2021 Medicaid Managed Care Summit
Strategies to Serve the Rapidly Expanding Medicaid Population
October 4-5, 2021 * Loews Miami Beach Hotel * Miami, FL

2021 Medicaid Managed Care Summit

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COVID-19 Advisory: BRI Network holds above all else, the health & safety of our attendees and their families. Currently this event is scheduled as an in-person event. We will however, continue to monitor and follow recommendations regarding capacity from CDC and other health agencies.

About the Conference

Medicaid is the single largest source of health coverage in the U.S. As the nation’s most vulnerable populations deal with the lasting health & economic effects of the COVID-19 pandemic, we will delve into the new strategies that both state agencies and health plans are using to continue providing the highest quality Medicaid services. With the marked increase and necessity of virtual healthcare & telehealth, providers are now positioning to reach their members on an unprecedented level, while still factoring in established social determinants of health.

Now more than ever, Medicaid leadership must convene to more effectively and rapidly address the physical and behavioral needs of a higher than normal at risk population, engage membership and improve outcomes.
By attending the 2021 Medicaid Managed Care Summit, you will learn what leaders are doing to respond to the changes resulting from the health pandemic and the current Presidential Administration.

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, October 4, 2021

7:15am – 8:00am
Conference Registration & Networking Breakfast

8:00am – 8:15am
Chairperson’s Opening Remarks

8:15am – 9:00am
Keynote: Update from CMS

Federal rules governing Medicaid managed care are important as managed care remains the predominant healthcare delivery system in most states. The speaker will address CMS regulations around Medicaid managed care, including several major changes regarding network adequacy, beneficiary protection, quality and payment.

9:00am – 9:45am
Transition to Managed Care in the Time of COVID

This presentation will provide insights to North Carolina’s transition to a managed care system during the pandemic. The presentation will outline how the state Medicaid agency adjusted its plans due to lessons learned from COVID including program design and long-term expectations.

Dave Richard
Deputy Secretary
North Carolina Medicaid

9:45am – 10:15am
Networking & Refreshments Break 

10:15am – 10:55am
Healthmine

10:55am – 11:40am
Integrating Behavioral Health into Medicaid Managed Care

Medicaid enrollees with behavioral health needs have a high prevalence of chronic conditions and are often frequent users of behavioral health services. More and more states are pursuing managed care models that integrate behavioral health services to improve outcomes, enhance care coordination, and control costs for this high-need population. This session will explore emerging options for integration, including comprehensive managed care carve-in, specialty plans for individuals with serious mental illness, and hybrid models. Also learn about balancing oversight and collaboration in state-plan relationships, engaging key stakeholders, and advancing clinical integration and cross-system accountability.

Kathleen Dougherty
Chief, Medicaid Managed Care Operations
State of Delaware Health and Social Services 

Maureen Ludlam, RN, CCM
Director Long Term Supports and Services
LTSS Highmark Health Options 

11:40am – 12:25pm
Phase Out of the Maintenance of Effort Requirement

The Families First Coronavirus Response Act (FFCRA) offered states a significant increase in Medicaid funding (a 6.2% FMAP increase), but in exchange for the additional funds, states were required to comply with strong maintenance of effort (MOE) protections. As we look forward to the end of the PHE, the disenrollment of the individuals who have maintained coverage as a condition of the MOE requirement comes with considerable challenges. The speaker will discuss the strategies New Mexico is working through, in partnership with their Managed Care Organizations and the state health insurance exchange, to minimize the burden on state staff, state budgets, and most importantly, to avoid coverage loss for members by ensuring a smooth transition to other sources of coverage.

Nicole Comeaux, JD, MPH
Medicaid Director
State of New Mexico 

12:25pm
Lunch Break 

1:10pm – 1:50pm
DCI Software 

1:50pm – 2:35pm
Telehealth in Managed Care: Real-Time Care Coordination

To provide quality care to complex patients, managed care health plans are required to deliver care coordination services, either internally or by contracting with other organizations. These services include health assessments and management for members who have complex care needs, including multimorbidity of physical and behavioral conditions, along with social or environment considerations. Telehealth allows patients to self-monitor their vitals daily and answer questions on how their symptoms are progressing. Moreover, it allows clinicians to receive alerts if there are any high-risk readings and to be proactive about addressing them. Most importantly, telehealth helps empower patients and creates self-management habits. In this session, learn about how the use of telehealth in managed care operations:

  • Empowers a patient to learn more about their condition
  • Promotes self-monitoring
  • Augments a care coordinator’s reach
  • Allows for more actionable interventions by the patient’s primary care team to prevent unnecessary healthcare spend and improve quality of life.

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

2:35pm – 3:05pm
Networking & Refreshments Break 

3:05pm – 4:05pm
Panel: Partnering with Community Providers to Address Enrollees’ Social Needs

Housing, nutrition, transportation, and other needs significantly affect health outcomes, a growing body of literature shows. States seeking to improve Medicaid beneficiaries’ health and limit unnecessary healthcare spending are increasingly focusing on how they can ensure that beneficiaries can obtain these services. This session will explore how states can build partnerships to ensure beneficiaries’ health-related needs are met in a number of ways.

Moderator:

Jan Smith Reed
Director, US Healthcare
T-Base Communications 

Panelists:

Katie Domalakes, MSW/LSW
Senior Director, Clinical Affairs and Program Development
UPMC Health Plan 

Joseph Stankaitis
Chief Medical Officer
Monroe Plan for Medical Care 

4:05pm – 4:50pm
Advancing Primary Care Innovation in Medicaid Managed Care

Primary care is the essential backbone of any healthcare system, particularly for low-income populations. Across the country, a variety of advanced primary care models are offering new ways to enhance primary care delivery. Despite the growth of these models, however, low-income individuals have consistently low rates of primate care utilization as well as poor health outcomes. This session will examine how strengthening primary care delivery through managed care can improve access, quality and efficiency of healthcare services for this often-at-risk population.

Lance Donkerbrook
Chief Executive Officer
Commonwealth Primary Care ACO 

4:50pm – 5:35pm
Impact of COVID-19 on Medicaid Managed Care Performance

States, healthcare providers, managed care organizations, and accountable care organizations are considering the impact of COVID-19 on health care quality and spending. States are examining their value-based payment programs and evaluating modifications to their quality measurement and cost performance policies, particularly those arrangements that hold entities financially accountable for performance. This session will examine performance management related to Medicaid managed care performance incentives, and policy options for state consideration.

Mark Kraics
Medicaid Managed Care Director
State of Rhode Island 

5:35pm
End of Day One

Day Two – Tuesday, October 5, 2021

7:15am – 8:00am
Networking Breakfast

8:00am – 8:15am
Chairperson’s Recap of Day One

8:15am – 9:00am
Managing Care for High-Cost, High-Risk Medicaid Members

A long standing question in healthcare is how to cut costs while improving outcomes, especially with a population who are most at-risk. At the University of Utah Intensive Outpatient Clinic, we have been able to partner with the University of Utah Health Plan to identify the highest utilizers of our system and treat them at a clinic specifically designed to meet their individual needs. With a team of physicians, social workers, and case managers, we have created a unique and effective clinic that addresses the medical, behavior, and social needs of at-risk patients, all under one roof. Using population health initiatives, the payer and providers have demonstrated successful outcomes for all involved parties including, most importantly, these high-acuity individuals.

Stacey Bank, MD
Medical Director, Intensive Outpatient Clinic
University of Utah Health 

Chad Westover
Chief Executive Officer
University of Utah Health 

9:00am – 9:45am
Integrating Social Determinants of Health into Medicaid Managed Care With a 1915(i) Amendment

States have several options on how to advance social determinants of health in Medicaid.  One option is a 1915(i) state plan amendment.  We believe North Dakota has the most extensive 1915(i) amendment in the country.  The target population is Medicaid clients with significant behavioral and mental health diagnoses.  This session will describe the State’s journey to CMS approval of North Dakota’s 1915(i) and the lessons learned from phase one of the implementation.

Caprice Knapp
Medicaid Director
North Dakota Department of Human Services 

9:45am – 10:15am
Networking & Refreshments Break 

10:15am – 11:00am
Addressing Social Determinants of Health to Reduce Health Disparities

With considerable evidence that interventions aimed at social determinants of health can positively influence costs and health outcomes, the discourse is changing among policy influencers and providers to look beyond clinical and disease conditions and address the environmental factors that impact our healthcare system. As the healthcare landscape continues to evolve, the shift to value-based payments is reframing the paradigm for lowering costs while increasing care quality. This session will examine the benefits of these efforts and how they extend beyond reduced care costs to include reducing health equity gaps and reducing long-standing health disparities.

Jacey Cooper
California State Medicaid Director
Chief Deputy Director, Health Care Programs
California Department of Health Care Services 

11:00am – 11:45am
The Value of Member Advisory Councils in Managed Care

Engaging beneficiaries in Plan governance is a vital component to any health organization seeking to better understand their consumers health needs, connect to the communities they serve and improve health outcomes. A growing number of health plans across the country are understanding that implementing Member Advisory Councils is one of the best ways to encourage valuable feedback, give members a voice in their care and give the plan and inside track on what is important from a member and community perspective. This session will discuss best practices when implementing a Member Advisory Council, creating an environment that encourages meaningful feedback, and utilizing that feedback in plan operations.

Tina Davis
Director, Outreach and Health Advocacy
First Choice VIP Care PLUS 

11:45am – 12:30pm
The CMS Interoperability Rule and the Need for State Medicaid Agency and Medicaid Managed Care Organization Collaboration

The CMS Interoperability Rule requires both State Medicaid/CHIP agencies and Medicaid/CHIP Managed Care Organizations to enable Medicaid/CHIP eligible individuals to easily access their health care data. This session will highlight how states are working alongside and with managed care organizations to ensure the app developer community is aware of this market and to ensure the beneficiary finds value in this new opportunity.

Elena Nicolella
Executive Director
New England States Consortium Systems Organization

12:30pm
Conference Concludes

Workshop – Tuesday, October 5, 2021

12:45pm – 2:45pm

Workshop A: State Approaches to Value-Based Payment in Medicaid Managed Care
Across the country, state Medicaid programs increasingly adopting value-based payment strategies to drive health care delivery system change and improve patient outcomes. States have a unique opportunity to used managed care organization (MCO) contracts and relationships to accelerate wide-scale adoption of value-based payment at the provider level. This session will review the multiple strategies used by states to advance value-based payment strategies through managed care. This presentation will also outline New York’s experience in designing and implementing a value-based payment strategy in Medicaid managed care, and lessons learned for policy makers, MCOs and providers. In 2015, New York committed to a goal of ensuring 80-90% of all Medicaid managed care payments would be value-based by 2020. Through extensive stakeholder engagement, partnership with CMS, and steady commitment to its goal, the state achieved and exceeded its target in 2020. This session will also include a current state overview of contract requirements and request for proposals to advance value-based payment goals, practical approaches for promoting value-based payment goals through MCO contracts, and guidance for assessing MCO interest in and experience with value-based payments. Attendees will leave this session with a better understanding of state strategies to advance value-based payment in Medicaid, trends in the current Medicaid environment, along with a deep dive into the New York experience and recommendations for applying these principles in other states.

Kalin Scott
Chief Innovation Officer
Helgerson Solutions Group LLC


Workshop B:
Tapping Into Community Based Networks – A Plan that Addresses the “Blind Spots” and Maximizes the Partnership Potential in Care Delivery
Join Guidehouse and partners in an engaging conversation on ways health plans can maximize the care experience through their CBO partnership. Supported by all sectors, this dialogue continues to be timely and opportunistic as health plans partner with existing, asset-rich CBO networks to efficiently deliver a wide range of care and strongly support the community living needs of members. This workshop will allow participants to engage in timely, tangible discussions relevant to lessons learned regarding CBO partnerships throughout the pandemic, and how such insights help position more resilient transformation. Participants will specifically discuss:

  • Scaling partnership strategy to address key health performance gaps
  • Challenges and opportunities to bolster business acumen for ongoing partnership success
    • Funding sources, technology platforms, etc.
  • Measuring ROI and telling the value story of community partnerships
  • Role of health equity and other concepts

Lance Robertson
Director, Healthcare
Guidehouse

Featured Speakers

Dave Richard

Dave Richard

Deputy Secretary

North Carolina Medicaid

Kathleen Dougherty

Kathleen Dougherty

Chief, Medicaid Managed Care Operations

State of Delaware Health and Social Services

Maureen Ludlam, RN, CCM

Maureen Ludlam, RN, CCM

Director Long Term Supports and Services

LTSS Highmark Health Options

Nicole Comeaux, JD, MPH

Nicole Comeaux, JD, MPH

Medicaid Director

State of New Mexico

Joann Sciandra, MHA, BSN, RN, CCM

Joann Sciandra, MHA, BSN, RN, CCM

Vice President, Care Coordination and Integration

Geisinger Health Plan

Katie Domalakes, MSW/LSW

Katie Domalakes, MSW/LSW

Senior Director, Clinical Affairs and Program Development

UPMC Health Plan

Lance Donkerbrook

Lance Donkerbrook

Chief Executive Officer

Commonwealth Primary Care ACO

Mark Kraics

Mark Kraics

Medicaid Managed Care Director

State of Rhode Island

Joseph Stankaitis

Joseph Stankaitis

Chief Medical Officer

Monroe Plan for Medical Care

Jacey Cooper

Jacey Cooper

California State Medicaid Director, Chief Deputy Director, Health Care Programs

Department of Health Care Services

Stacey Bank, MD

Stacey Bank, MD

Medical Director, Intensive Outpatient Clinic

University of Utah Health

Elena Nicolella

Elena Nicolella

Executive Director

New England States Consortium Systems Organization

Jan Smith Reed

Jan Smith Reed

Director, US Healthcare

T-Base Communications

Chad Westover

Chad Westover

Chief Executive Officer

University of Utah Health

Caprice Knapp

Caprice Knapp

Medicaid Director

North Dakota Department of Human Services

Tina Davis

Tina Davis

Director, Outreach and Health Advocacy

First Choice VIP Care PLUS

Kalin Scott

Kalin Scott

Chief Innovation Officer

Helgerson Solutions Group LLC

Lance Robertson

Lance Robertson

Director, Healthcare

Guidehouse

Mildred Menos

Mildred Menos

Director, Member Advocacy and Community Outreach Transformation

Horizon Blue Cross Blue Shield of New Jersey

Venue

Loews Miami Beach Hotel
1601 Collins Avenue
Miami Beach, FL 33139
305-604-1601

Mention BRI Network to get the discounted rate of $239/night or use link below to make reservations:

https://www.loewshotels.com/miami-beach/bri-network

Sponsors and Exhibitors

Lead Sponsor

Acumen is the original Fiscal/Employer Agent serving participants/employers since 1995 across the country. Acumen empowers individuals to live the life they choose and we work every day to ensure this is a reality for our customers

Executive Sponsor

HealthMine is the only Health Action Engagement company originally built inside a Value-Based Insurance Design (VBID) health plan that continuously empowers and incentivizes individuals to take action and improve their health. HealthMine’s services help health plans target and empower individuals to complete health actions through advanced analytics, prioritized clinical pathways and individualized member engagement to improve clinical quality and increase profitability. HealthMine is online at www.healthmine.com

 

Associate Sponsor

T-Base is the largest and fastest growing North American provider of high-quality and secure alternate format communications, providing alternate format and digital communications for end users who are low vision or blind.  Serving International Banking, Healthcare, Telecommunications, Education, and Government we are HIPPA certified, PCI-DSS, SSAE 18 and SOC2 Type2 Certified. Consult with T-Base for all things Digital, large print reflowed documents, audio, Braille and all other alternate formats.

Breakfast Sponsor

PointRight develops advanced analytics solutions that empower SNFs, payers, and other post-acute care stakeholders to improve facility performance and patient outcomes.  Care collaboration and post-acute partnerships continue to drive healthcare advancement and the urgent call for relevant and predictive analytics is one PointRight is here to answer.

WiFi Sponsor

MedImpact MedImpact is a highly experienced public sector PBM with Medicaid experience in 14 states helping to manage over 5 million lives. We also support Medicare and Exchange programs in 16 states. We are striving to bring a new and creative way to manage your members and improve their experience.

As Medicaid programs continue to evaluate their business models, embracing carved out PDL/PBM programs, MedImpact offers the opportunity for states to continue the high-touch concepts prevalent in managed care and deliver them in a fee-for-service compliant model leveraging proven technology and URAC and NCQA accredited processes to provide high quality member-centric programs to our clients.

Lanyard Sponsor

PursueCare offers virtual evidence-based addiction treatment for opioids, alcohol, and other substance use disorders, all through a mobile application. PursueCare offers a transitional digital addiction treatment program for patients, particularly those experiencing significant barriers to in-person care, by partnering with health systems, community health partners, employers, and health plans. Patients can also seek treatment without a referral. PursueCare is available in Kentucky, Ohio, New Jersey, Pennsylvania, West Virginia, and all of New England, with national expansion plans. For more information, visit www.pursuecare.com.

Exhibitors

Sandata Technologies, LLC

Sandata Technologies, LLC, is the leading U.S. provider of technology that makes it easier for Medicaid payers and providers to work together from day one. As the national Electronic Visit Verification leader, Sandata’s suite of solutions offers its 15,000+ agencies, 19 state Medicaid agencies, and 50+ Managed Care Organizations tools and capabilities to advance quality of care and improve patient and client outcomes.

Streamline Healthcare SolutionsStreamline Healthcare Solutions has been developing and implementing software solutions to behavioral healthcare organizations nationwide since 2003. Our web-based software solutions are well suited for organizations that wish to have one system that can map and incorporate its entire business processes to a single solution, and then continue to evolve as business needs develop. Our electronic health record solution, SmartCare™, is a web-based browser based enterprise-wide application built for the delivery, management and coordination of behavioral healthcare services. The SmartCare application is deployed in a live environment at all service levels.

Unite Us is a technology company that builds coordinated care networks of health and social service providers. With Unite Us, providers across sectors can send and receive secure electronic referrals, track every person’s total health journey, and report on tangible outcomes across a full range of services in a centralized, cohesive, and collaborative ecosystem. Unite Us’ dedicated team builds authentic, lasting partnerships with local organizations to ensure their networks have a solid foundation, launch successfully, and continue to grow and thrive. This social infrastructure helps communities transform their ability to work together and measure impact at scale.

Aspira Women’s Health Inc. is transforming women’s health with the discovery, development, and commercialization of innovative testing options and bio-analytical solutions that help physicians assess risk, optimize patient management, and improve gynecologic health outcomes for women.  Aspira Women’s Health is particularly focused on closing the ethnic disparity gap in ovarian cancer risk assessment and developing solutions for pelvic diseases such as pelvic mass risk assessment and endometriosis. OVA1plusTM combines our FDA-cleared products, OVA1® and OVERA®, to detect risk of ovarian malignancy in women with adnexal masses. Aspira GenetiXTM testing offers both targeted and more comprehensive genetic testing options with a gynecologic focus.  With over 10 years of expertise in ovarian cancer risk assessment, Aspira Women’s Health is delivering a portfolio of pelvic mass products over a patient’s lifetime with our cutting-edge research. The next generation of products in development are OVASightTM and EndoCheckTM. Visit our website for more information at www.aspirawh.com.

Over 12M adults in the US are living with a serious illness, and they often need care that extends beyond curative treatment. That’s where Vynca comes in. Our serious illness management platform couples technology and analytics with our board-certified, physician-led palliative care services, helping care teams manage their most vulnerable populations. By addressing physical, mental, spiritual, and social needs to improve the individuals’ quality of life, we provide whole-person care, anytime, anywhere.

Media Partner

 

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

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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