VALUE VISIT: Operational Excellence

Event Date: 5/5/2025 - 5/8/2025

Event Overview

5/5/2025 - 5/8/2025
Miami, Florida
Participation is limited to Health Plan Alliance members and invited guests

HPA members talking Regional health plans face mounting pressure to optimize administrative costs while maintaining their competitive edge in personalized service. With national insurers leveraging economies of scale, the challenge lies in strategically reducing expenses without sacrificing the high-touch, localized care that sets regional plans apart. This balancing act is crucial for ensuring long-term sustainability, keeping member costs affordable, and freeing up resources for vital investments in care management and innovation.

This Value Visit is the culmination of our "Take Cost Out" discussions, delivering actionable strategies for administrative excellence across your organization. Through intensive sessions on automation, workforce optimization, vendor partnerships, and operational waste reduction, you'll gain practical tools for immediate implementation. The event features real-world case studies, collaborative peer discussions, and expert insights on leveraging AI technologies and data-driven approaches to enhance operational efficiency while maintaining superior member experiences. From streamlining member services to optimizing payment integrity programs, you'll discover targeted solutions that drive measurable outcomes for your organization.

Who Should Attend

Executive stakeholders and leaders involved in health plan operations, project management, process improvement, vendor management, and optimizing organizational performance and efficiency won't want to miss this meeting.

Why Attend

Collaborative Impact: Immerse your team in intensive working sessions where you'll collaborate directly with peers to solve your organization's most pressing challenges through interactive workshops and hands-on activities.
Real-World Results: Learn from in-depth case studies and proven strategies implemented by peer health plans, gaining practical templates and solutions you can implement immediately within your organization.
Strategic Networking: Build lasting connections with carefully selected peer organizations facing similar challenges, creating a valuable professional network that extends beyond the event through ongoing collaboration.
Hands-On Learning: Skip the theory and dive into practical demonstrations and discussions with plans that have successfully navigated your current challenges, gaining insights you can apply to your own initiatives.
Included with Your Membership: While similar industry events cost thousands, this powerful networking opportunity is included in your membership—giving you unparalleled access to meaningful collaboration with regional, provider-sponsored, and independent health plan leaders.

Registration


ALLIANCE MEMBER
Fee End Date	Description	Amount
5/5/2025	Exclusive to Alliance Partner or Shareholder organizations	MEMBER PASS
ALLIANCE GUEST
Fee End Date	Description	Amount
5/5/2025	Only for invited guests of the Alliance	GUEST PASS
PLATINUM SPONSOR
Fee End Date	Description	Amount
5/5/2025	Exclusively for Platinum sponsors	PLATINUM PASS
SPONSOR
Fee End Date	Description	Amount
5/5/2025	*Registration code required	SPONSOR PASS
SPEAKER
Fee End Date	Description	Amount
5/5/2025	Confirmed faculty members	FACULTY PASS

Plan Your Trip

Location

The Palms Hotel & Spa

3025 Collins Ave
Miami Beach, FL 33140

Hotel Room Block

Expires April 14, 2025
$279 plus taxes and fees
To reserve your room, call the hotel’s reservations department at 305.908.5479 and request the Health Plan Alliance (Vizient) rate, or book online.

Please reserve early, as rooms in the group block are limited and may sell out before the deadline. Reservations made after the deadline are not guaranteed at the group rate, and the hotel may also be fully booked.

Miami Beach—A Haven for Relaxation and Nightlife

Near The Palms Hotel in Miami Beach, you’ll find plenty to explore, from the stunning white sands of Miami Beach itself to the lively attractions of nearby South Beach. Stroll along the Miami Beach Boardwalk for breathtaking ocean views, or head to Lincoln Road for trendy boutiques, cafes, and art galleries. For a cultural experience, visit The Bass, a contemporary art museum just a short drive away. Nature lovers can explore the Miami Beach Botanical Garden or take a short trip to Biscayne Bay for paddle boarding and boat tours. At night, indulge in Miami’s famous nightlife with upscale dining and vibrant clubs in the heart of South Beach.

Learn more

Ground Transportation

Uber/Lyft from the Miami International airport (MIA) is approximately $30-40 one-way. For directions and parking information visit the hotel website.

Thank you to our event sponsors

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Agenda

05/05/2025 6:00 PM - 8:00 PM
Reception: Monday
05/06/2025 8:00 AM - 9:00 AM
Networking Breakfast Be sure to let us know if you have dietary restrictions.
05/06/2025 9:00 AM - 10:00 AM
Keynote - Cutting Costs Without Cutting Corners: Strategic Approaches to Cost Containment Health plans are under increasing pressure to reduce costs—but where and how you cut can make all the difference. This session will explore strategies for reducing administrative, medical, and vendor costs while avoiding common pitfalls like cutting too deep or failing to reinvest savings effectively. From outsourcing in CM/UM and optimizing claims strategies to navigating sub-capping challenges and product benefit design trade-offs, we’ll examine what’s working, what’s not, and where health plans should focus their efforts to maximize value. Expect insights from Blues, large, and regional plans on striking the right balance between efficiency, sustainability, and growth. Speaker(s): Doris Stein, Managing Director Ken Barrette, Managing Director Alvarez & Marsal Healthcare Industry Group
05/06/2025 10:00 AM - 10:15 AM
Time to refill your cup and stretch
05/06/2025 10:15 AM - 11:15 AM
Leading Through Change: Navigating Morale and Retention in an M&A Transition Workforce reductions and organizational transitions can challenge even the strongest teams, but effective leadership and strategic change management can make all the difference. This session explores how to maintain staff morale, engagement, and retention during an acquisition, balancing transparency, communication, and cultural continuity. Hear insights on navigating uncertainty, sustaining employee trust, and leading through change in a way that strengthens—not weakens—your organization. Speaker: Sarah Morgan, Vice President of Human Resources Health New England
05/06/2025 11:15 AM - 12:15 PM
Getting It Right: Strengthening Alignment for Operational and Strategic Success Executing on strategic priorities requires more than good intentions—it demands alignment across teams, processes, and decision-making. This session highlights how one health plan is optimizing internal operations, from reengineering meeting structures to drive efficiency, to refining sales presentations that clearly articulate their market differentiators, to realigning key teams like Stars under Product for greater impact. Gain insights on practical changes that improve execution, enhance collaboration, and position organizations for long-term success. Speaker: Debbie Schiffman, Chief Operations Officer Quartz
05/06/2025 12:15 PM - 1:15 PM
Networking Lunch
05/06/2025 1:15 PM - 2:15 PM
Presbyterian’s Integration Journey: Breaking Down Barriers for Operational Success As health plans and provider systems integrate more deeply, navigating the evolving plan-system relationship requires new strategies, stronger coordination, and a shared enterprise mindset. This session highlights Presbyterian’s journey, offering a real-world look at how one health plan is aligning with its parent system to enhance efficiency, reduce friction, and drive financial sustainability. Hear from Kelly on how Presbyterian has reimagined member and patient engagement through centralized scheduling, self-service digital tools, and call center automation. Seth will share how Presbyterian is realigning horizontal integration—streamlining payment integrity, claims processing, and encounters—while also considering how plan decisions impact system care and how to strengthen partnerships with the delivery system. Join us to explore Presbyterian’s integration story—what’s working, what’s next, and key lessons for other health plans on a similar path. Speaker(s): Kelly Garcia, VP of Customer Service Center Seth Wilcox, VP of Operations Presbyterian
05/06/2025 2:15 PM - 3:15 PM
Best in Class Plans and Economies of Scale What does it take to be a best-in-class health plan, and how do economies of scale impact operational success? In this session, Douglas Sherlock will draw from two recent papers to examine the key drivers of top-performing health plans and the role of scale in enhancing efficiency and sustainability. Attendees will gain actionable insights into how data-driven strategies and benchmarking tools can help plans streamline operations, improve performance, and achieve sustainable success in a competitive landscape. Speaker: Douglas Sherlock, Senior Health Care Analyst Sherlock Company
05/06/2025 3:15 PM - 3:30 PM
Time to refill your cup and stretch
05/06/2025 3:30 PM - 4:30 PM
Peer-to-Peer Roundtable: What’s Working and What’s Not End the day with a collaborative peer-to-peer roundtable designed to foster candid discussions about real-world challenges and innovative solutions. Using a guided handout, attendees will share what’s working, what isn’t, and what they’re trying next in their organizations. This interactive session is the perfect opportunity to learn from your peers and gain fresh ideas to take back to your teams.
05/06/2025 6:00 PM - 8:00 PM
Dinner: Tuesday
05/07/2025 8:00 AM - 9:00 AM
Networking Breakfast
05/07/2025 9:00 AM - 10:30 AM
Rethinking Vendor Management: Lessons from Outside Industries Health plans often focus on vendor pricing, but a broader value-driven approach can unlock greater efficiency, innovation, and cost savings. This session brings an outside industry perspective to vendor management, exploring how private equity and cross-portfolio strategies optimize vendor relationships, mitigate risk, and drive long-term value. We’ll discuss where vendor agreements create system exposure, how physician decisions impact P&L, and why addressing leakage requires greater rigor. Join us for insights on reshaping vendor strategy to enhance performance and financial outcomes. Speaker: Chris Windfelder, Principal/Partner Ernst & Young
05/07/2025 10:30 AM - 10:45 AM
Time to refill your cup and stretch
05/07/2025 10:45 AM - 12:00 PM
Leveraging Automation and AI Explore how health plans are harnessing the power of Robotic Process Automation (RPA) and artificial intelligence (AI) to streamline operations and achieve significant cost savings. This session will feature real-world case studies that provide practical insights to reduce manual processes and improve efficiency across your organization. Speaker(s): Chuck Alvarado, Chief Administrative Officer MediGold
05/07/2025 12:00 PM - 1:00 PM
Networking Lunch
05/07/2025 1:00 PM - 2:00 PM
Risk Adjustment, Payment Integrity…Now What? CoventBridge will guide you through the essential steps to create a comprehensive Fraud, Waste, and Abuse (FWA) program. This session will empower you with the tools and strategies needed to detect, prevent, and effectively combat FWA within your organization. Learn how to build a robust framework that safeguards your health plan’s financial and operational integrity while ensuring compliance and efficiency. Don't miss this opportunity to strengthen your defenses against these costly challenges. Speaker: Ray Evans, VP Healthcare Sales CoventBridge
05/07/2025 2:00 PM - 3:00 PM
Inside the Vendor Landscape: Who’s Buying, Who’s Selling, and What’s Next The healthcare vendor ecosystem is evolving rapidly, with new players emerging, consolidation reshaping the market, and health plans rethinking their technology and service partnerships. In this session, an industry expert will break down who’s buying what, who’s selling what, and which systems are leading across the healthcare landscape. We’ll explore key trends in vendor selection, shifts in payer-provider integration, and what plans should consider when making strategic investments. Whether you're evaluating new partnerships or simply trying to keep up with the changing marketplace, this session will give you the insider perspective you need.
05/07/2025 3:00 PM - 3:15 PM
Time to refill your cup and stretch
05/07/2025 3:15 PM - 4:15 PM
Spotlight on Leadership: Insights in Action Participants will break into small groups in this interactive session to discuss critical leadership challenges and share actionable insights. Guided by thought-provoking questions, each group will explore topics such as navigating uncertainty, fostering innovation, aligning teams with long-term goals, and balancing short-term wins with strategic vision.
05/07/2025 6:00 PM - 8:00 PM
Dinner: Wednesday
05/08/2025 8:00 AM - 9:30 AM
Networking Breakfast For those that have later flights, we will meet at the hotel restaurant for a come and go breakfast.