RISE Bedrock of Health Care | Quality Agenda

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Quality

The Quality seminar provides best-in-class comprehensive education on quality programs for health plan professionals at a range of experience levels. From those beginning their work in quality improvement to those seeking to hone their skills or learn about a wider variety of quality measures and programs, this crucial training provides the information quality professionals need to know to help meet their plan’s goals for quality of care and member satisfaction. 

Tuesday - June 17, 2025

12:00 PM 12:05 PM

11:00 AM 11:05 AM

10:00 AM 10:05 AM

9:00 AM 9:05 AM

Opening Remarks

12:05 PM 12:55 PM

11:05 AM 11:55 AM

10:05 AM 10:55 AM

9:05 AM 9:55 AM

CMS, Medicare, and Quality

  • Explore the quality programs, their goals, and how they affect health plans  
  • Review the fundamentals of quality improvement methodologies and how they are applied     
  • Describe the structure and function of CMS, it’s role in setting quality standards, and how it interacts with health plans  
  • Delve into the basics of Medicare, Medicare Advantage, and Medicare Part D 

 

12:55 PM 1:05 PM

11:55 AM 12:05 PM

10:55 AM 11:05 AM

9:55 AM 10:05 AM

Break

1:05 PM 1:55 PM

12:05 PM 12:55 PM

11:05 AM 11:55 AM

10:05 AM 10:55 AM

Medicare Star Ratings

  • Gain an understanding of the key details of the Medicare Advantage Star Ratings Program   
  • Highlight crucial Stars Ratings factors that influence plan performance and quality assessment  
  • Examine and unpack the recently released Final Rules 

Melissa Smith 
Founder, Senior Advisor 
Newton Smith Group 

(Pending final confirmation) 

1:55 PM 2:05 PM

12:55 PM 1:05 PM

11:55 AM 12:05 PM

10:55 AM 11:05 AM

Break

2:05 PM 2:55 PM

1:05 PM 1:55 PM

12:05 PM 12:55 PM

11:05 AM 11:55 AM

The Essentials of Stars Math

  • Unpack the calculations behind determining Stars ratings  
  • Identify strategic levers that have the potential to add or subtract significantly to Stars scores, including QI measures, the Reward Factor, and the Health Equity Index  
  • Recognize potential financial implications of upcoming Stars changes 

 

Rex Wallace Team 

(Pending final confirmation) 

2:55 PM 3:05 PM

1:55 PM 2:05 PM

12:55 PM 1:05 PM

11:55 AM 12:05 PM

Break

3:05 PM 3:55 PM

2:05 PM 2:55 PM

1:05 PM 1:55 PM

12:05 PM 12:55 PM

CAHPS and the Measurement of Member Experience

  • Explore the CAHPS member satisfaction survey and its relation to quality improvement programs  
  • Discover how to manage data collection for a robust voice of the customer program  
  • Understand member engagement strategies for improved experience and survey participation  
  • Discuss provider engagement strategies for collaboration and improvement 

Dr. Shannon Decker, PhD, MBA, MBA, M.Ed., M.Ed  
Founder & CEO 
VBC One 

(Pending final confirmation)

3:55 PM 4:00 PM

2:55 PM 3:00 PM

1:55 PM 2:00 PM

12:55 PM 1:00 PM

Day One Wrap Up

Wednesday - June 18, 2025

12:00 PM 12:05 PM

11:00 AM 11:05 AM

10:00 AM 10:05 AM

9:00 AM 9:05 AM

Welcome Remarks

12:05 PM 12:55 PM

11:05 AM 11:55 AM

10:05 AM 10:55 AM

9:05 AM 9:55 AM

The Fundamentals of HEDIS®

  • Become familiar with HEDIS® measure authors, certification, and the scope of HEDIS® measures  
  • Learn how to effectively track and measure HEDIS® data and become familiar with important supplemental data options and compliance issues   
  • Identify strategic areas for HEDIS® score improvement and techniques for moving the needle 

 

12:55 PM 1:05 PM

11:55 AM 12:05 PM

10:55 AM 11:05 AM

9:55 AM 10:05 AM

Break

1:05 PM 1:55 PM

12:05 PM 12:55 PM

11:05 AM 11:55 AM

10:05 AM 10:55 AM

HEDIS® ECDS Measures & the Move to Digital Quality Measurement

  • Discuss the ECDS measures and the future of HEDIS® quality measurement   
  • Operationalize the integration of ECDS measure data into existing processes   
  • Learn best practices for fully digital reporting, which does not include a hybrid reporting option 

Vandna Bhrany 
Vice President, HEDIS Strategy & Analytics 
AmeriHealth Caritas 

 

1:55 PM 2:05 PM

12:55 PM 1:05 PM

11:55 AM 12:05 PM

10:55 AM 11:05 AM

Break

2:05 PM 2:55 PM

1:05 PM 1:55 PM

12:05 PM 12:55 PM

11:05 AM 11:55 AM

Additional Quality Programs

  • Select and design CCIPs and QIPs for efficient QI success    
  • Leverage HOS Surveys and measure MA health outcomes through PROMS   
  • Get to know the CMS Universal Foundation of Measures  
  • Review pharmacy-related quality measures and authors 

 

Rex Wallace Team 

(Pending final confirmation) 

2:55 PM 3:05 PM

1:55 PM 2:05 PM

12:55 PM 1:05 PM

11:55 AM 12:05 PM

Break

3:05 PM 3:55 PM

2:05 PM 2:55 PM

1:05 PM 1:55 PM

12:05 PM 12:55 PM

The Intersection of Quality and Health Equity

  • Understand the role of quality programs in realizing meaningful improvement in care for all members  
  • Use measurement data to identify health equity gaps and improve outcomes and experience for specific member populations  
  • Learn how to make the CMS health equity priorities benefit your quality programs 

Ana Handshuh 
Principal 
CAT5 Strategies 

(Pending final confirmation) 

3:55 PM 4:00 PM

2:55 PM 3:00 PM

1:55 PM 2:00 PM

12:55 PM 1:00 PM

Day Two Wrap Up