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JANUARY 23-24, 2017 DALLAS, TXDOUBLETREE BY HILTON DALLAS-MARKET CENTER
HEAR DIRECTLY FROM YOUR PEERS AT REGIONAL AND NATIONAL MA PLANS!
Take a season-by-season, interactive exploration of the timeline, critical steps, and overall strategies
that are essential for a successful MA bid!
What You Will Learn
•	 Gain a full understanding of the concepts, deadlines, steps, and interdependencies in the MA bid cycle
•	 Discover the technology tools and systems used in bid submission, and take a guided tour through their key elements
•	 Hear about CMS Desk Review and common pitfalls, and learn how a good offense can be the best defense against
them
•	 Learn how to optimize your bid team and get the right information to the right people at the right time
•	 Hear how to target a competitive analysis to get the most effective and actionable results with the most efficient use
of time
•	 Develop long-term planning and product development strategies to maximize your bid success year after year
•	 Discuss all of the above and more with your peers and colleagues in the bidding trenches!
SPONSORS
BRONZE
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
FeaturingInteractive
SessionsandHands-
onLearning
Opportuni-
ties!
THE MEDICARE
ADVANTAGE BIDDING
BOOTCAMP
A Four Seasons Framework for Preparing the CMS Bid
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
“In this world nothing can be said to be
certain, except death and taxes.”
And that your Medicare Advantage bid will
be due on the first Monday in June.
Or so Benjamin Franklin might add to his famous quote, were
he alive today and working with one of the thousands of health
plans that must apply annually to CMS in order to serve the
highly desired Medicare Advantage market of over 17 million
beneficiaries. Although the bid deadline is the same every
year, the process to get there is a smorgasbord of moving parts,
intermediate due dates, evolving technology tools and systems,
and hundreds of pages of documentation—all requiring the
participation of a collaborative, interdepartmental staff that often
cycles on-and-off a matrixed bid team. Whether you are preparing
your first bid or just wanting to refresh your knowledge of the
details, you’ll need help. We’ve got you covered with the Medicare
Advantage Bidding Boot Camp!
Occurring January 23-24 in Dallas, the Bidding Boot Camp is
strategically scheduled to deliver“just in time”training to jumpstart
your 2018 Medicare Advantage bid. The conference agenda is
uniquely structured to give you a seasonal framework for key tasks
and deadlines, while still highlighting the areas of planning and
product development that must be done year-round.
Join us for the Medicare Advantage Bidding Boot Camp. You’ll
grow your knowledge, connect with peers, and gain confidence
and expertise in executing your plan’s Medicare Advantage bid in a
logical and linear fashion.
About that, we say to Mr. Franklin, we can be certain!
Sincerely,
Terri Hammons
Terri Hammons, Conference Director
HEALTHCARE EDUCATION ASSOCIATES
P.S. We know that bid preparation is a team endeavor, so we’ve
made it easier for multiple members of your bidding team to attend
by offering special group discounts and early bird rates!
Gary J. Ward, Senior Director, Product Development and Management
AETNA
Julia Warner, Director, Product Management & Marketing
Communications
REGENCE BLUECROSS BLUESHIELD OF OREGON
Dedra Ogunmuyiwa, MPH, Manager, Medicare Programs
SCOTT & WHITE HEALTH PLAN
James Head, Director of Medicare Actuarial Services
CONNECTICARE
Debra Baverman, Business Development Officer - Government
Programs
MEMORIAL HERMANN HEALTH PLAN
Kyle Raeder, Controller
COMMUNITY CARE, INC
William Sota, Director of Product Management and Development*
GATEWAY HEALTH
Matt Kranovich, FSA, MAAA, Consulting Actuary
MILLIMAN
Matt Chamblee, Principal and Consulting Actuary
MILLIMAN
Matthew Hayes, Actuary
MILLIMAN
*pending final confirmation
This conference is designed for Medicare Advantage professionals
with responsibilities in areas including (but not limited to):
1.	 Take a comprehensive walk-through of the timeline and key
steps of the bid planning and development process and tackle
your first bid—or fifth or fifteenth—with confidence!
2.	 Avoid information overload at the start of the bid process
with a pathfinder through the CMS bid instructions and
documentation
3.	 Hear real-world examples on efficiently managing the
Medicare Advantage application process and working in the
Health Plan Management System
4.	 Gain an understanding of the essential elements of Star
Ratings and Risk Adjustment that can impact bid preparation
5.	 Find out how and when to incorporate sales and marketing,
operations, quality, and compliance as strategic business
partners in the bid development process
6.	 Discover how to use the Final Call Letter for the nuts-and-bolts
process of your bid
7.	 Dive into the Bid Pricing Tool with a guided, interactive
exercise through the trickiest elements and workbooks
8.	 Learn about the timeline and interdependencies of the Part
D submission, and how trends in formulary development can
impact your bid
9.	 Gain insight into the strategies for evaluating rewards and
incentives programs as part of your product offering
10.	 Communicate, commiserate, and celebrate with your peers
and colleagues as you grow your knowledge in all aspects of
the bid process!
•	 Product Management and
Development
•	 Medicare Advantage and
Senior Products
•	 Bid Development
•	 Government Programs/
Medicare Part D Plans
•	 Actuarial Analysis
•	 Finance
•	 Project Management
•	 Operations
•	 Risk Adjustment
•	 Revenue Management and
Analysis
•	 Marketing and Sales De-
partments
•	 Network Development
•	 Care Management
•	 Consultants
Our Expert Speaking Faculty
Top Ten Reasons to Attend
Who Should Attend?
8:00–9:00 		 Registration & Breakfast for All Participants
9:00–9:15 		 Chairperson’s Opening and Welcome Address
	
9:15–10:00	 Setting the Stage: An Orientation to Medicare
Advantage Bidding
•	 Introduction to the Medicare Advantage bidding process
•	 General overview of the bidding timeline
•	 Essential vocabulary, key terms, and acronyms for understanding and
contributing to the bidding conversation
•	 Understanding the key players in the bid process, and the typical roles
and interdependencies of various departments
Julia Warner, Director, Product Management & Marketing Communications,
Government Programs
REGENCE BLUECROSS BLUESHIELD OF OREGON
Winter
Key Dates and Deadlines
January 1, 2017—Plan Benefit Year Begins
Early January 2017—Release of CY 2018 Applications
Mid-February 2017—Advance Notice and Draft Call Letter Released (45 days
before Final Notice)
Mid/Late-February 2017—Applications due for CY 2018
10:00–10:45	 Pathfinder Session—Navigating CMS Instructions
and Documentation for MA Bidding: What You Need and Where to Find
It
CMS provides extensive documentation related to the bid submission
process and systems, yet for those new to bidding or seeking a refresher,
finding and navigating it can lead to information overload. This“pathfinder”
session will explore:
•	 The standard documents released by CMS—how do you locate them
and which ones are the most helpful?
•	 How to make the most of the CMS Bid Training Modules as a reference
and technical guidance tool
•	 Identifying areas of the CMS instructions that are prescriptive and
rigid, and which areas may allow for flexibility
•	 Strategies for tracking and complying with changes in instructions and
documentation from year to year
10:45–11:00	 Morning Networking Break
11:00–12:00	 Featured Panel—Hail, Hail, the Gang’s All Here!
Optimizing Interdepartmental Participation for a Successful Bid
Panelists will share experiences and insights into building and managing
the cross-functional, matrixed teams that are necessary for bid planning and
development.
•	 How to seamlessly incorporate Compliance as a strategic business
partner from the start to ensure a“no surprises”bid cycle
•	 Examples of best practices for communication and collaboration with
Operations in order to produce a viable product
•	 Looping in Sales and Marketing: when, how often, and for how long?
Panelists:
Dedra Ogunmuyiwa, MPH, Manager, Medicare Programs
SCOTT & WHITE HEALTH PLAN
James Head, Director of Medicare Actuarial Services
CONNECTICARE
Kyle Raeder, Controller
COMMUNITY CARE, INC
12:00–1:00	 Networking Lunch
1:00–2:00	Post-AEP Member Analysis to Drive Pre-Bid Planning Success
Analyzing and understanding the members you have and the members you
want is an essential step in the bid planning process. This session will cover:
•	 Standard techniques and strategies for evaluating the results of the
Annual Election Period
•	 How to accurately evaluate your new membership:
ʄʄ What worked and what didn’t for AEP?
ʄʄ Which benefit packages attracted which members?
•	 The effect of AEP enrollment numbers on accounting and finance, and
how forecasts and re-forecasts play into bid planning
•	 How can a brand new Medicare Advantage member versus a member
switching from another plan differ in impact on your plan in terms of
risk adjustment factors, care needs, and utilization?
Debra Baverman, Business Development Officer - Government Programs
MEMORIAL HERMANN HEALTH PLAN
2:00–3:00		 A Guided, Interactive Tour through the Medicare
Advantage Application Process and Health Plan Management System
(HPMS)
Take a guided tour through CMS’application process for MA plans, plus
the HPMS system, which sets the stage for the rest of your bid cycle. This
interactive session will explore:
•	 The key areas of the Application process, step-by-step
•	 Timelines and key dependencies in planning and data gathering for
the Application
•	 The Plan Benefit Package (PBP) and HPMS: looking ahead to bid
submission—
ʄʄ How to work with and around the rigid, fixed description fields 		
	 in the system in order to enter your data in an acceptable 		
	 manner, but still communicate the nuances of your 			
	 benefit offerings
Dedra Ogunmuyiwa, MPH, Manager, Medicare Programs
SCOTT & WHITE HEALTH PLAN
3:00–3:15	 Afternoon Networking Break
Spring
Key Dates and Deadlines
First Monday in April 2017—CMS Announcement of MA Capitation Rates
and Payment Policies, and the Final Call Letter
Early April, 2017—Release of the PBP and BPT software in HPMS
Mid April—Release of CMS Training Modules
Early/Mid May—Release of BPT Upload Functionality and other Modules in
HPMS
3:15–4:00		 Demystifying CMS Medicare Advantage Capitation
Rates, Payment Policies, and the Final Call Letter
The Final Call Letter is out, and the rates are set. At 250+ pages, the
document is anything but light reading. What does this mean for your bid?
This session will serve as a brief“CMS reimbursement rates 101”experience,
and also prepare you to understand the Final Call Letter:
•	 The basic applications of actuarial analysis
•	 How you will use the rate information for the nuts-and-bolts process
of your bid
•	 What are the impacts on revenue projections that should be factored
into the bid?
•	 The essentials of Star Ratings and Risk Adjustment and their potential
impact on your bid preparation and submission
Matt Chamblee, Principal and Consulting Actuary
MILLIMAN
4:00–5:00		 SPECIAL INTERACTIVE, HANDS-ON SESSION:
Mastering the Bid Pricing Tool (BPT)
In this guided, interactive exercise—designed as a“silo buster”to help those
in non-actuarial roles—participants will explore the Bid Pricing Tool and the
Day One: Monday, January 23, 2017
BPT workbooks, and engage with mock data samples to understand the key
aspects of this critical part of the bid.
•	 First things first—getting the BPT to work:
ʄʄ How to manage security settings and add-in files
ʄʄ Identifying other technology trip-ups that can waylay your bid
•	 BPT data entry:
ʄʄ How to plan for the time and resources necessary for this process
ʄʄ Understanding which tasks typically take longer than expected 		
	 so that you can plan accordingly
•	 Strategies to ensure the critical tasks such as experience reconciliation
are complete and accurate, and ensuring that the data in the bid
8:00–9:00	 Registration & Breakfast for All Participants
9:00–9:15 	Chairperson’s Recap of Day One 	
SPECIAL 2-PART SESSION: FOCUS ON THE PART D BID
9:15–10:00	 Focus on Pharma, Part 1—System & Process
Considerations for Your Part D Bid
•	 Making sense of the Final Call Letter in regard to the Part D Bid
•	 Understanding the timeline and interdependencies for Part D bid
submissions
•	 HPMS and BPT processes for Part D	
10:00–11:00	 Focus on Pharma, Part 2—Optimizing the Part D
Bid
•	 Latest trends and strategies in pharmacy formulary development
ʄʄ Designing the ideal tier structure for your plan
ʄʄ Which drug for which tier?
•	 Understanding NABA, and designing a pharmacy plan to 			
maximize rebates
•	 Assessing your Part D benefits, costs, and drivers:
ʄʄ Evaluating your pharmacy cost structure
ʄʄ What pharmacy network contracts do you have? What contracts 		
	 do you want?
ʄʄ Strategies for effective collaboration with PBMs
ʄʄ Understanding pharmacy network requirements that can affect 		
	 the bid
•	 How to balance the often conflicting consumer desires for both lower
costs and simplicity in plan design
Matthew Hayes, Actuary
MILLIMAN
11:00–11:15	 Morning Networking Break
Summer
Key Dates and Deadlines
1st Monday in June, 2017—Deadline for Bid Submission
June-August, 2017—CMS Desk Review
Late July/Early August 2017—CMS releases Part D National Average Bid
Amount (NABA)
Late July/Early August 2017—Rebate Reallocation Period
11:15–12:15	 The Bid is In! Now What? Desk Review, Audits, and 	
NABA
•	 The key elements, concepts and players involved in desk review and
actuarial bid audit
•	 Avoid road bumps in the bid process by understanding the critical
bid items that desk reviewers and bid auditors pay close attention to,
including reconciliations, non-benefit expense projections, risk score
projections, and related party contracts
•	 Part D“NABA”(National Average Bid Amount) —what does it mean for
your bid once it’s announced?
•	 Tips for managing the potential domino effect when changes to your
bid are required
Matt Kranovich, FSA, MAAA, Consulting Actuary
MILLIMAN
matches your financials
•	 How can you reduce common errors and omissions in data
submissions that may trigger challenges during desk review?
Matt Chamblee, Principal and Consulting Actuary
MILLIMAN
5:00–6:00		 Cocktail Reception Immediately Following
For more information about our sponsorhip opportunities, contact Jennifer
Clemence at 704-341-2438 or at jclemence@healthcare-conferences.com
12:15–1:15	 Networking Lunch
Fall, and a Circle Back to Winter
Key Dates and Deadlines
October 1, 2017—Plan Benefit Data Release
October 15 to December 7, 2017—Annual Election Period
January 1, 2018—New Plan Benefit Year Begins
Fall/Early Winter—Planning and Preparation for the Next Bid!
1:15–2:00		 Performing a Competitive Analysis—Targeting
your Time and Resources to Get the Most Bang for your Buck
The release of plan benefit data in the fall offers an unparalleled
opportunity to evaluate the competitive landscape. This session will cover:
•	 Techniques for evaluating how your plan’s benefit offerings stack up
against the competition
•	 Optimizing the time and resources for competitive analysis by
identifying and focusing on the benefit areas that are the biggest
drivers of consumer choice
•	 Using the results of the competitive analysis to modify your sales and
marketing strategy for the Annual Election Period--
ʄʄ Should you target your marketing dollars to your strength areas, 		
	 or do weaker areas offer hidden opportunities?
ʄʄ How to evaluate and leverage your supplemental 			
	 benefits to lure in the members you want
Gary J. Ward, Senior Director, Product Development and Management
AETNA
2:00–2:45		 Understanding Network Adequacy Requirements
for your Bid Submission
Building and documenting your provider network is both a concrete step in
the bid process and an integral part of year-round planning for long-term
bid success. The provider network is a critical component of your healthcare
offering, but also a top factor of the costs that must be considered for your
bid. This session will examine:
•	 Where to find, how to interpret, and how to work with CMS’s criteria
for network adequacy
•	 Tools, technologies, and strategies to measure network adequacy and
reduce the risk of deficiency findings
•	 Methods for defining a successful network for your plan—
ʄʄ Who are the key providers, and how does the structure of 		
	 provider contracts impact your bid and long-term planning?
ʄʄ How to incorporate risk adjustment models into network 		
	 building and planning
ʄʄ How are these network factors actually translated to actuarial 		
	 data and captured in your bid?
2:45–3:30		 Conference Capstone: Year-Round Product Design
and Development Strategies to Optimize Your Bid
•	 Conducting a bid post-mortem to identify where revenue was left on
the table, and tips and tricks to prevent it from happening in your next
bid
Day Two: Tuesday, January 24, 2017
Venue Details
DoubleTree by Hilton Hotel Dallas - Market Center
2015 Market Center Blvd
Dallas, TX 75207
(214) 741-7481
We have a limited number of hotel rooms reserved for the conference. The
negotiated room rate of $149 per night will expire on December 22, 2016,
although 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, availability will be at the hotel’s
discretion.
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 registra-
tions at the same time. Group discounts cannot be issued retroactively. For
more information, please contact Kathie Eberhard
at 704-341-2439 or at keberhard@healthcare-conferences.com
Refunds & Cancellations
For information regarding refund, complaint and/or program cancellation
policies, please visit our website: https://www.healthcare-conferences.com/
thefineprint.aspx
CPE Credits
Healthcare 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.nasbaregistry.org.
The recommended CPE credit for this course is 13.5 credits it in the follow-
ing field(s) of study: Specialized Knowledge and Applications.
For more information, visit our website: https://www.healthcare-confer-
ences.com/thefineprint.aspx
The Conference Organizers
Healthcare Education Associates is a division
of Financial Research Associates, LLC. HEA is a
resource for the healthcare and pharmaceuti-
cal communities to improve their businesses
by providing access to timely and focused
business information and networking op-
portunities 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 opportu-
nities. 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.health-
care-conferences.com
RISE (Resource Initiative & Society for
Education) Vision:
To build a community and an education-
al system that promotes successful careers for professionals who
aim to advance the quality, cost and availability of health care.
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
Bronze Sponsors
•	 Strategies for evaluating the tradeoffs of adding and removing
benefits
•	 Understanding the impact to your next bid, and how to operationalize
them
•	 Exploring rewards and incentives programs to enhance your plan’s
appeal:
ʄʄ How to measure the impact, whether good or bad, of rewards
and incentives to your plan’s bottom line
ʄʄ How to define and document rewards and incentives in the 		
	 actual bid process as a non-benefit expense
Gary J Ward, Senior Director, Product Development and Management
AETNA
William Sota, Director of Product Management and Development
GATEWAY HEALTH*
*pending final confirmation
3:30	 Conference Concludes
JANUARY 23-24, 2017 DALLAS, TXDOUBLETREE BY HILTON DALLAS-MARKET CENTER
FeaturingInteractive
SessionsandHands-
onLearning
Opportuni-
ties!
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
HEALTHCAREEDUCATIONASSOCIATES
200 WASHINGTON ST. SUITE 201
SANTA CRUZ, CA 95060
ATTENTION MAILROOM:
If undeliverable, please forward to the
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:
Please Mention This Priority Code When Registering
Make checks payable to Wilmington FRA Inc., and write
_________________ on your check.
Name
Company
Address
City
Phone
State
Email
Zip
Title
Payments must be received no later than
Please bill my: MC VISA AMEX DISCOVER
Card Holder’s Name:
Signature:
Check enclosed: Please bill me later:
Exp. Date:
Payment Method:
Four Ways to Register
704-341-2641 800-280-8440
www.healthcare-
conferences.com
HEA
200 Washington Street, Ste. 201
Santa Cruz, CA 95060
Fax Call Web Mail
THE MEDICARE ADVANTAGE BIDDING BOOT CAMP
HEAD OF PRODUCT
DEVELOPMENT OR CHIEF
ACTUARY
H421
H421
*SUBJECT TO HEA APPROVAL
(BEFORE AND ON 12/16/16) (AFTER 12/16/16)
EARLY BIRD STANDARD RATE
SERVICE PROVIDERS & CONSULTANTS
HEALTH PLAN & PROVIDERS*
GOVERNMENT, COMMUNITY GROUPS, &
ASSOCIATIONS*
$2095$1895
$1595
$995
$1795
$1095
January 16, 2017.
HEAR DIRECTLY FROM YOUR PEERS AT REGIONAL AND NATIONAL MA PLANS!
THE MEDICARE
ADVANTAGE BIDDING
BOOTCAMP
A Four Seasons Framework for Preparing the CMS Bid
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

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H421 brochure

  • 1. JANUARY 23-24, 2017 DALLAS, TXDOUBLETREE BY HILTON DALLAS-MARKET CENTER HEAR DIRECTLY FROM YOUR PEERS AT REGIONAL AND NATIONAL MA PLANS! Take a season-by-season, interactive exploration of the timeline, critical steps, and overall strategies that are essential for a successful MA bid! What You Will Learn • Gain a full understanding of the concepts, deadlines, steps, and interdependencies in the MA bid cycle • Discover the technology tools and systems used in bid submission, and take a guided tour through their key elements • Hear about CMS Desk Review and common pitfalls, and learn how a good offense can be the best defense against them • Learn how to optimize your bid team and get the right information to the right people at the right time • Hear how to target a competitive analysis to get the most effective and actionable results with the most efficient use of time • Develop long-term planning and product development strategies to maximize your bid success year after year • Discuss all of the above and more with your peers and colleagues in the bidding trenches! SPONSORS BRONZE 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 FeaturingInteractive SessionsandHands- onLearning Opportuni- ties! THE MEDICARE ADVANTAGE BIDDING BOOTCAMP A Four Seasons Framework for Preparing the CMS Bid 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. “In this world nothing can be said to be certain, except death and taxes.” And that your Medicare Advantage bid will be due on the first Monday in June. Or so Benjamin Franklin might add to his famous quote, were he alive today and working with one of the thousands of health plans that must apply annually to CMS in order to serve the highly desired Medicare Advantage market of over 17 million beneficiaries. Although the bid deadline is the same every year, the process to get there is a smorgasbord of moving parts, intermediate due dates, evolving technology tools and systems, and hundreds of pages of documentation—all requiring the participation of a collaborative, interdepartmental staff that often cycles on-and-off a matrixed bid team. Whether you are preparing your first bid or just wanting to refresh your knowledge of the details, you’ll need help. We’ve got you covered with the Medicare Advantage Bidding Boot Camp! Occurring January 23-24 in Dallas, the Bidding Boot Camp is strategically scheduled to deliver“just in time”training to jumpstart your 2018 Medicare Advantage bid. The conference agenda is uniquely structured to give you a seasonal framework for key tasks and deadlines, while still highlighting the areas of planning and product development that must be done year-round. Join us for the Medicare Advantage Bidding Boot Camp. You’ll grow your knowledge, connect with peers, and gain confidence and expertise in executing your plan’s Medicare Advantage bid in a logical and linear fashion. About that, we say to Mr. Franklin, we can be certain! Sincerely, Terri Hammons Terri Hammons, Conference Director HEALTHCARE EDUCATION ASSOCIATES P.S. We know that bid preparation is a team endeavor, so we’ve made it easier for multiple members of your bidding team to attend by offering special group discounts and early bird rates! Gary J. Ward, Senior Director, Product Development and Management AETNA Julia Warner, Director, Product Management & Marketing Communications REGENCE BLUECROSS BLUESHIELD OF OREGON Dedra Ogunmuyiwa, MPH, Manager, Medicare Programs SCOTT & WHITE HEALTH PLAN James Head, Director of Medicare Actuarial Services CONNECTICARE Debra Baverman, Business Development Officer - Government Programs MEMORIAL HERMANN HEALTH PLAN Kyle Raeder, Controller COMMUNITY CARE, INC William Sota, Director of Product Management and Development* GATEWAY HEALTH Matt Kranovich, FSA, MAAA, Consulting Actuary MILLIMAN Matt Chamblee, Principal and Consulting Actuary MILLIMAN Matthew Hayes, Actuary MILLIMAN *pending final confirmation This conference is designed for Medicare Advantage professionals with responsibilities in areas including (but not limited to): 1. Take a comprehensive walk-through of the timeline and key steps of the bid planning and development process and tackle your first bid—or fifth or fifteenth—with confidence! 2. Avoid information overload at the start of the bid process with a pathfinder through the CMS bid instructions and documentation 3. Hear real-world examples on efficiently managing the Medicare Advantage application process and working in the Health Plan Management System 4. Gain an understanding of the essential elements of Star Ratings and Risk Adjustment that can impact bid preparation 5. Find out how and when to incorporate sales and marketing, operations, quality, and compliance as strategic business partners in the bid development process 6. Discover how to use the Final Call Letter for the nuts-and-bolts process of your bid 7. Dive into the Bid Pricing Tool with a guided, interactive exercise through the trickiest elements and workbooks 8. Learn about the timeline and interdependencies of the Part D submission, and how trends in formulary development can impact your bid 9. Gain insight into the strategies for evaluating rewards and incentives programs as part of your product offering 10. Communicate, commiserate, and celebrate with your peers and colleagues as you grow your knowledge in all aspects of the bid process! • Product Management and Development • Medicare Advantage and Senior Products • Bid Development • Government Programs/ Medicare Part D Plans • Actuarial Analysis • Finance • Project Management • Operations • Risk Adjustment • Revenue Management and Analysis • Marketing and Sales De- partments • Network Development • Care Management • Consultants Our Expert Speaking Faculty Top Ten Reasons to Attend Who Should Attend?
  • 3. 8:00–9:00 Registration & Breakfast for All Participants 9:00–9:15 Chairperson’s Opening and Welcome Address 9:15–10:00 Setting the Stage: An Orientation to Medicare Advantage Bidding • Introduction to the Medicare Advantage bidding process • General overview of the bidding timeline • Essential vocabulary, key terms, and acronyms for understanding and contributing to the bidding conversation • Understanding the key players in the bid process, and the typical roles and interdependencies of various departments Julia Warner, Director, Product Management & Marketing Communications, Government Programs REGENCE BLUECROSS BLUESHIELD OF OREGON Winter Key Dates and Deadlines January 1, 2017—Plan Benefit Year Begins Early January 2017—Release of CY 2018 Applications Mid-February 2017—Advance Notice and Draft Call Letter Released (45 days before Final Notice) Mid/Late-February 2017—Applications due for CY 2018 10:00–10:45 Pathfinder Session—Navigating CMS Instructions and Documentation for MA Bidding: What You Need and Where to Find It CMS provides extensive documentation related to the bid submission process and systems, yet for those new to bidding or seeking a refresher, finding and navigating it can lead to information overload. This“pathfinder” session will explore: • The standard documents released by CMS—how do you locate them and which ones are the most helpful? • How to make the most of the CMS Bid Training Modules as a reference and technical guidance tool • Identifying areas of the CMS instructions that are prescriptive and rigid, and which areas may allow for flexibility • Strategies for tracking and complying with changes in instructions and documentation from year to year 10:45–11:00 Morning Networking Break 11:00–12:00 Featured Panel—Hail, Hail, the Gang’s All Here! Optimizing Interdepartmental Participation for a Successful Bid Panelists will share experiences and insights into building and managing the cross-functional, matrixed teams that are necessary for bid planning and development. • How to seamlessly incorporate Compliance as a strategic business partner from the start to ensure a“no surprises”bid cycle • Examples of best practices for communication and collaboration with Operations in order to produce a viable product • Looping in Sales and Marketing: when, how often, and for how long? Panelists: Dedra Ogunmuyiwa, MPH, Manager, Medicare Programs SCOTT & WHITE HEALTH PLAN James Head, Director of Medicare Actuarial Services CONNECTICARE Kyle Raeder, Controller COMMUNITY CARE, INC 12:00–1:00 Networking Lunch 1:00–2:00 Post-AEP Member Analysis to Drive Pre-Bid Planning Success Analyzing and understanding the members you have and the members you want is an essential step in the bid planning process. This session will cover: • Standard techniques and strategies for evaluating the results of the Annual Election Period • How to accurately evaluate your new membership: ʄʄ What worked and what didn’t for AEP? ʄʄ Which benefit packages attracted which members? • The effect of AEP enrollment numbers on accounting and finance, and how forecasts and re-forecasts play into bid planning • How can a brand new Medicare Advantage member versus a member switching from another plan differ in impact on your plan in terms of risk adjustment factors, care needs, and utilization? Debra Baverman, Business Development Officer - Government Programs MEMORIAL HERMANN HEALTH PLAN 2:00–3:00 A Guided, Interactive Tour through the Medicare Advantage Application Process and Health Plan Management System (HPMS) Take a guided tour through CMS’application process for MA plans, plus the HPMS system, which sets the stage for the rest of your bid cycle. This interactive session will explore: • The key areas of the Application process, step-by-step • Timelines and key dependencies in planning and data gathering for the Application • The Plan Benefit Package (PBP) and HPMS: looking ahead to bid submission— ʄʄ How to work with and around the rigid, fixed description fields in the system in order to enter your data in an acceptable manner, but still communicate the nuances of your benefit offerings Dedra Ogunmuyiwa, MPH, Manager, Medicare Programs SCOTT & WHITE HEALTH PLAN 3:00–3:15 Afternoon Networking Break Spring Key Dates and Deadlines First Monday in April 2017—CMS Announcement of MA Capitation Rates and Payment Policies, and the Final Call Letter Early April, 2017—Release of the PBP and BPT software in HPMS Mid April—Release of CMS Training Modules Early/Mid May—Release of BPT Upload Functionality and other Modules in HPMS 3:15–4:00 Demystifying CMS Medicare Advantage Capitation Rates, Payment Policies, and the Final Call Letter The Final Call Letter is out, and the rates are set. At 250+ pages, the document is anything but light reading. What does this mean for your bid? This session will serve as a brief“CMS reimbursement rates 101”experience, and also prepare you to understand the Final Call Letter: • The basic applications of actuarial analysis • How you will use the rate information for the nuts-and-bolts process of your bid • What are the impacts on revenue projections that should be factored into the bid? • The essentials of Star Ratings and Risk Adjustment and their potential impact on your bid preparation and submission Matt Chamblee, Principal and Consulting Actuary MILLIMAN 4:00–5:00 SPECIAL INTERACTIVE, HANDS-ON SESSION: Mastering the Bid Pricing Tool (BPT) In this guided, interactive exercise—designed as a“silo buster”to help those in non-actuarial roles—participants will explore the Bid Pricing Tool and the Day One: Monday, January 23, 2017
  • 4. BPT workbooks, and engage with mock data samples to understand the key aspects of this critical part of the bid. • First things first—getting the BPT to work: ʄʄ How to manage security settings and add-in files ʄʄ Identifying other technology trip-ups that can waylay your bid • BPT data entry: ʄʄ How to plan for the time and resources necessary for this process ʄʄ Understanding which tasks typically take longer than expected so that you can plan accordingly • Strategies to ensure the critical tasks such as experience reconciliation are complete and accurate, and ensuring that the data in the bid 8:00–9:00 Registration & Breakfast for All Participants 9:00–9:15 Chairperson’s Recap of Day One SPECIAL 2-PART SESSION: FOCUS ON THE PART D BID 9:15–10:00 Focus on Pharma, Part 1—System & Process Considerations for Your Part D Bid • Making sense of the Final Call Letter in regard to the Part D Bid • Understanding the timeline and interdependencies for Part D bid submissions • HPMS and BPT processes for Part D 10:00–11:00 Focus on Pharma, Part 2—Optimizing the Part D Bid • Latest trends and strategies in pharmacy formulary development ʄʄ Designing the ideal tier structure for your plan ʄʄ Which drug for which tier? • Understanding NABA, and designing a pharmacy plan to maximize rebates • Assessing your Part D benefits, costs, and drivers: ʄʄ Evaluating your pharmacy cost structure ʄʄ What pharmacy network contracts do you have? What contracts do you want? ʄʄ Strategies for effective collaboration with PBMs ʄʄ Understanding pharmacy network requirements that can affect the bid • How to balance the often conflicting consumer desires for both lower costs and simplicity in plan design Matthew Hayes, Actuary MILLIMAN 11:00–11:15 Morning Networking Break Summer Key Dates and Deadlines 1st Monday in June, 2017—Deadline for Bid Submission June-August, 2017—CMS Desk Review Late July/Early August 2017—CMS releases Part D National Average Bid Amount (NABA) Late July/Early August 2017—Rebate Reallocation Period 11:15–12:15 The Bid is In! Now What? Desk Review, Audits, and NABA • The key elements, concepts and players involved in desk review and actuarial bid audit • Avoid road bumps in the bid process by understanding the critical bid items that desk reviewers and bid auditors pay close attention to, including reconciliations, non-benefit expense projections, risk score projections, and related party contracts • Part D“NABA”(National Average Bid Amount) —what does it mean for your bid once it’s announced? • Tips for managing the potential domino effect when changes to your bid are required Matt Kranovich, FSA, MAAA, Consulting Actuary MILLIMAN matches your financials • How can you reduce common errors and omissions in data submissions that may trigger challenges during desk review? Matt Chamblee, Principal and Consulting Actuary MILLIMAN 5:00–6:00 Cocktail Reception Immediately Following For more information about our sponsorhip opportunities, contact Jennifer Clemence at 704-341-2438 or at jclemence@healthcare-conferences.com 12:15–1:15 Networking Lunch Fall, and a Circle Back to Winter Key Dates and Deadlines October 1, 2017—Plan Benefit Data Release October 15 to December 7, 2017—Annual Election Period January 1, 2018—New Plan Benefit Year Begins Fall/Early Winter—Planning and Preparation for the Next Bid! 1:15–2:00 Performing a Competitive Analysis—Targeting your Time and Resources to Get the Most Bang for your Buck The release of plan benefit data in the fall offers an unparalleled opportunity to evaluate the competitive landscape. This session will cover: • Techniques for evaluating how your plan’s benefit offerings stack up against the competition • Optimizing the time and resources for competitive analysis by identifying and focusing on the benefit areas that are the biggest drivers of consumer choice • Using the results of the competitive analysis to modify your sales and marketing strategy for the Annual Election Period-- ʄʄ Should you target your marketing dollars to your strength areas, or do weaker areas offer hidden opportunities? ʄʄ How to evaluate and leverage your supplemental benefits to lure in the members you want Gary J. Ward, Senior Director, Product Development and Management AETNA 2:00–2:45 Understanding Network Adequacy Requirements for your Bid Submission Building and documenting your provider network is both a concrete step in the bid process and an integral part of year-round planning for long-term bid success. The provider network is a critical component of your healthcare offering, but also a top factor of the costs that must be considered for your bid. This session will examine: • Where to find, how to interpret, and how to work with CMS’s criteria for network adequacy • Tools, technologies, and strategies to measure network adequacy and reduce the risk of deficiency findings • Methods for defining a successful network for your plan— ʄʄ Who are the key providers, and how does the structure of provider contracts impact your bid and long-term planning? ʄʄ How to incorporate risk adjustment models into network building and planning ʄʄ How are these network factors actually translated to actuarial data and captured in your bid? 2:45–3:30 Conference Capstone: Year-Round Product Design and Development Strategies to Optimize Your Bid • Conducting a bid post-mortem to identify where revenue was left on the table, and tips and tricks to prevent it from happening in your next bid Day Two: Tuesday, January 24, 2017
  • 5. Venue Details DoubleTree by Hilton Hotel Dallas - Market Center 2015 Market Center Blvd Dallas, TX 75207 (214) 741-7481 We have a limited number of hotel rooms reserved for the conference. The negotiated room rate of $149 per night will expire on December 22, 2016, although 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, availability will be at the hotel’s discretion. 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 registra- tions at the same time. Group discounts cannot be issued retroactively. For more information, please contact Kathie Eberhard at 704-341-2439 or at keberhard@healthcare-conferences.com Refunds & Cancellations For information regarding refund, complaint and/or program cancellation policies, please visit our website: https://www.healthcare-conferences.com/ thefineprint.aspx CPE Credits Healthcare 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.nasbaregistry.org. The recommended CPE credit for this course is 13.5 credits it in the follow- ing field(s) of study: Specialized Knowledge and Applications. For more information, visit our website: https://www.healthcare-confer- ences.com/thefineprint.aspx The Conference Organizers Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceuti- cal communities to improve their businesses by providing access to timely and focused business information and networking op- portunities 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 opportu- nities. 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.health- care-conferences.com RISE (Resource Initiative & Society for Education) Vision: To build a community and an education- al system that promotes successful careers for professionals who aim to advance the quality, cost and availability of health care. 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 Bronze Sponsors • Strategies for evaluating the tradeoffs of adding and removing benefits • Understanding the impact to your next bid, and how to operationalize them • Exploring rewards and incentives programs to enhance your plan’s appeal: ʄʄ How to measure the impact, whether good or bad, of rewards and incentives to your plan’s bottom line ʄʄ How to define and document rewards and incentives in the actual bid process as a non-benefit expense Gary J Ward, Senior Director, Product Development and Management AETNA William Sota, Director of Product Management and Development GATEWAY HEALTH* *pending final confirmation 3:30 Conference Concludes
  • 6. JANUARY 23-24, 2017 DALLAS, TXDOUBLETREE BY HILTON DALLAS-MARKET CENTER FeaturingInteractive SessionsandHands- onLearning Opportuni- ties! 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 HEALTHCAREEDUCATIONASSOCIATES 200 WASHINGTON ST. SUITE 201 SANTA CRUZ, CA 95060 ATTENTION MAILROOM: If undeliverable, please forward to the 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: Please Mention This Priority Code When Registering Make checks payable to Wilmington FRA Inc., and write _________________ on your check. Name Company Address City Phone State Email Zip Title Payments must be received no later than Please bill my: MC VISA AMEX DISCOVER Card Holder’s Name: Signature: Check enclosed: Please bill me later: Exp. Date: Payment Method: Four Ways to Register 704-341-2641 800-280-8440 www.healthcare- conferences.com HEA 200 Washington Street, Ste. 201 Santa Cruz, CA 95060 Fax Call Web Mail THE MEDICARE ADVANTAGE BIDDING BOOT CAMP HEAD OF PRODUCT DEVELOPMENT OR CHIEF ACTUARY H421 H421 *SUBJECT TO HEA APPROVAL (BEFORE AND ON 12/16/16) (AFTER 12/16/16) EARLY BIRD STANDARD RATE SERVICE PROVIDERS & CONSULTANTS HEALTH PLAN & PROVIDERS* GOVERNMENT, COMMUNITY GROUPS, & ASSOCIATIONS* $2095$1895 $1595 $995 $1795 $1095 January 16, 2017. HEAR DIRECTLY FROM YOUR PEERS AT REGIONAL AND NATIONAL MA PLANS! THE MEDICARE ADVANTAGE BIDDING BOOTCAMP A Four Seasons Framework for Preparing the CMS Bid 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