All things Medicare
Milliman is hosting a webinar series on Medicare topics that cover emerging trends in the Medicare Advantage market. See below for recordings and slides from past webinars.
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Did you VBID your MA bid? We did: A discussion of insights and challenges
December 11, 2024
The 2025 bid season marked the first year of Phase III in the Medicare Advantage VBID program. This phase unveils new requirements and options for MA plans, along with a revamped application process and a competitive bidding rubric.
Join our expert panelists as they delve into these pivotal Phase III developments, offering valuable insights and addressing the challenges faced from the recent bid cycle. Gain from their shared lessons and explore CMS’s latest evaluation of VBID program outcomes. Discover the future trajectory of VBID and its transformative implications for the Medicare Advantage competitive landscape.
The Big Rural Apple: Medicare reimbursement changes under the inpatient prospective payment system
November 13, 2024
A hospital’s wage index is an important component of Medicare facility reimbursement. Hospitals have significant flexibility to reclassify into different geographic areas to maximize their revenue, and with recent rule changes this can have substantial impacts on entire states. Join us for a discussion of the wage index calculations, including a case study of how one hospital in New York City was able to reclassify as “rural” and increase 2025 reimbursement in upstate New York by about 10%, after 2025 bids were submitted. We also discuss several other states with meaningful changes, including California, Florida, Illinois, and Massachusetts.
Breaking bid: What just happened?
September 18, 2024
The 2025 Medicare Advantage bid cycle has been one of the most tumultuous yet, as stakeholders took a stab at addressing significant changes to the risk models, the Inflation Reduction Act, significant Star Rating changes, bid resubmissions, unexpected PDP demonstrations, and potential regulatory uncertainty from the Supreme Court. Join us for an insightful discussion as we delve into these critical topics and more. Don't miss this opportunity to stay ahead of the curve and gain valuable insights.
Midnight approaches: Reactions to Part D reforms
March 20, 2024
As midnight on June 3 approaches, many plans face considerable uncertainties relating to the Inflation Reduction Act’s benefit redesign, Medicare Prescription Payment Plan, and changes from the Advance Notice. In fact, uncertainty is driven not just by how the market and enrollees may react to the Inflation Reduction Act, but the possible actions by pharmaceutical manufacturers and pharmacies.
Medicare Advantage, Part D, and duals regulatory changes
February 21, 2024
A deep dive into the policies influencing Medicare Advantage, Part D, and the dual-eligible market. Milliman Medicare industry leaders cover key topics including the 2025 Advance Notice, Proposed Rule, Inflation Reduction Act and more.
MA supplemental benefits: A 2024 market overview
December 13, 2023
From decreases in star ratings, CMS-HCC re-classification, reduced MA growth percentages, and IRA impacts to Part D benefit design, Medicare Advantage Organizations faced significant headwinds when putting together their supplemental benefit packages for 2024. This webinar discusses key findings in 2024 mandatory supplemental benefit trends, as plans seek to remain competitive in an evolving Medicare Advantage landscape.
Know your worth: Contracting in Medicare value-based programs
November 8, 2023
As value-based contracting continues to gain popularity in Medicare, health plans and providers need to work together to develop reasonable terms, good working relationships, and opportunities for both parties to win. In this session, we discuss different ways to achieve these goals to ensure value creation with aligned incentives.
Walking on eggshells? Looking at the Past, Present and Future of Employer Group Waiver Plans
October 11, 2023
Employer Group Waiver Plans (EGWPs) have consistently provided millions of retirees stable medical and prescription drug coverage, but upcoming changes threaten that stability. Changes stemming from the Inflation Reduction Act will affect how employers offer coverage. After walking through a brief history in time, we provide a snapshot of the current market and navigate the future impacts of the IRA from an employer perspective.
Star Wars: CMS strikes back
September 6, 2023
In this webinar we take a dive into the latest changes by CMS to the Medicare Advantage star ratings programs. Some of these changes will have a heavy downward impact on many carriers' star ratings. We will cover the new star measures put into place by CMS, the cut points, the new Health Equity Index, and the pending proposed rules from December 2022.
Innovations in Medicare Research: The CMS Research Identifiable Files
August 9, 2023
The CMS Research Identifiable Files (RIF) provide an important data source that has already transformed the Medicare research landscape. Join our presenters Jonah Broulette, Simon Moody, and Rob Pipich as they discuss what information is available, how it can be accessed, and how it can be used to promote innovation in the Medicare marketplace.
Tool Time: Milliman tools to help solve your Medicare Advantage and Part D challenges
July 17, 2023
Now that Medicare Advantage and Part D bids have been submitted, we would like to invite you to our very first Medicare Webinar Series tool showcase. Please join our presenters for a high-level overview of some Milliman tools that our clients find helpful in managing their Medicare Advantage and Part D business.
CY 2024 Medicare bidding hot topics
April 19, 2023
June 5th is quickly approaching! Join our presenters Kevin Pierce, Alex Cires, and Philip Nelson as they highlight some of the hot topics for Medicare Part C and D bid development in advance of the 2024 bid deadline.
It’s worth the risk: Medicare Advantage risk adjustment hot topics
March 17, 2023
The ever-changing world of Medicare Advantage risk adjustment is changing yet again. Join our presenters as they discuss risk model changes for the 2024 bid year and beyond as well as considerations in risk score coding accuracy in light of the final RADV audit rule.
2024 Medicare Advantage and Part D regulatory and legislative changes
February 22, 2023
Join us for a discussion of regulatory and guidance updates impacting 2024 MAPD bids including draft BPT changes and proposed rule impacts.
Webinar: Funding fundamentals: Basics of Medicare Advantage revenue
January 18, 2023
Medicare Advantage can be one of the more complex types of insurance coverage when it comes to understanding the numerous revenue sources. Medicare actuaries Matt Kridgen, Ali Heinrich, and Jason Choi walk through the primary components of Medicare Advantage funding, including Part C benchmarks and payment rates, Part D subsidies and settlements, and the importance of risk scores and risk adjustment.
Webinar: Beyond the Fundamentals of Supplementals
December 14, 2022
Supplemental benefits continue to be a key area of growth and innovation in the Medicare Advantage space. This webinar discusses key findings in 2023 mandatory supplemental benefit trends, and the growth of non-uniform benefits such as VBID and SSBCI. Additionally, we take a closer look at MA dental coverage.
Medicare Revenue: The All-Star Game
November 9, 2022
Whether you are new to the Medicare Advantage field or are looking to increase your current Medicare revenue and marketing power, CMS STAR ratings play a critical role in the bid process and the long-term success of your plan. This webinar will improve your ability to efficiently and effectively optimize your STAR ratings by providing winning strategies, important considerations, and key steps to make you an all-star player in the Medicare revenue game.
Webinar: D-SNPs: Beyond the Bid
September 14, 2022
Join us as our consultant team provides an overview of the Dual Eligible Special Needs Plan (D-SNP) landscape, operational considerations, model of care requirements, and policy changes impacting the implementation and operation of a D-SNP. Whether new to D-SNP, evaluating expansion, or assessing current D-SNP operations, listeners will gain an understanding of the interrelated variables relevant to D-SNPs.
Webinar: Follow the money: Your guide to Medicare financial performance
August 10, 2022
Join our Milliman consultants as they explore Medicare Parts C & D from a financial perspective, highlighting recent financial performance, discussing key CMS files health plans use to monitor financials, considering cash flows including various settlements, and offering insights on risk-based capital considerations.
Webinar: Critical Considerations for New Entrants in the Medicare Advantage Market
July 13, 2022
Even though the initial Medicare bid process for 2023 has just ended, health plans that are either new to Medicare or new to a particular market should start to think about certain key obstacles for the 2024 plan year. In this webinar, we discuss a variety of strategic, operational, and administrative issues that plans will have to face in order to be successful.
Webinar: CY 2023 Medicare bidding hot topics
April 13, 2022
June 6th is quickly approaching! In this session, Milliman consultants highlight some of the hot topics for Medicare Part C and D bid development for CY2023.
Webinar: Medicare Advantage and Part D Trend Discussion
March 9, 2022
Join us in a discussion of several areas of trend impacting bids in 2023 including:
- Part D Trends
- COVID-19
- Part C reimbursement and contracting trends
Webinar: What's not so negative about Part D
February 9, 2022
What is the new frontier for Part D? Will the Direct Subsidy go negative this year? Will the updated OOPC model negatively impact plan offerings? Will Build Back Better and other legislation negatively impact your bid and members? Or are these opportunities to take (Medicare) advantage of? We look at those topics along with Formulary strategy, the National Average Benchmark Amount, the Low Income Benchmark, and more.
Webinar: Chronic Kidney Disease in Medicare
January 19, 2022
Join our Milliman presenters for an overview of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the Medicare system. This webinar focused on costs, payments, and policies impacting Medicare Advantage plans and bids.
Webinar: Emerging Trends in the 2022 Medicare Advantage Market
December 8, 2021
Join our Milliman presenters as they look ahead to 2022 and highlight key changes occurring in the Medicare Advantage (MA) marketplace. We will discuss the competitive landscape and design of plans targeting various Medicare-eligible populations, including a focus on supplemental benefits and emerging trends in the Part C and D markets. Our three presenters bring a broad array of expertise in these topics and are excited to share their thoughts with you.
Webinar: How do you look? Positioning your plan in Medicare Plan Finder
November 10, 2021
As Medicare Advantage and Prescription Drug Plans develop their strategy for 2023, representing your plan to attract new beneficiaries is a critical component of that strategy. The CMS Medicare Plan Finder tool is a key means by which Medicare eligible beneficiaries choose a plan and sales agents use to help beneficiaries compare benefit options. We walk through the Medicare Plan Finder, including a tour behind the scenes, and focus on discussing strategies so how you want your plan to look is how your plan actually looks!
Webinar: Succeeding in the Part D PBM RFP and contracting process
October 6, 2021
The results of the Part D PBM RFP and contracting process is a major component of success for Medicare Advantage/Part D plans. Regulatory compliance and financial analysis are uniquely different when evaluating RFP submissions for Medicare plans in particular. Leveraging both operational PBM experts and Medicare actuaries can lead to a more detailed and strategic RFP. In this webinar, we dive into key elements for success in the Part D PBM process, including valuing the impact to net plan liability, understanding the pros and cons of network and formulary strategies, and understanding how to evaluate the ability for each PBM to offer the operational expertise needed to compliantly and effectively manage Part D benefits.
Webinar: Medicare Advantage MCOs, meet ACOs. You should talk.
September 8, 2021
In recent years, providers are taking on increasing levels of risk and responsibility for their Medicare fee-for-service (FFS) patients. Accountable Care Organizations (ACOs) have become a popular option for provider groups and health plans transitioning towards more risk-based contracts. In this session, we provide background on the history of the CMS-sponsored risk sharing programs, examine the current and future landscape, analyze drivers of performance in these programs, and discuss how MA plans are well-positioned to generate additional revenue through these models.
Webinar: Incentives Aligned: Value-based contracting and strategies for Medicare patients
August 11, 2021
As the Medicare population grows and providers develop an appetite for risk, health plans and providers need to work together to develop reasonable terms, good working relationships, and opportunities for both parties to win. In this session, we address key considerations for Medicare Advantage value based contracting, including challenges and risks to providers and health plans. We also discuss alternatives to Medicare Advantage that providers are increasingly embracing, such as Medicare Shared Savings Programs, Bundled Payments for Care Improvement, Direct Contracting, and other CMS programs. Finally, we address how providers can create aligned strategies to care for their Medicare Advantage and traditional Medicare populations and how health plans can support (and benefit from!) these efforts.
Webinar: Get ready to expand into new areas – best practices for Medicare Advantage Organizations
June 23, 2021
There are a variety of ways Medicare Advantage Organizations can grow and develop their business. Whether it’s expanding to new regions, introducing new products, or enrolling and managing new populations, there are many important actuarial and operational considerations and strategies to consider. This session identifies key stakeholders and the decisions involved in evaluating these opportunities, and discusses the importance of understanding how stakeholder decisions are interconnected / dependent on each other for success.
Webinar: MAPD Hot Topics for CY2022
April 14, 2021
Ready to submit bids? Probably not yet, but we are here to help! In this session, Milliman experts will highlight hot topics for Medicare Advantage Prescription Drug (MAPD) bid development in advance of the 2022 bid deadline.
Webinar: MA payment basics – Following the money
March 10, 2021
Ever wondered how CMS sets the Medicare Advantage (MA) benchmarks and how payments flow from CMS to health plans and from health plans to providers? In this session Milliman experts will follow the funds flow from the county benchmark to plan revenue, and to MA plans’ provider network.
Webinar: Risky Business: How risk adjustment and risk scores impact Medicare Advantage plans
February 10, 2021
Since revenue paid by the Centers for Medicare and Medicaid Services (CMS) to Medicare Advantage (MA) plans is heavily dependent on risk scores, MA plans need to ensure their risk scores reflect the actual health status of their population. This session will provide background regarding what is included in each member’s risk score, how risk scores are calculated, and how risk scores are developed as part of the bid submission.
Living on the Regs - How this time of transition will shape 2022 Medicare Bids
January 13, 2021
Milliman’s Jason Karcher, David Koenig, and Tracy Margiott discuss the latest changes to the Medicare regulatory landscape.
Emerging Trends in the 2021 Medicare Advantage Market
December 16, 2020
What are the changes occurring in the 2021 Medicare Advantage marketplace? Listen to Milliman’s Robert Eaton, Julia Friedman, and Nicholas Johnson as they discuss nationwide trends specific to general enrollment and dual-eligible special needs plans.
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