2019 Medicaid Managed Care Summit
Strategies to Serve the Rapidly Expanding Medicaid Population
September 9-10,2019 * Fairmont Scottsdale Princess * Scottsdale, AZ

2019 Medicaid Managed Care Summit

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About the Conference

Medicaid is the single largest source of health coverage in the U.S. Now more than ever before, states are relying heavily on managed care organizations to serve their Medicaid beneficiaries to improve the quality of care delivered and control costs. Bringing together Medicaid leaders from states and health plans, as well as government leaders and policymakers, this summit will address the most pressing issues facing state Medicaid managed care. You will learn about national trends and innovative programs to best serve the growing Medicaid population; current federal and state policies and regulations; strategies to better manage utilization of health services; social determinants of health to better serve members; improvements in healthcare quality and outcomes; how to best coordinate care for complex populations; coordinating and integrating LTSS in managed care plans; how to achieve value-based care; and much more.

Who Should Attend?
From State & Government Agencies:

Directors and Managers of:

• State Medicaid
• Managed Care
• Health Services/Healthcare Programs
• Human/Social Services
• Medical Assistance
• Strategic Planning
• Policy Analysis
• Compliance
• Quality Assurance
• Quality Improvement
• Healthcare Financing

From Health Plans & Managed Care Organizations:

Chief Executive Officers, Chief Operating Officers, Chief Financial Officers, Chief Medical Officers, Chief Strategy Officers, and Chief Information Officers

Also, Presidents, Vice Presidents, Directors and Managers of:

• Medicaid
• Long-Term Care
• Behavioral Health
• Sales and Marketing
• Network Development
• Compliance
• Clinical Affairs
• Finance
• Operations
• Quality
• Risk Management
• Public Policy
• Utilization Review
• Medicare
• Managed Care
• Clinical Services

This Program is Also Relevant to:

Organizations Providing Services for:

Care Management Technology * Care Management for the Elderly * Pharmacy Benefit Administrators * Health Management Solutions * Behavioral Health Services * Revenue Enhancement Services * Reinsurance Services

Conference Agenda

Day One – Monday, September 9, 2019
7:15am – 8:00am

Conference Registration & Networking Breakfast

8:00am – 8:10am

Chairperson’s Opening Remarks

8:10am – 8:50am

Solutions to Tackle Opioid Misuse and Addiction and Ensuring Access to Effective Treatment

In this session learn what states are doing to prevent opioid misuse and addiction and improve the quality of care for the Medicaid managed care population. Topics to be discussed will include:

– Measures to curb overprescribing
– Improving access to quality treatment programs
– Challenges associated with the development of enhanced opioid treatments
– The impact on state budgets
– Strategies for partnering with outside agencies to help members remain engaged in treatment

Lisa Hettinger
Deputy Director of Health Services
Idaho Department of Health and Welfare

8:50am – 9:30am

Organizational Diagnostics to Improve Customer Services and Program Integrity

Maryland tapped a small group of senior-level Medicaid experts in 2018 to complete a diagnostic assessment of its programs and operations, including managed care. This inexpensive initiative, which was completed in four months, helped Maryland better align their benefits policy and customer service efforts with their managed care delivery system. This session will consider how a simple “outside perspective” can yield significant program insights and set direction for positive organizational change.

Rich Albertoni
Manager
Public Consulting Group

R. Schrader
Chief Operating Officer
Maryland Department of Health

9:30am – 10:10am

Leveraging the Community Health Worker as a Resource to Drive Outcomes within your High-Risk Populations

This session will address the value of adding the Community Health Worker to your Care Management model. Topics to be discussed will include:

– Integrating the community health worker into your care team
– Expanding the role of the community health worker
– Developing a community health worker onboarding program

Joann Sciandra, MHA, BSN, RN, CCM
Vice President, Care Coordination and Integration
Geisinger Health Plan

10:10am – 10:40am

Networking & Refreshments Break

10:40am – 11:20am

The Quadruple Aim: Building Performance Metrics for Medicaid Managed Care

As states across the nation adopt managed care for the administration of the Medicaid benefit, quantifying the value of the buy made in terms of cost and quality presents new and unique challenges. This session will outline how one state has aligned quantification strategies with the objectives of the quadruple aim and shifted the state’s management enterprise to accommodate higher functioning auditing, surveillance, and quantification capabilities. This session will cover elements related to talent acquisition and human resources, data and analytics tools, scope of work development, and organizational culture.

Matthew Van Patton, DHA
Director, Medicaid and Long-Term Care
Nebraska Department of Health and Human Services

11:20am – 12:00pm

Building a Culture of Engagement for Medicaid Managed Care Members

This session will address strategies for effective Medicaid managed care member engagement. Topics to be discussed will include:

– Engaging members through advocacy and outreach programs
– Connecting members to resources and helping them navigate the healthcare system
– The case managers role in member engagement
– Incentives that drive high-value behaviors and more personalized connections
– Early engagement strategies
– Developing a member-centric, collaborative approach to care management
– Health needs assessments
– Shared decision-making models

Roseann DeGrazia
Vice President Regional Network Management
UPMC Health Plan

12:00pm – 1:00pm

Lunch

1:00pm – 1:40pm

Innovative Pilots Turned Best Practices in Medicaid Managed Care

Learn about what plans are doing to implement rapid cycle pilot programs that are likely to develop into best practices, and how you can best implement this process in your organization. Topics to be discussed will including:

– Aligning strategies to improve quality, manage cost and drive innovation
– Designing quality programs through rapid cycle improvement process method
– Measuring effectiveness of programs that impact high utilizers of Medicaid services
– Leveraging results to implement programs that best serve populations with complex conditions

Dorothy K. Young, PhD, MHSA
Mississippi Division of Medicaid

1:40pm – 2:40pm

Panel: Value-Based Payments in Medicaid Managed Care

States are increasingly looking to move away from volume-driven fee-for-service payments and toward value-based payment arrangements. This panel will explore state options for using managed care contracts to accelerate value-based payment arrangements. Topics to be discussed will include:

– Establishing quality metrics
– Baselines for patient outcomes
– Determining parameters for “improved health”

Panelists:
Leesa M. Allen
Executive Deputy Secretary
Pennsylvania Department of Human Services

Michael Randol
Medicaid Director
Iowa Department of Human Services

Lisa Truitt
Director of the Health Care Delivery Management Administration
DC Department of Health Care Finance

2:40pm – 3:10pm

Networking & Refreshments Break

3:10pm – 3:50pm

Innovative Use of On-Demand Transportation Services to Improve HEDIS Scores, LANE ER Utilization and EMS Transportation Utilization

HEDIS quality measures have a significant role in the healthcare industry regarding closing gaps in care and decreasing the use of costly acute care through preventive services. Access to affordable, convenient transportation often plays a crucial role in a Medicaid enrollee’s access to preventive services, and a lack of access in this area can lead to higher use of ER and 911 services for non-emergent care. This session will provide an overview of how AmeriHealth Caritas DC collaborated with an innovative NEMT broker, Access2Care, and an on-demand/rideshare transportation company, Lyft, to address these challenges. The session will also illustrate the correlation between member use of this program and improvements in the plan’s HEDIS results, low acuity non-emergent (LANE) ER utilization, EMS Utilization and other enrollee outcomes.

Keith Maccannon
Director of Marketing, Community Relations and Outreach
AmeriHealth Caritas District of Columbia

3:50pm – 4:30pm
Gina Conflitti, MD, MBA
Vice President Chief Medical Officer
Aetna Medicaid

Tracey Green
Vice President Personalized Health
Aetna Medicaid

4:30pm – 5:10pm

Moving Toward Holistic Care: Real Life

There is a heightened focus on what truly influences a person’s health outcomes that is driving discussions, innovations and strategies to address a person’s health beyond their time as patient. How one lives, works, plays and ages in their community, along with access to resources, has more impact than a doctor’s visit. In this session we will break it down real time and discuss the following topics:

– The importance of integrating traditional health care with real life wellbeing
– Values and beliefs – the impact on holistic care; medical model meets social and community approach
– Bolstering community capacity to ensure the health care system addresses health influencers such as food insecurity and employment and housing supports

Merrill A. Friedman
Senior Director, Disability, Policy Engagement, Federal Affairs
Anthem, Inc.

5:10pm

End of Day One

Day Two – Tuesday, September 10, 2019
7:15am – 8:00am

Networking Breakfast

8:00am – 8:15am

Chairperson’s Remarks

8:15am – 9:00am

Creating a Member Engagement Strategy for Hard to Reach Members

Engaging hard to reach populations to be active participants in their care. This presentation will provide an overview of North Carolina’s strategy to engage with members to be active participants in their care and North Carolina’s efforts to implement an integrated, whole person health system. We will discuss how statutorily created advisory groups empower members to advocate for themselves and others, and how this advocacy can transform individuals and systems. We will also discuss several of the programs North Carolina has developed to empower hard to reach populations, most notably the Leadership Fellows Academy, a joint venture with the University of North Carolina, North Carolina State University, and The Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.

Ken Schuesselin, Jr.
Associate Director for Consumer Policy
Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
North Carolina Department of Health and Human Services

9:00am – 9:45am

Effective Care Coordination: Managing Members With Special Needs; The Dual Eligible Population

In a Fully Integrated Dual Eligible Special Needs Program (FIDE SNP), effective care coordination of membership can result in higher member satisfaction, improved MLR and MCR and overall programmatic successes. This presentation will demonstrate the key aspects to effective and efficient care delivery of this highly specialized population.

Carol Smolij, BSN, RN, CPHQ
Director Clinical Special Needs Plan
Horizon NJ TotalCare (HMO SNP)
Horizon BCBS of New Jersey

9:45am – 10:15am

Networking Breakfast

10:15am – 11:00am

Community Engagement for Medicaid Beneficiaries and Communities

Kentucky has worked toward implementing community engagement for over two years. Our partnerships with stakeholders throughout the Commonwealth have been key in connecting beneficiaries with resources to help them move forward. Each beneficiary’s move forward is unique. This presentation will highlight our approach to ensure success for both beneficiaries and communities through innovative approaches and grassroots partnerships.

Tracy Williams
Program Manager
Kentucky HEALTH Office of Educational Programs

11:00am – 11:45am

Member Engagement through the Social Determinants of Health

Many health plan members now have expanded access to care but they may not need clinical services or seek preventative care annually. Other members may be experiencing episodic increases in their clinical utilization. Both member types are looking for meaning in value in the relationships that they are developing – how can you provide the connection that they desire. This session will explore how social determinants of health can provide opportunities for member engagement. Topics will include:

– Workforce development programs engaging a diverse segment of members and producing results across the board
– Housing programs for pregnant mothers in high infant mortality areas
– Early childhood education that encourages communication between parent and child

Amy M. Riegel
Director, Housing
CareSource

11:45am – 12:30pm

The Future of the Healthcare Landscape and Medicaid

There is a lot of uncertainty surrounding what the future of healthcare will look like – in particular, Medicaid. This session will present an overview of the current healthcare and Medicaid landscape, important considerations and what to expect in the future, what you should be focusing on, and how potential changes might affect your operations and strategy. Learn about regulations that are likely to impact the Medicaid managed care market over the next few years, as well as topics such as:

– Administration’s policy priorities and agenda for reforming Medicaid and Medicaid managed care
– Implications to state budgets and what this means for the Medicaid population
– Implications to managed care organizations and state contracts and relationships
– Key issues to consider as your organization develops strategies to meet the policy goals and upcoming implementation requirements
– Operational challenges and efforts to increase transparency and accountability

Ashley A. H. Gray, MPP
Director, State Affairs – Medicaid
Blue Cross Blue Shield Association

Workshop – Tuesday, September 10, 2019
12:45pm – 2:45pm
The Future of the Healthcare Landscape and Medicaid and How we get There

Much uncertainty continues to shroud the future of the Medicaid landscape. While no one has a crystal ball to know how everything will ultimately play out, fully understanding the potential modifications to Medicaid is critical for states, health plans and MCOs moving forward within the new Medicaid landscape. Will the lure of work requirements lead more states to potentially expand Medicaid? If work requirements don’t survive a legal challenge, will the Medicaid landscape shift in the other direction with no additional Medicaid expansions, and possible rollbacks of existing expansions? This workshop will provide attendees with:

• Where we are with Medicaid expansion
• Where we will possibly see expansion next, and the opportunity this represents
• How the newly expanded states are expanding Medicaid – i.e. new beneficiary requirements
• Approaches to Medicaid Expansion for future expansion states
• Implications to managed care organizations and state contracts and relationships
• How to adjust your strategy to meet the goals of potential requirement changes associated with Medicaid expansion

Whether it’s navigating the more certain changes that will impact all states and MCOs in the near future, or preparing for less certain changes that may not ultimately materialize, MCOs and states will benefit from having a better understanding of the road ahead for Medicaid.

Jason Silva, JD, PMP
Senior Consultant
Health Management Associates

Featured Speakers

Lisa Hettinger

Lisa Hettinger

Deputy Director of Health Services

Idaho Department of Health and Welfare
Rich Albertoni

Rich Albertoni

Manager

Public Consulting Group
R. Schrader

R. Schrader

Chief Operating Officer

Maryland Department of Health
Joann Sciandra, MHA, BSN, RN, CCM

Joann Sciandra, MHA, BSN, RN, CCM

Vice President, Care Coordination and Integration

Geisinger Health Plan
Matthew Van Patton, DHA

Matthew Van Patton, DHA

Director, Medicaid and Long-Term Care

Nebraska Department of Health and Human Services
Leesa M. Allen

Leesa M. Allen

Executive Deputy Secretary

Pennsylvania Department of Human Services
Michael Randol

Michael Randol

Medicaid Director

Iowa Department of Human Services
Lisa Truitt

Lisa Truitt

Director of the Health Care Delivery Management Administration

DC Department of Health Care Finance
Keith Maccannon

Keith Maccannon

Director of Marketing, Community Relations and Outreach

AmeriHealth Caritas District of Columbia
Gina Conflitti

Gina Conflitti

Vice President, Chief Medical Officer

Aetna
Tracey Green

Tracey Green

Vice President Personalized Health

Aetna Medicaid
Merrill A. Friedman

Merrill A. Friedman

Senior Director, Disability, Policy Engagement, Federal Affairs

Anthem, Inc.
Dorthy K. Young, PhD, MHSA

Dorthy K. Young, PhD, MHSA

Office of the Governor

Mississippi Division of Medicaid
Ken Schuesselin, Jr.

Ken Schuesselin, Jr.

Associate Director for Consumer Policy, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services

North Carolina Department of Health and Human Services
Carol Smolij, BSN, RN, CPHQ

Carol Smolij, BSN, RN, CPHQ

Director Clinical Special Needs Plan, Horizon NJ TotalCare (HMO SNP)

Horizon BCBS of New Jersey
Tracy Williams

Tracy Williams

Program Manager

Kentucky HEALTH Office of Educational Programs
Amy M. Riegel

Amy M. Riegel

Director, Housing

CareSource
Ashley A. H. Gray, MPP

Ashley A. H. Gray, MPP

Director, State Affairs – Medicaid

Blue Cross Blue Shield Association
Jason Silva, JD, PMP

Jason Silva, JD, PMP

Senior Consultant

Health Management Associates
Stephen N. Konsin Jr.

Stephen N. Konsin Jr.

Vice President

Syrtis Solutions
Shawn M. Shuman

Shawn M. Shuman

Senior Director, Clinical and Business Development, Regional Network Management

UPMC Health Plan
Venue
Fairmont

Fairmont Scottsdale Princess
7575 East Princess Drive
Scottsdale, AZ 85255
480-585-4848

“Mention BRI Network for a Special Discounted Rate of $229/night – Reserve Early!”

Sponsors and Exhibitors

Executive Sponsor

Syrtis SolutionsSyrtis Solutions provides the payer of last resort market with technology-based solutions to prospectively cost avoid pharmacy claims and increase medical cost recovery. The organization is managed by industry veterans with experience in pharmacy claims processing and claimant recovery processes. The combined and unique experiences of the company’s founders led to the development and deployment of ProTPL, a real-time point of sale cost avoidance service. ProTPL accesses the nation’s largest E-Prescribing master patient index (MPI) utilizing industry standard transactions at the point of sale. The program has identified that between 6% – 14% of all claims submitted under payer of last resort health plans have other pharmacy coverage. Integration of ProTPL results in the real-time identification of claims that have other coverage. These claims can be cost avoided along with all future claims for that recipient. This effectively eliminates the post-payment recovery process all together. In addition, the captured pharmacy information can be cross walked to the recipients active medical coverage information for added cost avoidance savings.

 

Exhibitors

Mom’s Meals NourishCare Mom’s Meals NourishCare provides high-quality meal solutions direct to the homes of senior’s and patient’s nationwide. Customers choose every meal every order from our broad selection of entrees, including those to support common health conditions. Mom’s Meals has been a leading nutrition provider for nearly 20 years.

 

healthwise Since 1975 our mission has been to help people make better health decisions. The Healthwise mission combined with our innovative spirit leads to health education, technology and services that power health partnerships. Healthwise solutions for Care Management, Digital Experiences, and Shared Decision Making give you a better way to deliver tailored, meaningful health education and show that it makes a difference. Learn more at www.healthwise.org/healthplans.

 

Media Partner

Managed Care Managed Care delivers high-interest articles and features developed through original research and writing. Its editorial mission is to advise managed markets physicians, pharmacists, and executives on the integration of the business and medical aspects of the rapidly changing managed care market. A strict fact-checking and peer-review process assures the accuracy and relevance of editorial content.

 

Medicaid Blackbook

 

FAQ

Are there group discounts available?

  • Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee

Are there discounts for Non-Profit/Government Organizations?

  • Yes – please call us at 800-743-8490 for special pricing

What is the cancellation policy?

  • Cancellations received 4 weeks prior to the event will receive a refund minus the administration fee of $225. Cancellation received less than 4 weeks prior to the event will receive a credit to a future event valid for one year.

Can the registration be transferred to a colleague?

  • Yes – please email us in writing at info@brinetwork.com with the colleague’s name and title

Where can I find information on the venue/accommodations?

  • Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.

What is the suggested dress code?

  • Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket

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