Agenda
Explore the full schedule of sessions, workshops, and networking opportunities planned for November in Baltimore
Register to Attend ⭐
Tuesday - November 03, 2026
12:00 PM
12:00 PM – 5:30 PM
Information Desk Open
1:00 PM
1:00 PM – 5:00 PM
Workshop: AI Bootcamp for Quality Teams
AI is already reshaping how Medicare Advantage quality teams work, reading charts, prioritizing gap closure, and drafting member outreach, but for most HEDIS® teams the real questions are practical: what's worth piloting, how do you know it works, and how do you govern it before NCQA and CMS come asking?
This hands-on, no-hype bootcamp is built specifically for MA quality and HEDIS® professionals:
- You'll work from real plan use cases
- Build a governance framework aligned to NCQA's proposed 2027 AI accreditation standards
- Leave with tools you can put in front of your leadership the following week
Speaker
Vandna Bhrany
Principal at 8BAdvisors
Speaker
Kari Clements
Staff Vice President, HEDIS Improvement at Elevance Health
5:00 PM
5:00 PM – 6:00 PM
Networking Cocktail Reception and Exhibit Hall Opening
Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.
Wednesday - November 04, 2026
8:00 AM
8:00 AM – 6:00 PM
Exhibit Hall Open
8:00 AM
8:00 AM – 4:00 PM
Information Desk Open
8:00 AM
8:00 AM – 9:00 AM
Networking Breakfast
9:00 AM
9:00 AM – 9:10 AM
Welcome Remarks
9:10 AM
9:10 AM – 10:00 AM
Keynote Address
Fireside Chat with NCQA: HEDIS® at the Halfway Point of the Digital Transition
Hear the latest directly from the source. Unpack what NCQA is doing to advance digital HEDIS® measures and how organizations can prepare for the transition.
Moderator, Speaker
Rebecca Jacobson
CEO & President at Astrata Inc.
Speaker
Tricia Elliott
Vice President, Quality Implementation at NCQA
Speaker
Wendy Talbot
Vice President, Measure & Data Operations at National Committee for Quality Assurance (NCQA)
10:00 AM
10:00 AM – 10:45 AM
Fireside Chat: 2026–27 HEDIS® and Stars Policy Shifts and Their Bottom-Line Impact
- Unpack how the Clover Health ruling exposed which Star Ratings measures CMS can and can't use - and what that means for health plans
- Connect courtroom outcomes to the CY2027 final rule's measure removals and reward-factor changes, and to NCQA's MY 2027 specification updates, to see where policy and litigation are pulling Stars strategy in different directions
- Get a practitioner's read on what to prepare for heading into the 2027–29 ratings years, regardless of how the pending appeals shake out
Moderator, Speaker
Melissa Newton Smith
Founder, Senior Advisor at Newton Smith Group
Speaker
Mark Newsom
President and Founder at Health Evaluations, LLC
10:45 AM
10:45 AM – 11:00 AM
Tools and Technology Spotlight: Ingenia
Speaker
Rodolfo Velasco
Chief Revenue Officer at Ingenia
11:00 AM
11:00 AM – 11:25 AM
Networking Break
11:25 AM
11:25 AM – 12:10 PM
One Visit, More Value: Bringing Risk and Quality Together
- Discover how to combine risk adjustment and quality in a single visit, from documenting conditions and addressing HEDIS® care gaps to closing the loop with follow-up care
- Explore how to integrate labs and screenings into the visit workflow, from identifying member needs to coordinating completion and results
- See how visits at trusted locations can bring assessments and screenings into a familiar setting for members
- Learn how post-visit care coordination connects members with needed services and support -and provides plans with evidence of treatment
Speaker
John Criswell
Founder, CEO, Chairman at Porter
Speaker
Charline Marcelle
Manager, Quality and Accreditation at CareFirst BlueCross BlueShield
12:10 PM
12:10 PM – 1:10 PM
Networking Lunch
1:10 PM
1:10 PM – 2:00 PM
Track A
Panel - The Member Experience Still Counts: CAHPS and Experience Strategy in an Outcomes-First Stars Era
- Understand exactly where member experience still moves your Star Ratings (and your revenue) now that administrative measures are gone and weighting has been recalibrated under the CY2027 final rule
- Identify which CAHPS survey items respond best to plan intervention, and where your experience investment delivers measurable ratings return
- Discover how HEDIS® data can predict and improve CAHPS results, from using gap-closure outreach as an experience touchpoint to spotting access problems before they show up in survey scores
Speaker
Leon Lead
Founder & Principal Consultant at Leon Lead Consulting, LLC
Speaker
Brendan Generelli
Director of Medicare Stars & Quality at Johns Hopkins Health Plans
Speaker
Tina Dueringer, BSN, RN, CCM, PCC
CEO, Principal Advisor at Dueringer Advisors
1:10 PM – 2:00 PM
Track B
Beyond the Measure: Connecting Behavioral Health Quality Improvement to Clinical & Financial Outcomes
- Look beyond the numerator compliance to evaluate whether behavioral health quality interventions are actually changing member health, utilization and cost, not simply closing a documented care gap.
- Explore a Virginia Medicaid case study that achieved an 11% reduction in TCOC by aligning depression screening and follow-up interventions with a targeted member engagement strategy, validated behavioral health screening, and measurable clinical outcomes.
- Make every quality dollar work harder with a framework for connecting gap closure to downstream clinical and financial outcomes and prioritizing interventions that deliver measurable value beyond the numerator.
Speaker
Shawn Roberts
Senior Director of Behavioral Health at Sentara Health Plans
Speaker
Suze Cucci
Executive Programs Officer at Pyx Health
2:00 PM
2:00 PM – 2:50 PM
Track A
Session Presented by Ingenia
2:00 PM – 2:50 PM
Track B
Case Study - Where Equity Meets the Data: Breaking Through Your Toughest Performance Barriers
- Examine how health equity factors show up in your HEDIS® data, with case study insights into gap closure for specific populations
- Take an expert-led deep dive into two measures where disparities weigh heaviest: Depression Screening and Follow-Up (DSF-E), which begins counting toward Star Ratings in the 2027 measurement year, and Glycemic Status Assessment (GSD/hemoglobin A1c)
- Learn how to balance performance across subpopulations with targeted interventions that close equity gaps and raise your overall depression screening and glycemic control rates at the same time
Speaker
Ljubica (Bea) Popovac-Roberts
Principal at Blue Shield of CA
2:50 PM
2:50 PM – 3:20 PM
Networking Break
3:20 PM
3:20 PM – 4:10 PM
Track A
From Barriers to Better Outcomes: Transforming Heart Failure Care in Rural Communities
- Learn how Medication Care Management can help reduce Total Cost of Care by addressing medication-related risks before they lead to costly acute care.
- Discover strategies for effectively engaging rural and hard-to-reach populations while overcoming barriers to medication adherence and ongoing care.
- Explore how predictive analytics and proactive clinical intervention can work together to identify at-risk members and improve outcomes.
- See the measurable impact of a collaborative approach to heart failure care, including reductions in hospital admissions and ER visits, significant PMPM savings and a strong return on investment.
Speaker
Michell Butler
Sr. Director of PlanPlus Operations at PlanPlus by Curant Health
Speaker
Jeremy Combs
US Market Lead - Health Plans at PlanPlus by Curant Health
Speaker
Paula Jacobson
Director of Quality & Population Health at Security and Sanford Health Plan
3:20 PM – 4:10 PM
Track B
Session to be announced
4:10 PM
4:10 PM – 4:15 PM
Transition Break
4:15 PM
4:15 PM – 5:00 PM
Roundtable Discussions
Participate in a facilitated roundtable discussion and deep dive with peers on timely topics:
- Small Plan Idea Exchange – Working with Constrained Resources - Dwight Pattinson, Founder and Principal Advisor, QPAdvantage
- Double Duty or Divide & Conquer? The HEDIS® + Risk Adjustment Chart Review Debate - Ryan Dodson, New Vision Health
- MRR – How to have a record year! Tina Dueringer, BSN, RN, CCM, PCC, CEO, Principal Advisor, Dueringer Advisors
- FHIR and Bulk Data: Where Is Everyone, Really?
- The HEDIS® Workforce of 2030: Reskilling Abstractors and Building the New Quality Team Ljubica (Bea) Popovac-Roberts, Principal, Blue Shield of CA
- Members Who Don't Pick Up: Outreach Fatigue and Engaging the Hard-to-Reach - Patrice Moore, Southland CCP
- One Team, Many Report Cards: Managing HEDIS® Across Multiple Lines of Business - - Leon Lead, Leon Lead Consulting, LLC
- Let's Talk about AI - Marcos Vasquez, Ultimate Health Plans, Inc.
Speaker
Marcos Vazquez
Director of HEDIS & Stars Operations at Ultimate Health Plans, Inc.
Speaker
Patrice Moore
Vice President at Southland Care Coordination Partners, Inc.
Speaker
Ryan Dodson
CRC, Risk Adjustment Consultant at Choice Medical Group
Speaker
Leon Lead
Founder & Principal Consultant at Leon Lead Consulting, LLC
Speaker
Ljubica (Bea) Popovac-Roberts
Principal at Blue Shield of CA
Speaker
Tina Dueringer, BSN, RN, CCM, PCC
CEO, Principal Advisor at Dueringer Advisors
Speaker
Dwight Pattison
Founder & Principal Consultant at QPAdvantage
5:00 PM
5:00 PM – 6:00 PM
Networking Cocktail Reception
Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.
Thursday - November 05, 2026
8:00 AM
8:00 AM – 11:00 AM
Information Desk Open
8:00 AM
8:00 AM – 9:00 AM
Networking Breakfast
9:00 AM
9:00 AM – 9:10 AM
Welcome Remarks
9:10 AM
9:10 AM – 10:00 AM
Quickfire Session - AI on the Ground: Real Quality-Team Use Cases and Honest ROI
Plans share what actually worked (and didn’t): NLP and agentic AI for chart review and abstraction, supplemental-data validation, member outreach targeting.
Moderator, Speaker
Reid Kiser
MS, Founder & Managing Partner at Kiser Healthcare Solutions, LLC
Speaker
Marcos Vazquez
Director of HEDIS & Stars Operations at Ultimate Health Plans, Inc.
Speaker
Jimmy WuRohe
Chief Product Officer at Clarest Health
Speaker
Mariah Osborn
Director of Medicare STARs at UPMC Health Plan
10:00 AM
10:00 AM – 10:50 AM
Case Study: One Chart, Two Teams – A Health Plan’s Shared Repository for Quality and Risk Adjustment
HEDIS and risk adjustment chase many of the same charts on separate timelines, through separate vendors, often asking the same provider for the same record twice. One health plan spent years building the alternative: a single centralized repository both teams retrieve from and work in. Hear what it took to build, fund and adopt — including the parts still in progress.
- Learn how the project cleared internal hurdles: establishing shared ownership and funding, securing cross-functional alignment, and leveraging a strategic partnership between Quality, Risk Adjustment, and IT/Analytics.
- Explore how the IT/Analytics team's expertise in quality, risk adjustment, and technology enabled the successful launch of a shared enterprise platform.
Speaker
Tamara Hess
Manager, Risk Adjustment and Stars IT at Blue Cross of Idaho
Speaker
Katie Gries
Manager, Quality Management at Blue Cross of Idaho
10:50 AM
10:50 AM – 11:20 AM
Networking Break
11:20 AM
11:20 AM – 12:50 PM
Work Groups: HEDIS, Measure-by-Measure
Work Groups: HEDIS, Measure-by-Measure
This interactive session is designed to facilitate constructive dialogue regarding specific HEDIS measures. Participants will engage in deep, collaborative discussions to identify barriers, share strategies, lessons learned, and best practices, and explore innovative solutions to improve performance on these measures.
Round 1 Measures:
- Controlling High Blood Pressure (CBP) - - Mariah Osborn, Director of Medicare STARs, UPMC Health Plan
- Depression Screening and Follow-Up (DSF-E) - Keith Bell, Principal, Payer Solutions, Kiser Healthcare Solutions LLC
- Colorectal Cancer Screening + Follow-Up After Positive Non-Invasive Test (COL-E/COF-E)
- Kidney Health Evaluation for Patients With Diabetes (KED)
- Transitions of Care (TRC) - Timika Bryant, CHPW
- Medication Adherence (Part D: Diabetes, Hypertension, Cholesterol)
- Osteoporosis Management in Women (OMW) - Tracey Papas, Quality Strategy & Innovation Staff Vice President, Elevance Health
- Follow-Up After ED Visit for People With Multiple High-Risk Chronic Conditions (FMC) - Ryan Dodson, New Vision Health
Round 2 Measures:
- Glycemic Status Assessment for Patients With Diabetes (GSD) - Tracey Papas, Quality Strategy & Innovation Staff Vice President, Elevance Health
- Eye Exam for Patients With Diabetes (EED) - Leon Lead, Leon Lead Consulting, LLC
- Care for Older Adults (COA)
- Plan All-Cause Readmissions (PCR) - Dwight Pattinson, Founder and Principal Advisor, QPAdvantage
- Blood Pressure Control for Patients With Diabetes (BPD) - Ljubica (Bea) Popovac-Roberts, Principal, Blue Shield of CA
- Adult Immunization Status (AIS-E)
- Controlling High Blood Pressure (CBP) (encore) - Mariah Osborn, Director of Medicare STARs, UPMC Health Plan
- Depression Screening and Follow-Up (DSF-E) (encore) - Keith Bell, Principal, Payer Solutions, Kiser Healthcare Solutions LLC
Speaker
Timika Bryant
Manager, HEDIS Performance Measurement at CHPW
Speaker
Ryan Dodson
CRC, Risk Adjustment Consultant at Choice Medical Group
Speaker
Keith Bell
Principal, Payer Solutions at Kiser Healthcare Solutions LLC
Speaker
Tracey Papas
Staff VP, Quality Strategy and Innovation at Elevance Health
Speaker
Mariah Osborn
Director of Medicare STARs at UPMC Health Plan
Speaker
Ljubica (Bea) Popovac-Roberts
Principal at Blue Shield of CA
Speaker
Dwight Pattison
Founder & Principal Consultant at QPAdvantage
Speaker
Leon Lead
Founder & Principal Consultant at Leon Lead Consulting, LLC
12:50 PM
12:50 PM – 1:00 PM
Closing Remarks
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