1. 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
GOLD
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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
TheonlyMedicareAdvantagebid
event is back! Learn best
practicesandall-new
advancedstrategy
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

2. 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 Director
HEALTHCARE EDUCATION ASSOCIATES
IMPORTANT INFORMATION
VENUE DETAILS
Paradise Point Resort & Spa
1404 Vacation Road
San 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,downtownSanDiegoandtopattractions
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,
pleasecontactKathieEberhardat(704)341-2439
or keberhard@healthcare-conferences.com.
REFUNDS AND CANCELLATIONS
For 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
• MedicareAdvantageandSeniorProducts
• 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

3. 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 FACULTY
Kyle Raeder, COMMUNITY CARE, INC.
Osato Chitou, AMIDA CARE
David Neiman, WAKELY CONSULTING GROUP
Matt Chamblee, MILLIMAN
Alex Cires, MILLIMAN
Kimberly Kauffman, SUMMIT HEALTHCARE
Brenda Stubblefield, AFFINITY HEALTH PLAN
Debbi Greer, HEARING CARE SOLUTIONS
Matt Kranovich, MILLIMAN
Kevin Mowll, RISE
Jarem Hallows, TRUHEARING
Kat Gesh-Wilson, BLUE CROSS BLUE SHIELD
NORTH CAROLINA
Michelle Hoffner, BOLTON HEALTH ACTUARIAL
Linda Borths, QUEST ANALYTICS
SPONSORS
GOLD GOLD SILVER SILVER
CPE CREDITS
Healthcare Education Associates is
registered with the National Association
ofStateBoardsofAccountancy(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 OPPORTUNITIES
Enhance 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.
Tolearnmoreaboutsponsorshipopportunities, please contact Jennifer Clemence at (704) 341-2438 or jclemence@healthcare-conferences.com.
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4. 8:00 - 8:45 REGISTRATION & CONTINENTAL BREAKFAST
8:45 - 9:00 CHAIR’S WELCOME AND ORIENTATION
Kevin Mowll, Executive Director
RISE
9:00 – 9:30 BIDDEVELOPMENTPROJECTMANAGEMENT
AND BEST PRACTICES
What 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 development
Kyle Raeder, Director of Reimbursement & Financial Planning
COMMUNITY 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 Compliance
AMIDA CARE
10:00 - 10:15 MORNING BREAK sponsored by
10:15 – 11:00 PRE-JANUARY: LOOKING AT THE EARLY
PARTICIPANTS IN THE BID PROCESS
In 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 incomplete
David Neiman, Senior Consulting Actuary
WAKELY 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 NABA
David Neiman, Senior Consulting Actuary
WAKELY 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 Actuary
MILLIMAN
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 Care
SUMMIT HEALTHCARE
2:00 - 2:45 JANUARY: MAPPING OUT THE COMPETITIVE
LANDSCAPE
How 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 Actuary
WAKELY CONSULTING GROUP
Brenda Stubblefield, Assistant Vice President, Medicare Operations
AFFINITY HEALTH PLAN
2:45 - 3:00 AFTERNOON BREAK sponsoredby
• 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

5. 3:00 - 4:00 PART 1: USING SUPPLEMENTAL HEARING
BENEFITS TO DIFFERENTIATE
Do 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 Development
TRUHEARING
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 reimbursement
Osato Chitou, Esq., MPH, Director of Medicare Compliance
AMIDA CARE
DAY TWO: TUESDAY, AUGUST 25, 2015
4:00 - 5:00 PART 1: SESSION TBD
Kat Gesh-Wilson, Vice President - Federal Segment
BLUE CROSS BLUE SHIELD NORTH CAROLINA
PART 2: RESPONDING TO THE CMS
ADVANCED NOTICE
• Best case scenario
• Worst case scenario
• “Best guess” to the likely scenario
Matt Chamblee, FSA, MAAA, Principal and Consulting Actuary
MILLIMAN
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
hasinput? Howdoyoufilterthisinformationinaconstructiveway?
• 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 man
Michelle Hoffner, Managing Director
BOLTON 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, Actuary
MILLIMAN
10:30 - 11:00 MORNING BREAK
11:00 – 11:30 VALUE-ADDED ITEMS AND SERVICES
Debbi Greer, Vice President Clint Services & Communications
HEARING CARE SOLUTIONS
11:30 - 12:00 PART D BID DESIGN
Alex Cires, FSA, MAAA, Actuary
MILLIMAN
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 advantage
Matt Kranovich, Actuary
MILLIMAN
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 jclemence@healthcare-conferences.com
“High-level logistical linear overview of the bid process.”
Bing Bing Liang, CareOregon

6. AUGUST 24-25, 2015 PARADISE POINT RESORT & SPA SAN DIEGO, CALIFORNIA
CMS BIDDING:
FROM PROCESS TO
STRATEGYLeveraging Your Bid for Competitive Medicare Advantage Outcomes
TheonlyMedicareAdvantagebid
event is back! Learn best
practicesandall-new
advancedstrategy
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
ASSOCIATES
200 WASHINGTON ST. SUITE 201
CMS BIDDING: FROM PROCESS TO STRATEGY
ATTENTION MAILROOM:
If undeliverable, please forward to the
Head of Medicare Product Development
INCORRECT MAILING INFORMATION: If you are receiving multiple mailings, have updated information or would like
to be removed from our database, please fax our database team at 704-341-2641 or call 704-341-2387. Please keep in
mind that amendments can take up to 8 weeks. Conference Code: H317
Please Mention This Priority Code When Registering
Make checks payable to Healthcare
Education Associates, and write
H317 on your check.
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