda Borths, National Sales Director, QUEST ANALYTICS

PART 2: PROVIDER RELATIONSHIPS AND YOUR BID--ALIGNING INCENTIVES THROUGH THE BID TO CREATE LONG TERM IMPACT• Analyzing the relationship between your bid and provider incentive models• Understanding mechanics versus behavior—what are the realistic expectations for what we can control? How can we get our providers to help? How is this envisioned in the bid?Kimberly Kauffman, Vice President, Value-Based CareSUMMIT HEALTHCARE

2:00 - 2:45 JANUARY: MAPPING OUT THE COMPETITIVE LANDSCAPEHow do teams assemble and analyze information about the shifting market? How does this information inform sales and marketing decisions? What techniques can the product management team use to leverage this information for a competitive advantage?

David Neiman, Senior Consulting ActuaryWAKELY CONSULTING GROUPBrenda Stubblefield, Assistant Vice President, Medicare OperationsAFFINITY HEALTH PLAN

2:45 - 3:00 AFTERNOON BREAK sponsored by

• Competitor positions• Market share• Product position• Historical growth

• Bid input• Future enrollment• Attrition

“The conference reinforced the info I knew and filled in the blanks I was missing.”

Karrie Howard, Humana

3:00 - 4:00 PART 1: USING SUPPLEMENTAL HEARING BENEFITS TO DIFFERENTIATEDo hearing benefits matter to prospective members making buying decisions? What are the tradeoffs to offering supplement benefits versus value-add discount programs? How does it impact the bid process?Jarem Hallows, Vice President of Business DevelopmentTRUHEARING

PART 2: BUILDING OTC BENEFITS INTO YOUR BID• Why should you consider it and how does it work?• How is it funded?• Compliance considerations• Challenges in handling manual reimbursementOsato Chitou, Esq., MPH, Director of Medicare ComplianceAMIDA CARE

DAY TWO: TUESDAY, AUGUST 25, 2015

4:00 - 5:00 PART 1: SESSION TBDKat Gesh-Wilson, Vice President - Federal SegmentBLUE CROSS BLUE SHIELD NORTH CAROLINA

PART 2: RESPONDING TO THE CMS ADVANCED NOTICE• Best case scenario• Worst case scenario• “Best guess” to the likely scenarioMatt Chamblee, FSA, MAAA, Principal and Consulting ActuaryMILLIMAN

8:00 - 8:45 BREAKFAST sponsored by

8:45 - 9:00 RECAP OF DAY ONE

9:00 - 9:45 MARCH: ASSEMBLING THE STRAW MAN• Establishing product options—how many should you include? Where do you look to start trimming down options?• Evaluating preliminary claims info and Rx claims• Forecasting risk scores – how does this affect your preliminary bid design? • Understanding early risk adjustment projections and the impact on your portfolio and financial goals• Dollars per-member-per-month revenue • Sweeps and lump-sum payments• Gathering reactions to the straw man from the team—who has input? How do you filter this information in a constructive way?• Administrative dollar assumptions – how much money are you allocating to your operating costs?• Department staffing• Marketing spend• Change in budget historical analysis• Other trends in healthcare costs worth considering for your initial straw manMichelle Hoffner, Managing DirectorBOLTON HEALTH ACTUARIAL

9:45 - 10:30 APRIL – MAY: RESPONDING TO THE FINAL CALL LETTER• Revenue projections• Brief overview of the ins-and-outs of the final rate• STARs – how does the rating fit into the bid? How confident are we about October announcements on these ratings?• Risk Adjustment—how do the work-in-progress and work plan initiatives fit into bid considerations?• How do actuaries use the information?• Final claims—weighing concerns about completion factors• Trend-mitigation—weight given to business initiatives as planned?Matt Kranovich, ActuaryMILLIMAN

10:30 - 11:00 MORNING BREAK

11:00 – 11:30 VALUE-ADDED ITEMS AND SERVICESDebbi Greer, Vice President Clint Services & CommunicationsHEARING CARE SOLUTIONS

11:30 - 12:00 PART D BID DESIGNAlex Cires, FSA, MAAA, ActuaryMILLIMAN

12:00 - 12:30 JUNE AND BEYOND: AUDITS, NABA, AND APPROVAL• Can you implement changes after filing? What is the revision and resubmission process?• Understanding desk review and the bid audit—what went wrong? What can we do better for next time?• What kind of shockwaves should you expect from the NABA release and approval? • Using the rebate reallocation process from the Part D average bid to your advantageMatt Kranovich, ActuaryMILLIMAN

12:30 CONFERENCE ADJOURNS

5:00 - 6:00 COCKTAIL RECEPTION IMMEDIATELY FOLLOWING For more information about our sponsorship opportunities contact Jennifer Clemence on (704) 341-2438

or [email protected]

“High-level logistical linear overview of the bid process.”Bing Bing Liang, CareOregon

AUGUST 24-25, 2015 PARADISE POINT RESORT & SPA SAN DIEGO, CALIFORNIA

CMS BIDDING: FROM PROCESS TO STRATEGYLeveraging Your Bid for Competitive Medicare Advantage Outcomes

The only Medicare Advantage bid event is back! Learn best

practices and all-new advanced strategy

topics in an interactive

setting!

H E A L T H C A R E E D U C A T I O N A S S O C I A T E S P R E S E N T S

T O R E G I S T E R : C A L L ( 8 6 6 ) 6 7 6 - 7 6 8 9 O R V I S I T U S A T W W W . H E A L T H C A R E - C O N F E R E N C E S . C O M

HEALTHCARE EDUCATION ASSOCIATES200 WASHINGTON ST. SUITE 201

CMS BIDDING: FROM PROCESS TO STRATEGY

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