Medicare Advantage Benefit Innovations and the Challenge of Estimating ROI

The session will consist of an overview of benefit innovations in the Medicare Advantage program, including newly-permissible supplemental benefits, VBIDs and 'proximate flexibilities, such as rewards programs and provider network flexibilities that have the potential to impact member utilization and outcomes. The lead speaker is a former CMS leader and health plan product development VP who has spoken/written extensively on this topic. He will recruit two unconventional benefit vendors to speak regarding their benefit's potential to positively impact utilization and therefore partially offset the costs of their service. At the conclusion of this session, attendees will be able to: • Consider the full range of benefit/service flexibilities now available in the Medicare Advantage program • Understand how leading Medicare Advantage organizations are analyzing the likely positive impact of new benefits and services on their members and member utilization • Learn how actuaries can apply the likely utilization savings of new benefits and services to their bids and lead the analysis of benefits to determine actual savings

Elizabeth Klodas

Dr. Klodas has dedicated her career to preventive cardiology. Trained at Mayo Clinic and Johns Hopkins, she serves as the Chief Medical Officer for Step One Foods. Dr. Klodas is a nationally sought out speaker and has an active role at the American College of Cardiology. Her clinical interests include prevention of heart disease and non-invasive cardiac imaging and she has published dozens of scientific articles throughout her career. She has also authored a book for patients, 'Slay the Giant: The Power of Prevention in Defeating Heart Disease,' and served as founding Editor-in-Chief of the patient education effort of the American College of Cardiology. In addition to her practice and her duties at Step One Foods, she also serves as medical editor for webMD.

Damian Rippole

Damian has 20 years of financial leadership experience in both public and private sleep/health companies. Prior to joining Ebb in 2012, he was the Corporate Controller for Respironics, a global leader in the sleep and respiratory markets, that was acquired by Philips in 2008 for $5.2 billion. After the acquisition, he was Controller for the Philips’ Home Healthcare business and led its global finance integration. Damian also spent seven years in public accounting at Ernst & Young and was a Senior Manager in E&Y’s Assurance and Advisory Business Services practice.At Ebb, Damian partners with the leadership team in all aspects of the business, focused principally on the direct to consumer business model, including strategy development and execution.

Michael Adelberg

Mike Adelberg leads the Healthcare Strategy Practice at Faegre Drinker Consulting. He has 25 years progressive healthcare industry and government experience in Medicare, Medicaid and commercial health insurance. Mike spent fifteen years at the Centers for Medicare and Medicaid Services (CMS), including concurrently serving as the director of the Insurance Programs Group and the acting director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance Oversight (CCIIO); serving as the Director of Medicare Advantage Operations, where he supervised the annual cycle for review and approval of Medicare Advantage contracts and plans, developed CMS’s operational policy, and led the monitoring of Medicare Advantage contractors; and serving as the associate regional administrator for Medicare operations (Chicago Region). Mike gained private sector experience as vice president of product development and government affairs for the Universal American Corporation, a multi-state health insurer which operated Medicare Advantage and Part D plans (subsequently acquired by Wellcare). He has also led or co-led health policy studies published in Health Affairs and The American Journal of Managed Care. Mike speaks and publishes frequently on Medicare Advantage topics including provider networks, benefits, marketing, and plan oversight. He’s been quoted in the Washington Post, New York Times, Modern Healthcare, NPR, and other leading media. In his spare time, Mike is an author. He’s written three novels, a history book, several scholarly journal articles, and over sixty book reviews.

Bill Alldredge

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Webcast Session
08/13/2020 at 11:00 AM (EDT)  |  Recorded On: 08/24/2020
08/13/2020 at 11:00 AM (EDT)  |  Recorded On: 08/24/2020
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