View Agenda | The RISE Part D Master Class

Rise

/media/5211/rise-logo.png

Part D Masterclass
August 5– 6, 2024
Orlando, FL

Past Agenda

Monday - August 5, 2024

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

5:00 AM 6:00 AM

Registration Desk Opens and Networking Breakfast

8:00 AM 6:00 PM

7:00 AM 5:00 PM

6:00 AM 4:00 PM

5:00 AM 3:00 PM

Exhibit Hall Open

9:00 AM 9:50 AM

8:00 AM 8:50 AM

7:00 AM 7:50 AM

6:00 AM 6:50 AM

Workshop Part 1: Best Practices in Formulary Design and Management

  • Discuss the role of formulary management in enhancing patient care
  • Explore innovative approaches in formulary management for controlling costs
  • Highlight the value of data analytics in monitoring formulary efficacy

Nikki Hungate, MHA, EdD, Principal/Owner
Brightstar Health Solutions, LLC

Matthew Hayes, Principal and Consulting Actuary
Milliman

Justin Harris, Senior Actuarial Manager, FSA, MAAA
Milliman

9:50 AM 10:50 AM

8:50 AM 9:50 AM

7:50 AM 8:50 AM

6:50 AM 7:50 AM

Workshop Part 2: Enhancing FWA Programs at Your Organization

  • Learn how to integrate analytics to detect and prevent FWA
  • Discuss the current challenges in preventing FWA in Medicare plans
  • Outline best practices for building robust internal controls for your compliance framework

Ana Handshuh, Principal
Cat5 Strategies

Helen Liu, Former Vice President of Pharmacy Operations
ATRIO Health Plans

10:50 AM 11:20 AM

9:50 AM 10:20 AM

8:50 AM 9:20 AM

7:50 AM 8:20 AM

Networking Break

11:20 AM 11:30 AM

10:20 AM 10:30 AM

9:20 AM 9:30 AM

8:20 AM 8:30 AM

Welcome and Opening Remarks

Matthew Hayes, Principal and Consulting Actuary
Milliman

11:30 AM 12:15 PM

10:30 AM 11:15 AM

9:30 AM 10:15 AM

8:30 AM 9:15 AM

Navigating CMS Part D Payment Changes for 2025

  • Understand the new payment structure and the impact on premiums, subsidies, and cost-sharing 
  • Discuss the strategic implications on plan design 
  • Identify the operational challenges health plans may face with the new changes 

Melissa Smith, Founder
Newton Smith Group

Rachel Madden, Actuary, FSA, CERA, MAAA
Milliman

12:15 PM 1:15 PM

11:15 AM 12:15 PM

10:15 AM 11:15 AM

9:15 AM 10:15 AM

Networking Lunch

1:15 PM 2:10 PM

12:15 PM 1:10 PM

11:15 AM 12:10 PM

10:15 AM 11:10 AM

Strategies for PBM Negotiations and Rebates

  • Discuss contracting strategies to achieve favorable pricing 
  • Highlight compliance challenges in contracting and how to proactively address them 
  • Analyze the impact of contracting on member satisfaction 

Roxanne Newland, Vice President of Pharmacy Operations
Rebellis Group

Helen Liu, Former Vice President of Pharmacy Operations
ATRIO Health Plans

2:10 PM 3:00 PM

1:10 PM 2:00 PM

12:10 PM 1:00 PM

11:10 AM 12:00 PM

Addressing Social Determinants of Health in Part D Planning

  • Discover how to integrate SDOH data into formulary decision-making processes
  • Highlight innovative approaches to leverage SDOH insights for improved member care plans
  • Explore key metrics for evaluating the impact of SDOH in Part D planning

Shannon Decker, PhD, MBA, MBA, M.Ed., M.Ed., Principal
VBC One

3:00 PM 3:20 PM

2:00 PM 2:20 PM

1:00 PM 1:20 PM

12:00 PM 12:20 PM

Networking Break

3:20 PM 4:05 PM

2:20 PM 3:05 PM

1:20 PM 2:05 PM

12:20 PM 1:05 PM

Breaking Down Part D for Better Star Ratings

  • Explore the specific Part D measures that are weighted most heavily in the Star Ratings calculations
  • Examine the challenges plans face in tracking and improving these metrics
  • Outline the role of data analytics in identifying areas for improvement

Luis Cerda, Star Ratings Consultant
Rex Wallace Consulting

Melinda Nelhuebel, Senior Director of Operations, Pharmacy
Blue Cross Blue Shield of Massachusetts

4:05 PM 4:50 PM

3:05 PM 3:50 PM

2:05 PM 2:50 PM

1:05 PM 1:50 PM

Effective Risk Management in Part D Operations

  • Outline strategies for mitigating risk associated with medication management 
  • Learn best practices for using risk assessment tools 
  • Discuss the challenges of balancing risk in strategic decision making for Part D plans 

Casey Gardner, Consulting Actuary
Wakely Consulting Group

Laura Sheriff, MSN, CPC, CRC
Industry Expert in Risk Adjustment Operations

 

4:50 PM 5:00 PM

3:50 PM 4:00 PM

2:50 PM 3:00 PM

1:50 PM 2:00 PM

Closing Remarks

Matthew Hayes, Principal and Consulting Actuary
Milliman

5:00 PM 6:00 PM

4:00 PM 5:00 PM

3:00 PM 4:00 PM

2:00 PM 3:00 PM

Networking Cocktail Reception

Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.

Tuesday - August 6, 2024

8:00 AM 9:00 AM

7:00 AM 8:00 AM

6:00 AM 7:00 AM

5:00 AM 6:00 AM

Registration Desk Opens and Networking Breakfast

8:00 AM 12:50 PM

7:00 AM 11:50 AM

6:00 AM 10:50 AM

5:00 AM 9:50 AM

Exhibit Hall Open

9:00 AM 9:10 AM

8:00 AM 8:10 AM

7:00 AM 7:10 AM

6:00 AM 6:10 AM

Welcome Remarks and Day One Takeaways

Matthew Hayes, Principal and Consulting Actuary
Milliman

9:10 AM 10:00 AM

8:10 AM 9:00 AM

7:10 AM 8:00 AM

6:10 AM 7:00 AM

Leveraging AI and Health Behavior Management in Medicare Part D: Enhancing Outcomes and Efficiency

  • Explore how AI and behavioral science can be used to improve medication adherence
  • Discuss the role of predictive analytics in identifying individual barriers to action
  • Understand how AI can provide a scalable approach to engage members with Social Risk Factors

Helen Liu, Former Vice President of Pharmacy Operations
ATRIO Health Plans

Dave Burianek, Senior Vice President
MedOrion

Asaf Kleinbort, CEO & Co-Founder
MedOrion

10:00 AM 10:45 AM

9:00 AM 9:45 AM

8:00 AM 8:45 AM

7:00 AM 7:45 AM

Enhancing Patient Outcomes with Medication Therapy Management Programs

  • Discuss the fundamentals of MTM in the context of Part D 
  • Outline strategies for implementing successful MTM programs 
  • Examine how health plans can use data analytics to identify eligible members 

Gary Melis, Clinical Pharmacist
Network Health

Randee Bowder, RPH, CEO
myMTMcare

10:45 AM 11:05 AM

9:45 AM 10:05 AM

8:45 AM 9:05 AM

7:45 AM 8:05 AM

Networking Break

11:05 AM 11:50 AM

10:05 AM 10:50 AM

9:05 AM 9:50 AM

8:05 AM 8:50 AM

The ABC’s of Audit Readiness

  • Identify key lessons from 2023-2024 and CMS focus areas
  • Highlight best practices for CMS Program Audit Readiness
  • Discuss compliance oversight of the PBM

Joy Enright, Director, Client Audit
CVS Health

Colleen Gianatasio, Director, Clinical Documentation
CDPHP

Melissa Broaddus, Manager Client Audit-Compliance Oversight
CVS Health

11:50 AM 12:50 PM

10:50 AM 11:50 AM

9:50 AM 10:50 AM

8:50 AM 9:50 AM

Networking Lunch

12:50 PM 1:35 PM

11:50 AM 12:35 PM

10:50 AM 11:35 AM

9:50 AM 10:35 AM

Adapting to CMS Advance Notice Updates Under the Inflation Reduction Act

  • Discuss the expected changes in how Medicare will negotiate drug prices
  • Review the operational challenges health plans may face from adapting to new subsidy structures
  • Understand the compliance aspects of the IRA that will take effect CY 2025

Michelle Juhanson, Director, Government Programs
PSGConsults

Omar Daoud, Senior Director of Pharmacy
Community Health Plan of Washington

1:35 PM 2:20 PM

12:35 PM 1:20 PM

11:35 AM 12:20 PM

10:35 AM 11:20 AM

Roundtables: Collaborative Strategies for Navigating Part D Compliance

Ranarda Jones, CEO
PSyn Inc.

2:35 PM 2:40 PM

1:35 PM 1:40 PM

12:35 PM 12:40 PM

11:35 AM 11:40 AM

Closing Remarks

Matthew Hayes, Principal and Consulting Actuary
Milliman