A star-studded event – 2023 Stars and Bid Forum 

November 20, 2023

Prime/MRx clients, industry experts and thought leaders gathered at the Caribe Royale hotel for two days of dedicated presentations, panels discussions and networking.  

“The Stars and Bid Forum was the perfect setting to connect with clients and demonstrate the Medicare expertise and innovation the Government Programs division at Prime/MRx delivers customers and members,” said Michelle Juhanson, VP and Chief of Staff II, Medicare Part D. “This event allowed for in-depth conversations about Prime/MRx solutions and the most important issues in Medicare including 2025 bids, the Inflation Reduction Act and Star Ratings. Holding the event in-person in Orlando offered plenty of networking opportunities. We received rave reviews from our attendees about the content and venue. Clients are already talking about looking forward to next year’s summit.”

The agenda included the following presentations: 

Because I Said I Would: Alex Sheen, four-time TEDx Talk speaker and founder of because I said I would, an international social movement and nonprofit organization.  

2024 Star Ratings: Melissa Smith, Healthmine  

2025 Anticipated Market Changes: Matthew Hayes, Milliman 

Center of Excellence – Medicare Trade, Formulary and Newtwork Updates: Josh Wynveen, Paul Glynn, Chris Quam and Colleen Berg-Nelson. 

Government Program Products: Jay Maloney, Heidi Pomeday, Kevin Donley, Sagar Makanji 

Risk Adjustment: Drew McStanley, Casey Gardner from Wakely 

Client Expectations/Roadmap: Vikki Ahern and Michelle Juhanson 

Breakout Sessions:  

Strategy Playbooks: Prime/MRx actuaries presented the newly developed MAPD Strategy Playbook, which focuses on the Part D Keys to Success in the MAPD market. 

Coverage Determination & Appeals: Insights into process improvement opportunities that have been discovered with the integration of Prime/MRx.  

EGWP: Discussion on how EGWPs are an important Medicare offering that allows employers greater flexibility and lower costs to their retirees. 

Regulatory: Breakout session focused on the Prime/MRx interpretation and response to the 2024 Final Rule and the Inflation Reduction Act. 

Member Experience: The Member Experience breakout addressed current state and future state member experience considerations based on CMS data and upcoming changes. 

SDoH/ Health Equity: The Health equity and social determinants of health (SDoH) session shared what policy changes Prime/MRx expects to see in the Star Ratings program and how health plans intend to address them. 

Medicare Plan Finder: Covered the strategies and goals for the 2025 Medicare Plan Finder year.  

  • Overall Plan Finder goal for 2025 
  • In depth Plan Finder Reviews 
  • Data driven pricing strategies 
  • IRA implications on Plan Finder 
  • Expansion/continuation of 2024 procedures  

Competitive Intelligence: The Competitive Intelligence breakout session provided an update on the changes in the Medicare Marketplace for 2024 and a deep dive into the WellCare Value Script LCE PDP that has a premium of under $1 in most regions.  

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