The 2nd Annual HEDIS® & Quality Improvement Forum


October 13-14, 2020
AC Hotel | Nashville, TN
#QualityScoresIEN

This event was rescheduled from the original dates of July 20-21

Proven Strategies to Boost Your HEDIS®** Score and Improve Patient Outcomes

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13

October 2020

Tuesday

Day One

  • 7:45 AM
    Registration & Networking Breakfast
  • 8:30 AM

    Welcome and Chairperson’s Opening Remarks

  • 8:45 AM

    Examining the Latest HEDIS® Measures, Changes, Technical Specifications, and Release Timeline

    • • New measure and technical specifications release timeline
    • • Taking a close look at the latest NCQA initiatives
    • • Practical strategies for integrating new measures into your quality program
    • • Assessing the effectiveness of the reduction of measures and other measure evolutions
    • • Anticipated changes for 2022

    Melissa Smith, Senior Vice President, Stars & Strategy
    GORMAN HEALTH GROUP

  • 9:30 AM

    Case Study: Setting Up an Organization-wide Environment for Success with Behavioral Health HEDIS Reporting

    • • Background
    • • Collaboration: Forming the right team for success
    • • Follow-up after hospitalization for mental illness
    • • Branching out: Using our collaborative team to identify needs in other areas of behavioral health
    • • The future of behavioral health

    Rodney Truong, Manager Quality Performance Management/HEDIS
    L.A. CARE HEALTH PLAN

    Rose Kosyan, MFT, Manager, Behavioral Health Clinical Services
    L.A. CARE HEALTH PLAN

  • 10:30 AM
    Morning Networking Breakfast
  • 10:45 AM

    Aligning HEDIS® and Star Ratings Efforts: A Value-added Integration

    • • Looking at HEDIS® from a Stars lens
    • • Aligning HEDIS® and Stars neatly for better results
    • • Funding considerations
    • • Looking at Stars programs to meet rating and interventions
    • • Strengthening provider follow-up

    Moderator:
    TBA

    Panelists:
    Jamie McPherson, MBA, MPA, BSN, SSBB, Vice President, Quality and Safety Officer
    VIRGINIA PREMIER HEALTH PLAN

    Daniel Weaver, Vice President Stars, Quality, & Risk Adjustment
    GATEWAY HEALTH PLAN

    Shelly Siedelberg, MPA, CPHQ, HEDIS/Quality Improvement Program Manager
    DENVER HEALTH MEDICAL PLAN

  • 11:45 AM

    New Quality Dollars: Quality, Risk Adjustment, and APMs

    • • Merging quality and risk adjustment initiatives
    • • Recognizing the financial component for quality
    • • Emphasizing the crucial aspect of medical record completion on HEDIS®
    • • Aligning resources and tools
    • • Reducing silos
    • • Overcoming communication barriers
    • • Organizational re-structuring

    Jamie McPherson, MBA, MPA, BSN, SSBB, Vice President, Quality and Safety Officer
    VIRGINIA PREMIER HEALTH PLAN

  • 12:30 PM
    Networking Luncheon
  • 1:45 PM

    Successful Targeted Interventions for Population Health Programs

    • • Retrieving data from reliable sources
    • • Population health segmentation including accurate claims, health, publicly available censor data, income, age, and more
    • • Effectively using data analytics to segment your population
    • • Driving member participation with rewards and incentives that work
    • • Proactive steps of intervention
    • • Accurately measuring quality improvement
    • • Quantifying the ROI of population health

    Dr. Yvonne Heredia,
    NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND

  • 2:30 PM

    The Right Way to Request HEDIS® Data from Providers for the Best Results

    • • Best practices for requesting data from providers
    • • Minimizing burdensome circumstances
    • • What works, what doesn’t, and how to get your providers to cooperate
    • • Developing a partnership that includes financial incentives and strong communication
    • • How do your providers rate among their competition?
    • • Decreasing cost and administrative burden for providers

    Kathryn DeBardi, Medical Records Reviewer Quality Documentation***
    PREMERA BLUE CROSS

  • 3:30 PM
    Afternoon Networking Break
  • 3:45 PM

    Developing Targeted Interventions to Improve CAHPs and HOS Scores

    • • Actionable items to improve the member experience and increase CAHPs and HOS rates
    • • Structuring the survey to acquire key Star Rating measures
    • • Honing in on the ideal target group
    • • Capturing, measuring, and reporting performance results

    Daniel Weaver, Vice President Stars, Quality, & Risk Adjustment
    GATEWAY HEALTH PLAN

  • 4:30 PM

    ECDS, Transparency, and the Future of HEDIS®: Driving Improvement

    • • What are the latest developments for ECDS from NCQA?
    • • What does the future of reporting and ECDS look like?
    • • Simplifying data capture
    • • Successfully aligning your reporting and quality initiatives
    • • What should plans be doing now for ECDS?

    Shelly Siedelberg, MPA, CPHQ, HEDIS/Quality Improvement Program Manager
    DENVER HEALTH MEDICAL PLAN

  • 5:00 PM
    Networking Reception
  • *** Pending Confirmation

14

October 2020

Wednesday

Day Two

  • 8:00 AM
    Networking Breakfast
  • 8:45 AM

    Chairperson’s Recap of Day One

  • A Two-Part Focus on Closing Gaps in Care

  • 9:00 AM

    Part I: Strategies for Closing Care Gaps between Payer, Provider, and Members

    • • Identifying gaps in care
    • • Are your data points strong enough to identify where the gaps are?
    • • Sharing data and closing the gaps in care
    • • Which gaps can you close and what’s the low-hanging fruit?
    • • Tracking services not rendered to members
    • • Enhancing clinical documentation

    Janine A. Sala, Director, Quality Improvement, Population Health
    UNITEDHEALTHCARE, HPN QUALITY IMPROVEMENT

    DeAnna James Anderson, MBA, Director, Population Health Member Wellness and HEDIS Operations***
    VIRGINIA PREMIER HEALTH PLAN

  • 10:00 AM

    Part II: Gaps of Care Part II: Identifying What You Do Best and What You Need Help With

    • • You can’t be an expert at everything to everyone
    • • Targeting what the work is that needs to be done
      • • Identifying your goals and what is necessary to achieve them
    • • Identifying your strengths and gaps
    • • The “Build vs buy” stalemate
    • • Deciding for what work you need a partner
      • • Selecting partners
      • • Becoming an attractive partner

    Michele Fisher, Chief Contracting and Payer Relations Officer
    UW MEDICINE HEALTH SYSTEM

  • 10:45 AM
    Morning Networking Break
  • 11:00 AM

    Telehealth & HEDIS®: How Has the NCQA’s Telehealth Insertion Helped or Hindered Member Progress?

    • • Is there any evidence that telehealth is helping member progress?
    • • Which areas are most useful?
    • • How are members responding?
    • • What can plans learn from member experience and engagement?
    • • What other trends in telehealth are surfacing? What can we expect from the future?
    • • What are NCQA’s next initiatives with telehealth?
    • • How can you track telehealth satisfaction?
  • 11:45 AM

    Thought-Leadership Topic TBA

  • 12:15 PM
    Networking Luncheon
  • 1:30 PM

    Strategies to Reduce the Quality Measurement Burden to Alleviate Clinician Burnout and Improve Patient Safety

    • • Quality measurement burden as an important driver of clinician burnout and patient safety
    • • Strategies to reduce the quality measurement burden
    • • Exploring the role of government and different quality stakeholders in reducing the burden
    • • Evidence on the quality of quality measures and quality measurement

    Jatin Dave, MD, MPH, Chief Medical Officer***
    NEW ENGLAND QUALITY CARE ALLIANCE

  • 2:15 PM

    Building Effective HEDIS® Teams: HEDIS®: Training Concepts and IRR Reporting for a Roadmap

    • • Writing a working version of a HEDIS Abstraction manual and how to validate examples
    • • Building strong abstraction and overread teams for the best possible outcome
    • • Owning the quality outcome of the HEDIS project
    • • How using a HEDIS full-service vendor can alleviate the health plan’s burden and increases HEDIS ratings

    Kim A. Williams, CPHQ, Senior Clinical Quality Consultant, Director of Quality HEDIS SME
    GUARDIAN ANGEL CONSULTING

  • 3:00 PM
    End of the 2nd Annual HEDIS® & Quality Improvement Forum
  • *** Pending Confirmation

*National Committee for Quality Assurance
**Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of the National Committee for Quality Assurance (NCQA).

NCQA is not affiliated with this Summit and does not endorse the content presented at this event.

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