2023 Medicaid Managed Care Summit

March 30-31, 2023 * Embassy Suites Downtown * Nashville, TN

2023 Medicaid Managed Care Summit








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. Managed care plays a key role in the delivery of health care to Medicaid enrollees.


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, ensuring equitable access to care, expanding access to behavioral and mental health; improving outcomes and lowering costs; standards for provider network adequacy and 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 - Thursday, March 30, 2023

7:15am – 8:00am

Conference Registration and Networking Breakfast


8:00am – 8:15am

Chairperson’s Opening Remarks


8:15am – 9:00am

The Future of Oversight

The Office of Inspector General (OIG) recently issued a report that speaks volumes about the oversight of Medicaid managed care organizations.  As the OIG puts it, CMS has “opportunities” to “strengthen states’ oversight.”  An alternative framing would be that CMS and many states have not met minimum standards of stewardship for Medicaid funds and the beneficiaries in Medicaid managed care. This session will explore the future of oversight of Medicaid managed care and how to best ensure access to quality in Medicaid and CHIP managed care programs.


9:00am – 9:45am

Working with Medicaid Managed Care Organizations to Ensure Equitable Access to Advanced Primary Care

In new procurements and contracts, state Medicaid agencies are expecting more from Medicaid managed care organizations (MCOs), and are increasing requirements that promote primary care innovation, health equity, and community engagement. To meet these requirements, MCOs are increasingly working in partnership with community health centers, family planning clinics, and other safety-net providers to improve access to, and the quality of, primary care for individuals enrolled in Medicaid. This session will explore how states, Medicaid MCOs, and primary care teams can stay accountable to the communities they serve.


9:45am – 10:15am

Networking and Refreshments Break


10:15am – 11:00am

Expanding Access to Behavioral and Mental Health

Behavioral health conditions—including mental illnesses and substance use disorder (SUD)—are especially common among Medicaid enrollees. States are taking advantage of new federal policy options to address behavioral health issues in Medicaid and are also developing other initiatives to improve mental health and substance use outcomes. This session will provide insights on integrating behavioral health services within a comprehensive managed care arrangement and will help you understand how to develop integrated care approaches that leverage existing capacity and account for variations in managed care.


11:00am – 11:45am

Medicaid, Health Equity and Social Determinants of Health

The COVID-19 pandemic has highlighted and exacerbated longstanding racial and ethnic disparities in healthcare. Prior to the pandemic, people of color fared worse than white people across many measures, reflecting inequities within the healthcare system as well as across social determinants of health. Medicaid programs can help to address health disparities. This session will examine the role Medicaid can play in advancing health equity, including:

  • How does health coverage vary by race and ethnicity?
  • How can Medicaid help to reduce racial health disparities?
  • What are key issues to watch looking ahead?


11:45am – 12:30pm

State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid

State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. Common delivery and payment reform models used by state Medicaid programs include patient-centered medical homes (PCMHs), ACA Health Homes, accountable care organizations (ACOs), and episodes of care. However, there is variation in which models are most widely used, how states combine and implement these models, and how long states have been engaged in efforts to transform payment and delivery systems. Some models may be implemented in Medicaid fee-for-service (FFS) delivery systems while other payment and delivery system reform models are implemented through managed care. This session will explore:

  • What delivery system and payment reform initiatives are in place across states?
  • How are states using financial incentives and non-financial incentives as part of efforts to improve quality and outcomes?
  • How are states leveraging managed care plan contracts to advance delivery system and payment reform initiatives?


12:30pm – 1:30pm

Lunch Break


1:30pm – 2:15pm

Implementing Tech-Enabled Innovation in Medicaid Managed Care

As healthcare organizations increasingly use technology-enabled innovation to improve quality and enhance access to care, it is important for states and health plans to ensure that Medicaid populations have equitable access to beneficial technologies available to commercial and Medicare populations. Tech-enabled solutions include a wide variety of interventions such as telehealth, texting, health education apps, cross-sector data-sharing, electronic health records, e-prescribing, and in-person care delivery that integrates technology.

This session will explore the opportunity of technology-enabled innovation to improve care for Medicaid populations and how state Medicaid agencies and plans can support implementation of new technologies within Medicaid managed care programs.


2:15pm – 3:15pm

Panel: Medicaid Managed Care Industry Trends

Medicaid continues to be the dominant health insurance program in the U.S. as measured by enrollment and remains the largest source of funding for health-related services for people with low income. This session will provide an overview of Medicaid managed care trends, including the modernization of Medicaid, business model transformation, healthcare reform, healthcare ecosystems, Medicaid expansion, and consumerism.


3:15pm – 4:15pm

Networking and Refreshments Break


4:15pm – 5:00pm

The Role of Medicaid Managed Care Plans in Addressing the Opioid Crisis

Medicaid managed care plans are poised to play a significant role in helping states address the opioid crisis by incentivizing utilization of effective therapies and developing policies that help stem the flow of prescription opioid drugs. Health plans are also developing models aimed at coordinating and improving treatment of opioid use disorder. This session will examine opioid initiatives and a roadmap for future treatment and prevention strategies.



End of Day One

Day Two – Friday, March 31, 2023

7:15am – 8:00am

Networking Breakfast


8:00am – 8:15am

Chairperson’s Recap


8:15am – 9:00am

Standards for Provider Network Adequacy

CMS issued final rules for provider network adequacy in Qualified Health Plans (QHPs) offering coverage in the Marketplaces that the federal government operates through HealthCare.gov. Under these rules, which come with the title, “Notice of Benefit and Payment Parameters” (NBPP), CMS will require QHP provider networks to meet minimum time-and-distance standards beginning in 2023 and minimum standards for appointment wait times beginning in 2024. Strong network adequacy standards are necessary to achieve greater equity in healthcare and enhance consumer access to quality, affordable care through the Marketplaces. The same applies to the other coverage programs that CMS administers—Medicare, Medicaid and CHIP. In each of these programs, managed care plans are paid to organize provider networks to deliver covered services to beneficiaries. If the networks are not adequate, beneficiaries will have difficulty accessing the services they need. The starting point for access is the setting and enforcement of network adequacy standards. This session will examine all this and more related to standards for provider network adequacy.


9:00am – 9:45am

Fee-for-Service vs. Managed Care
States are continually challenged by the high and growing cost of caring for people in need of long-term services and supports (LTSS). As a result, we’re seeing an increasing number of states providing LTSS through capitated Medicaid managed care programs called managed long-term services and supports (MLTSS). States look to MLTSS programs in an effort to rebalance their Medicaid expenditures away from institutional care and toward home- and community-based services. This provides a streamlined way for beneficiaries to access all of the services necessary to live their best lives in the location of their choosing. This session will break down the difference between providing LTSS through a managed care model versus a fee-for-service model.


9:45am – 10:15am

Networking and Refreshments Break


10:15am – 11:00am

Quality and Accountability in Medicaid Managed Care

Over the past two decades, state Medicaid programs have been on a steady march away from fee-for-service toward payment and delivery systems designed to bring greater budget predictability, quality and accountability. For most states, this has meant increasing reliance on Medicaid managed care. Today, managed care is the primary delivery system for Medicaid nationally. With this growth has come similar growth in expectations. States are covering a broader array of services for more high-need enrollees, bringing more rigor to their contracting, oversight, and payment processes, and holding managed care plans accountable for achieving targeted goals. This session will explore tips on leveraging managed care accountability tools, locating state quality data, and improving state reporting on health disparities.


11:00am – 11:45am

SUD Treatment through Medicaid Managed Care and ASAM Criteria

As the opioid epidemic continues, Medicaid programs across the country are increasingly taking on more responsibility to provide beneficiaries with substance use disorder treatment, including inpatient treatment. One strategy states are using is applying for an SUD Section 1115 Demonstration waiver (SUD waiver) from CMS to expand Medicaid-funded treatment options. Some states with approved SUD waivers have formally implemented the American Society for Addiction Medicine (ASAM) Criteria to promote consistency in client placement for SUD treatment. The ASAM Criteria is a clinically driven multidimensional client assessment model that emphasizes treatment outcomes, client-specific lengths of service, and a team-based approach to care. This session will feature a state that implemented their SUD waiver, who will profile how the ASAM Criteria is used within the context of managed care and utilization review, and the challenges and best practices associated with its use.


11:45am – 12:30pm

Innovations in Medicaid Managed Care Pharmacy: Providing Access Innovative Drug Therapies

The future continues to bring tremendous opportunities with revolutionary new drug therapies. Innovative new therapies also bring the challenge of affordable access and Medicaid managed care is no exception. Growth in Medicaid managed care is likely to continue because of program expansion and the transition of complex high-needs populations into managed care—and despite any enrollment reductions that result from community engagement and work requirements. Innovations in drug therapies will require innovations in Medicaid Managed Care in order to provide sustainable access for an expanding population. Topics to be discussed will include:

  • Medicaid drug pricing and the need for transparency
  • Aligned incentives to support whole person care
  • Carve-in, carve-out and hybrid models



Conference Concludes



Workshop - Friday, March 31, 2023

12:45pm – 2:45pm

Workshop: Addressing Health Equity in Medicaid Managed Care

Advocates have long pushed states and CMS to improve Medicaid data collection and reporting on health disparities with little to show for it. It is now long past time for the agency, Congress and other health policymakers to fulfill that principle with real and urgent action. This session will provide tools to understand the various Medicaid managed care requirements for collecting and reporting data on health equity. Many barriers, including both a lack of funding and political will, continue to obstruct such reporting. We will also explore the potential of CMS’s new data reporting system, T-MSIS, for improving the quality, frequency and transparency of health disparities data in Medicaid.



Embassy Suites Downtown
708 Demonbreun Street
Nashville, TN 37203

Mention BRI Network to get the discounted rate of $269/night

Sponsors and Exhibitors



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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