Expectations are that over time reimbursement rates will decline at a steady rate of 2% for the next five years. During this panel discussion, hear from leading Medicare Advantage plans, consumer advocates, and policy experts to gain an understanding of the current political and regulatory landscape, gauge potential policy changes, gauge potential policy changes, and examine potential risk factors.

• Investigate the potential change to a voucher-based system and how it would affect plans’ business strategies
• Review changes to the Star Ratings Program for 2015 to understand where to focus personnel and resources in the next year
• Explore approaches to remain profitable in light of changing reimbursement rates and other risk factors
• Explore how to capitalize the benefits of a Medicare Advantage plan such as predictable costs for members and prescription benefits

Examine strategies that reduce cost, including the creation of new risk-sharing models with providers or members, innovative ways to reach rural populations in a cost-efficient manner, strategies using predictive modeling to generate insightful data, and ways to collaborate with providers to make an impact on reducing readmissions.

• Utilize methods to share the risk with members by readjusting co-pays and out of pocket maximums on an annual basis with a minimum financial impact to the business
• Explore innovative cost-cutting techniques, such as the use of mHealth and telemedicine technologies, being used to reach rural populations
• Discover ways that plans can have an impact on reducing hospital readmissions through utilization management and the sharing of predictive modeling data

Hear how one health plan worked with providers outside of an ACO to achieve higher quality measures, better clinical outcomes, and reduced costs.

• Align quality and development goals with physicians to build a positive collaborative relationship
• Implement proven successful physician incentive models using quality measures outside of a fee-for-service model
• Understand the importance of clinical engagement
• Incorporate case managers in provider facilities to improve the quality of care
• Recognize the necessity of robust data sharing with providers to improve clinical outcomes and member engagement

According to the CBO, in 2012 28% of Medicare costs went towards reimbursement for the treatment of Advanced Illnesses. It is estimated that around 80% of those costs are in the last few weeks of life for the member.

• Utilize data to identify members and potential cases that would fit best within the program
• Collaborate with case management staff and providers to improve conversations with members about their advanced illness
• Understand the business strategy behind an advanced illness program and its ROI

Industry leaders propose that Medicare Advantage health plans should consider the use of Bundled Payment programs to improve outcomes and quality and reduce cost.

• Gain an in-depth understanding of partnering with the CMS Innovation Center regarding Bundle Payment for Care Improvement
• Learn the structure and financial arrangement that CMS has with post-acute care facilities
• Explore the component provider categories of the 90-day episodes, such as hospital readmissions, physician services, and other ancillary providers
• Discover the key performance drivers and metrics in the bundled payment program such as reduced in-patient length of stay, hospital readmissions, and improved transitions of care

Understand the importance of product portfolios, CMS demonstrations, and pursuing decisions to prosper growth and revenue.

• Explore successful and unsuccessful product design within your health plan and select a comprehensive 2016 portfolio
• Learn how to gain internal buy-in for product portfolios
• Discuss the advantages of CMS demonstrations and investing in Special Needs Plans
• Discover how to make difficult determinations to eliminate programs that are declining in growth and profitability

In this session, discuss the goals of delivering better care for patients and align them to better succeed in this era of healthcare reform and accountable care, organizations are transforming care through population health management (PHM).

• Transform care through population health management to better succeed in accountable care
• Address several key concepts to deliver better care through goal alignment, care coordination, accountable care organizations, and patient-centered medical homes
• Integrate these key concepts with innovative technology to achieve better-than-expected outcomes

To help bring beneficiaries, providers and health plans together, Medicare Advantage (MA) plans must find ways to become creative so they can develop innovative and collaborative solutions that will transform healthcare. In this session, explore best practices embraced by an existing MA plan that have allowed them to make progress on this journey by aligning technology, quality, and a roadmap for the future.

• Learn about emerging market strategies
• Discuss ways to maximize operational efficiencies
• Hear about the importance of building relationships to enable transformation