OPEN MINDS Performance Management Institute

Attendees, exhibitors & solutions

Who this event is for

Industry trends

Key trends shaping this market and its wider industry.

Market news

Latest updates from across the market.

Hotel tiers

A range of accommodation options near the venue and across key areas.

Local transport

Get around the city with these convenient transport options.

Frequently asked

Glossary

1

HEDIS

The Healthcare Effectiveness Data and Information Set, NCQA's measure library that health plans use to report clinical quality. At this event it is the reference point for measure-level performance, supplemental data strategy and year-over-year rate movement.

2

Star Ratings

The CMS 1-5 quality ratings for Medicare Advantage and Part D contracts, built from HEDIS, CAHPS, pharmacy and administrative measures. Star performance links directly to quality bonus payments, which is why plan teams use conferences like this one to compare cut-point strategies.

3

CAHPS

The Consumer Assessment of Healthcare Providers and Systems surveys that capture member experience of care, access and plan service. CAHPS results feed Star Ratings and are usually reviewed alongside operational call-centre and appeals data.

4

Risk adjustment (HCC)

The payment methodology that adjusts capitation for a member's illness burden using hierarchical condition categories. Documentation accuracy and coding completeness are recurring working sessions for plans and delegated provider groups.

5

Value-based care

Contracting models that tie payment to quality results and total cost of care rather than volume of services. Attendees typically compare how different payer and provider models define shared savings, quality gates and downside risk.

6

Shared savings and ACO arrangements

Accountable care structures in which providers keep a share of savings against a spending benchmark if quality thresholds are met. Discussions at performance-management events usually turn on benchmark setting, attribution and reconciliation timelines.

7

Gaps in care

Open clinical or pharmacy measures a member has not yet completed, used as the operational worklist for quality teams. Gap closure campaigns are the day-to-day execution layer behind published HEDIS rates.

8

Attribution

The rules that assign members to a provider, panel or contract for measurement and payment purposes. Attribution methodology changes can move reported performance materially, so it is a frequent source of debate between plans and provider groups.

9

Delegated functions

Activities such as credentialing, utilization management or claims processing that a payer delegates to a provider organisation, subject to oversight audits. Delegation oversight is a common topic for provider-sponsored plans.

10

Medical loss ratio (MLR)

The share of premium revenue spent on clinical care and quality improvement rather than administration and margin. Quality spend that counts toward MLR is a practical link between performance programmes and finance teams.

11

Population health management

Panel-level management of outcomes, utilization and social risk across a defined member group. It is the umbrella under which quality, care management and analytics teams at this event frame their work.

12

Social determinants of health (SDOH)

Non-clinical factors such as food, housing, transport and social support that shape health outcomes and are increasingly used in risk stratification and quality programme design.

13

Supplemental data and data aggregator validation

Clinical data pulled from EHRs, labs and health information exchanges to fill measure gaps in HEDIS reporting, with vendor validation programmes governing whether that data can be used. Plans at this event compare sourcing strategies and validation timelines.

14

Benchmarking

Comparing plan, provider or market performance against peers, national percentiles or prior-year results. Benchmark context is the main reason attendees bring their own scorecards to sessions rather than relying on slides alone.