The top sessions, insights, and moments from AHIP 2023

AHIP 2023 recently welcomed thousands of healthcare leaders, analysts, researchers, and innovators to Portland, Oregon for three days of connection and learning. This blog covers all the key moments from this year’s event.

AHIP 2023 opening remarks

Addressing a room without a single empty seat, AHIP President & CEO, Matt Eyles, emphasized the need for better affordability, access, and value for all patients. Recognizing the impact of market shifts such as hospital consolidation and rising drug prices, Eyles offered three areas of focus for plans to consider in addressing the top challenges of the moment:

1. 1. Keeping a focus on Medicaid enrollment
   2. Improving health equity
   3. Restoring trust in the healthcare system

He then urged the crowd to take full advantage of all the sessions and presentations throughout AHIP 2023, stating, “There are countless opportunities and bold ideas for how we can improve health and healthcare. These ideas are scalable and sustainable, and have the power to make a tangible difference for patients and consumers.”

Inovalon session: Preparing for the CMS Health Equity Index

In collaboration with Elevance Health, Inovalon shared how health plans can prepare for the Centers for Medicare & Medicaid Services (CMS) Health Equity Index. Recently developed as an enhancement to the Medicare Advantage (MA) Stars program, the Health Equity Index will incentivize contracts to perform well for socially at-risk beneficiaries.

Christie Teigland, PhD, VP of Research Science and Advanced Analytics at Inovalon, first explored the nuts and bolts of how the Health Equity Index will be calculated and techniques MA plans can employ to understand their performance on the composite measures. This includes benchmarking internally to understand differences in outcomes of members with social risk factors versus members without social risk factors and benchmarking to other MA plans to identify the largest disparities to focus resources on areas of greatest need.

Kimberly Switlick-Prose, VP of Enterprise Star Performance at Elevance Health, then dug a little deeper into how health inequities are multi-faceted and how social risk factors interact, such as race/ethnicity and dual eligible status and the importance of evaluating both between-group and within-group disparities. She then presented a conceptual model to enable health plans to focus on health equity across the care continuum and across each of the Star measure domains, providing specific examples of concrete actions Elevance is taking to address systemic disparities, such as targeted used of the Value-Based Insurance Design Model (VBID), the State Small Business Credit Initiative (SSBCI), and other supplemental benefits to deploy high-impact interventions.

Dr. Jocelyn Hines, Medical Director at Inovalon, closed the session with a summary of successful community engagement initiatives that underscore the essential need for collaboration and partnerships to truly advance health equity and achieve the highest level of care possible for every person.

Harvard and Inovalon publish new findings

At our booth, conversations were buzzing about our latest research with Harvard Medical School. Inovalon and Harvard researchers are collaborating on a first-of-its kind research study to understand how beneficiaries who enroll in Medicare Advantage differ in their baseline demographic, socioeconomic, and health characteristics to those who enroll in Medicare Fee-for-Service (FFS) at age 65. Using information from their commercial insurance plan coverage allows a rigorous comparison not contaminated by the type of Medicare the beneficiary enrolls in at age 65.

The study leveraged Inovalon’s unique primary source dataset, the MORE² Registry®, which covers a significant share of members across a wide range of insurance markets, including MA, FFS, and commercial insurance. The data is complete and longitudinal in nature—it includes 100% of a patient’s adjudicated claims—and uniquely tracks individuals as they transition across different insurance types and from commercial to Medicare coverage.

The results of the study provide a better understanding of the core customer segments of MA, and which beneficiaries are more likely to enroll in MA vs. FFS. For health plans, these insights can help them better target their offerings to meet the needs of their core customer base and enhance member recruitment and retention efforts.

Are you struggling to convert commercial members to your MA offerings or looking to better understand where your new MA enrollees are coming from? Would it benefit your MA plan to be able to project newly enrolled members’ healthcare resource needs and expected cost? This research puts Inovalon in a unique position to help you answer these questions and deliver maximum value to members while optimizing marketing, growth, and retention efforts.

Inovalon recognized as a top-rated vendor

To top off all the excitement of AHIP 2023, Black Book Research, a healthcare-centric market research and public opinion research company, announced Inovalon was the top performing healthcare solution vendor for payer cloud solutions.

This comes as a result of crowdsource polling conducted by Black Book between January and June this year, with more than 2,400 health plan user participants. We are greatly honored to receive this recognition and are committed to continue delivering best-in-class solutions for our health plan customers.

Achieve more across quality, risk, research, and beyond

Whether your plan needs support preparing for the CMS Health Equity Index, managing quality improvement and risk score accuracy programs, or conducting your next study, we are here to help.

Our team of skilled industry analysts and solutions experts are here to answer your biggest questions. Contact us today to learn how our data-driven software, research capabilities, and extensive industry expertise can help you succeed.

Inovalon and design^®, Inovalon^®, and the MORE² Registry® are trademarks of Inovalon, Inc.