The 3^rd Annual
Supplemental Benefit
Innovations to Drive Health Outcomes

Workshop Registration

Reward-Ready Benefits: Designing Supplemental Programs that Boost Stars, Improve Cost Savings, and Elevate Member Experience

Learning Objectives

• Regulatory snapshot
• Gain a clear overview of the latest CMS guidance and policy updates that will shape 2026 supplemental benefit strategies
• Data-driven design
• Explore how market research and member segmentation inform rewards and incentives programs that enhance specific Stars measures and support cost savings
• Blueprint for value
• Walk through a step-by-step framework for building supplemental benefits that drive revenue growth, cost efficiency, and a superior member experience
• Hands-on modeling exercise

Use Wakely's benefit-design tool to model your own rewards-and-incentives program and project its impact on quality

• Measures and budget planning
• Real-world perspective
• Hear directly from our panel of experts including best practices and actionable insights for 2026 benefit design

Workshop Leaders:

Networking Continental Breakfast

Chairperson's Opening Remarks:

Christine Leo,

AVP for Medicare,

Hinge Health

Decoding the New Administration: Navigating Policy Shifts in Supplemental Benefits

• Understanding policy language: what recent changes really mean for Medicaid, Medicare, state-based care, and supplemental benefits
• Comparing access and support structures pre- and post-Trump administration, especially in transportation, food, and non-medical services
• Impact of new food restrictions - what is considered healthy food to various conditions?
• Health Equity Index renamed and reframed: what's the new focus and how will plans respond?
• Growing pressure on plans to address unmet needs with flexible support, cash assistance, healthy food, and beyond
• Health plan perspective and outlook

Panel:
Life After VBID: Navigating the Sunset and the Shift Toward SSBCI in Medicare Advantage

• VBID Sunset in 2025: What it means for plans?
• How are plans leveraging SDOH through SSBCI
• The critical role of D-SNPs and how VBID supported dual integration—adapting care models accordingly
• Operational challenges: How are plans streamlining processes under SSBCI
  • eligibility
  • benefit access
  • vendors
• Lessons from VBID Implementation: Insights into how small vs. large plans approached VBID
• How are plans adjusting for SSBCI administration and vendor partnerships

Moderator:

Panelists:

Panel:
ROI & Rate Increases: How to Structure, Measure, and Justify Benefits in a Cost- Compressed Environment

• Perspective Vs. reality
• Actuarial perspective and health plan management
• Understanding ROI through multiple lenses: cost, clinical outcomes, and access
• Distinguishing “table stakes” from “nice-to-haves”
• Benefits often chosen for member growth, not just ROI
• Aligning access, quality and cost
• Chronic care and GLP-1 programs: integrating lifestyle and prevention to drive long-term cost reduction
• Challenges in proving ROI
• How supplemental benefits can move beyond marketing tools to become true levers for total cost of care reduction and quality improvement

Moderator:

Panelists:

Networking Refreshment Break

Panel:
Reimagining Dental Benefits: Strategic Integration, Innovation, and Medical Alignment

• Underutilized dental benefits: Plans paying for it whether members use it or not
• Why plans are increasingly motivated to drive dental benefit utilization
• Trends in benefit design: rising generosity, increased provider networks, and inclusion of high-cost services like dentures and implants
• The evolving link between dental and medical: identifying medically necessary dental needs tied to chronic or serious conditions
• How upcoming definitions of medically necessary dental could reshape coverage
• Why revamping outdated dental offerings is essential to competitiveness, member satisfaction, and bottom-line performance

Moderator:

Michael Adelberg,

Executive Director

National Association of Dental Plans

Panelists:

Panel:
Navigating Customer Communications and Shifting CMS Guidance on Mid Year Notifications: Key Considerations for Plans and Actuarial Insights

• Review CMS' 9/8/2025 communication on delayed enforcement and key takeaways / timing
• Immediate / longer term impacts to in-flight work and planning based updated guidance
• Lessons learned from any 2026 planning or investment
• Assessing how plans may test mid-year notifications and refine the process for better member understanding vs prioritizing other 2026 initiatives
• Discuss other strategies for encouraging utilization and customer engagement with supplemental benefits

Moderator:

Panelists:

Reimagining Medicare Supplemental Benefits: Closing Care Gaps Through Fintech-Driven Rewards, Incentives, and E-Commerce

• How supplemental benefits and rewards can be structured to directly close care gaps (e.g., screenings, labs, Rx adherence)
• How plans can use supplemental benefits and incentives to engage hard-to-reach populations and reduce member abrasion
• The latest models for rewards & incentives that move beyond gift cards, delivering accountability, compliance, and member trust
• How fintech-enabled infrastructure can create one seamless member experience across Medicare and Medicaid that reduces friction and confusion using a single digital-first experience
• Real-world lessons on building a closed-loop system where benefits and incentives translate into measurable improvements in Stars, HEDIS, and outcomes

Networking Lunch

A Two-Part Discussion:
Building Supplemental Benefits That Work: Bringing Compliance, Clinical, Sales, and Operations Together for Stars, CAHPS, and Health Equity

Part I Co-Designing Supplemental Benefits: Turning Field Signals into Cross-Functional Decisions

• Use a cross-functional intake and simple scorecard (clinical value, compliance risk, ops readiness, member resonance)
• Translate field feedback into clear eligibility/use rules, documentation, and plain-language messaging tied to CAHPS/Stars
• Set owners and cadence (RACI + monthly review) to iterate benefits and track activation and equity reach

Part II Build-Operate-Prove: Vendor Playbooks for Compliance-Ready Benefits that Move CAHPS & Stars

• Convert plan design into scalable fulfillment, sustained activation, and audit-ready data from enrollment through outcomes
• Define the minimum dataset and SLAs needed to demonstrate CAHPS/Stars impact and reduce grievances
• Buyer checklist: activation plan, audit packet, equity targeting/reporting, and change-management approach

Moderator:

Panelists:

Using Data to Decode Risk: Optimizing Supplemental Benefits Through Analytics and Technology

• Investigating correlations between supplemental benefit utilization and low-risk members—what the data reveals so far
• Leveraging CMS-submitted data to inform plan design, identify care gaps, and support smarter interventions
• The growing role of technology and predictive analytics in supplemental benefits: How are plans using it for tangible results
• How health plans are navigating data sharing with vendors?
• Data access and utilization challenges—how retrospective insights impact future benefit availability and targeting
• Differentiating small vs. large plan capabilities in managing data-driven SB operations and vendor coordination

Janine V. Angel

Senior Director, Medicare Strategic Business Operations & Compliance

Centene

Harnessing AI to Transform Medicare Advantage Plan Design and Operations

As the Medicare Advantage market grows more competitive and faces increasing financial pressures, success will depend on the ability to design differentiated, cost-effective products and streamline operations. Both generative and traditional AI technologies can play a pivotal role by:

• Analyzing member and agent interactions to better understand member needs
• Evaluating how benefit choices affect enrollment and medical loss ratio (MLR)
• Rapidly extracting competitive insights from PBP files and EOC documents
• Delivering product intelligence to downstream teams, including sales and member services
• Automating the generation and review of multilingual EOCs, ANOCs, and Summary of Benefits documents

Networking Refreshment Break

Strategic Outlook: Navigating the 2026 Medicare Advantage Landscape

• Learn key takeaways from the Medicare Advantage 2026 AEP
• Explore critical insights, including carrier trends, significant benefit adjustments, and changes in market footprint and plan value
• Understand key differences by plan type and size
• Address the impact of important regulatory updates related to 2026 AEP
• Help your plan strategically navigate and succeed in the 2026 MA landscape

Navigating the Numerous Disruptions in SNPs & Supplemental Benefits: OTC Coverage and Compliance Challenges

• Understanding D-SNP: What supplements are required for coverage?
• The complexity of OTC medications: Knowing when and how they should be covered
• Ensuring compliance
• Financial resources
• Allocating funds for required DSNP and OTC coverage
• The challenge of verifying coverage
• Spending rebate dollars to buy down costs or letting the cost flow through to members?
• Looking at the out of pocket costs for DSNP and bids
• How is CMS responding to I-SNP and C-SNPs - impactful?

Networking Cocktail Reception