Event Schedule
Pre-Conference Maternal Health Spotlight
Paving the Way to Improving Maternal Health at the CMS Innovation Center
Karin E. Bleeg, MPH,
Acting Director, Division of Health Innovation and Integration (DHII),
CMS Innovation Center
Leveraging Culturally Competent, Personalized Maternal and Infant Care Models: Linking Women to Equitable Clinical Interventions and Evidence-Based Community Supports
Engaging Medicaid Members with a Maternity Benefit that Meets Their Needs from Conception to Postpartum: Identifying Risks, Addressing SDoH, and Enhancing the Member Experience
Panel Discussion: Transforming Medicaid to Combat the Maternal Health Crisis: Reducing Disparities and Advancing Improved Access to Critical Services that Impact Maternal Morbidity and Support Healthy Outcomes
Panelists:
Jacqueline Collins, RN, CPHQ, MSML,
Senior Director,GA and AR Quality Improvement,
CareSource
Erica Moore-Smith, LCSW,
Supervisor, Social and Community Services,
Inland Empire Health Plan
Chantel Neece DNP, MBA, APRN, FNP-BC, GERO-BC, CPHQ, SSBBP
Sr. Director- Maternal/Child Services & Member SDOH
Sentara Health Plans
Harvey Karp, MD
Co-Founder
Happiest Baby
Welcome Reception
Chairperson’s Welcome
Clay Farris,
Founder and Practice Lead,
Mostly Medicaid
MEDICAID 2025 LANDSCAPE
Taking a Look at the Political Landscape: What Election Results Mean for the Future of Medicaid
Clay Farris,
Managing Editor,
Mostly Medicaid
Value-Based Contracting: Stop Swimming Against the Tide and Build a Boat
- Current state of value-based contracting
- Where it works and doesn’t and why
- What are we really trying to do, and maybe better ways to do it
- How do we go forward?
Mike Rapach,
CEO,
CareFirst Community Health Plan of Maryland
Panel Discussion: Addressing Social Needs through Medicaid: Screening for SDoH and Mitigating the Negative Health Impacts of Unmet HRSN
Moderator:
Tiffany Stone,
Deputy Director, Government Programs,
Michigan Association of Health Plans
Panelists:
Kanita Bourne, LCSW, MPA,
Manager, Social & Community Service,
Inland Empire Health Plan
Julie Joseph, MD
Chief Medical Officer
BlueCare Tennessee
Melissa Smeltzer, MSN, BSN, RN, CPHQ, PAHM
Director of Quality Improvement
BlueCare Tennessee
CASE STUDY: Bending the Cost Curve: North Carolina’s Successful Strategy Investing in Whole Person Health
Kody Kinsley,
Secretary,
North Carolina Department of Health and Human Services
Morning Refreshment Break
Panel Discussion: Managing the Evolving Pharmacy Benefit in Medicaid
- GLP-1s – Balancing Access vs. Cost
- Background – GLP-1 agonists (Glucagon-like-peptide-1): Class of medication that regulates blood sugar, appetite, and digestion. Current indications can include type 2 diabetes, obesity, or both. Examples of GLP-1’s include: Ozempic, Wegovy, and Mounjaro
- Medicaid coverage for diabetes common, but coverage for weight loss varies significantly by state
- Levers to Control Use (e.g., Prior Authorization, Utilization Management, Lifestyle Programs)
- Fraud, Waste, & Abuse Concerns
- New & Emerging Gene and Cell Therapies (e.g., Sickle Cell, Hemophilia, HIV PrEP)
- Significant advancement comes with high sticker price
- Not new per se, but also biosimilars – what does this look like moving forward for Medicaid
- Expanded Pharmacist Scope of Practice/Authority
- Pharmacists continue to get more and more added to their ‘list of services’ (e.g., vaccinations, blood pressure readings)
- How to deal with given workforce constraints
Moderator:
Stephanie Schlomer, MPH,
Regulatory & Quality Strategist, Regulated Markets—Health Insurance Marketplace & Medicaid,
Express Scripts by Evernorth
Panelists:
Tracey Davis, PharmD,
Director of Pharmacy,
AmeriHealth Caritas District of Columbia
Risk Adjustment and Revenue Integrity…then what? Discover the Main Reason Your Plan is Underperforming
Amanda Brown,
Vice President - Revenue Integrity,
CoventBridge Group
Ray Evans,
Vice President – Healthcare Sales,
CoventBridge Group
CARE DELIVERY
CASE STUDY: Integrating Community Health Workers into Healthcare Teams: Leveraging These Key Resources for Health System Navigation and Resource Coordination, Health Promotion and Education, and Screening and Assessment
Jim Milanowski,
CEO,
Genesee Health Plan
Luncheon
Panel Discussion: Leveraging a Care Integration Strategy to Optimize the Patient Experience and Advance Whole Health: Addressing Coverage Barriers and Care Gaps for High-Cost, High-Risk Populations
Panelists:
Jacqueline Collins, RN, CPHQ, MSML,
Senior Director, GA and AR Quality Improvement,
CareSource
Dorthy K. Young, Ph.D., MHSA,
Chief Health Data, Operations and Research Officer,
Mississippi State Department of Health
Rafi Cices,
Head of BOI, Coding & Billing,
CityBlock Health
Hospital to Home Continuity of Care for NICU Graduates
Developing a D-SNP Model of Care: Addressing the Barriers that the Dual Eligible Population Faces through Tailored Solutions within a Unified Framework
Chris Esguerra, MD,
Chief Medical Officer,
Health Plan of San Mateo
Leveraging Chronic Care Models that Advance Health Equity and Drive Improved Outcomes
Afternoon Refreshment Break
Panel Discussion: Facilitating Transitions from Incarceration into the Community: Ensuring Continuity of Coverage, Reducing Disparities in Care, and Decreasing Recidivism Rates
Moderator:
Kevin Bagley, DHA, MBA, FACHE,
Former Medicaid Director,
State of Nebraska
Panelists:
Megan Raleigh LISW-S,
Manager of Addiction Services County Corrections,
MetroHealth
Creating Access to Care through Delivering High Quality Networks: Addressing the Unique Needs and Health Equity Considerations of Medicaid Members and Ensuring Network Adequacy
Transforming Medicaid: Integrating Whole Health and Sustainable Solutions for Healthy Aging
In this presentation, we will explore how Medicaid can be leveraged to deliver comprehensive care that addresses physical, mental, behavioral, and health-related social needs. We’ll focus on enhancing the consumer journey and ensuring sustainability in aging services by:
- Whole Health Approach for Aging Populations: Designing Medicaid solutions that integrate medical care with mental health and social needs, recognizing that mind and body are inseparable for effective, person-centered care.
- Addressing Health-Related Social Needs: Incorporating housing, nutrition, transportation, and social connectivity into Medicaid strategies to create a supportive environment for older adults.
- Enhancing Transitions of Care: Developing seamless care pathways from hospital to home or community to long-term care, aimed at reducing readmissions and improving health outcomes.
- Sustainable Models of Care Delivery: Leveraging cross-sector partnerships and value-based care to ensure continuity, access, and cost-effective care for aging populations.
Mina Chang, PhD,
Deputy Director, Chief Analytics & Compliance Division,
Ohio Department of Aging
Cocktail Reception
SPONSORED BY:
CARE DELIVERY(continued)
CASE STUDY: Leveraging Electronic Visit Verification (EVV) Data to Monitor Service Delivery: Ensuring Services are Documented, Preventing Fraud and Abuse, and Managing Care and Resources Efficiently
Alexandra (Ali) Fernández, MHS,
Bureau Chief, Bureau of Long Term Care, Division of Medicaid,
Idaho Department of Health and Welfare
Chris Barrott,
Program Manager, Division of Medicaid,
Idaho Department of Health and Welfare
Developing, Testing, and Evaluating Alternative Payment Methodologies: Delivering Medical and Administrative Cost Savings while Enhancing Clinical Quality
CASE STUDY: A Triple Crown of Care: Efficiency, Access, and Continuity with MCOs and KHIE
Managed Care Organizations (MCOs) derive substantial benefits from state-based Health Information Exchanges (HIEs) such as the Kentucky Health Information Exchange (KHIE), which enhance data sharing, improve interoperability, and facilitate superior care coordination, leading to better patient outcomes. KHIE enables MCOs to gain a comprehensive understanding of patient health, supporting effective management of complex and chronic conditions. HIEs like KHIE promote seamless collaboration across healthcare providers, ensuring coordinated and patient-centered care. This interconnected approach not only improves health outcomes but also results in significant cost savings, essential for MCOs aiming to manage expenses while delivering high-quality care. This presentation will illustrate how MCOs leverage KHIE data to deliver superior care with a more complete understanding of their patients.
Andrew C. Bledsoe,
Deputy Executive Director, Office of the Inspector General,
Kentucky Health Information Exchange
CASE STUDY: How New Jersey Leveraged Medicaid-Funded Infrastructure to Expand Interoperability to LTCs
As long-standing facilitators of many statewide healthcare initiatives, the New Jersey
Department of Human Services (NJDHS) and New Jersey Health Information Network
(NJHIN) are leading the nation by driving cutting-edge interoperability efforts in their state
while ensuring healthy outcomes for more than 2.2 million Medicaid beneficiaries.
COVID-19 was the catalyst for a widespread push to connect the state HIE to public health
registries—a move that is paying dividends for providers today. Notably, New Jersey is also
one of the only HIEs to meaningfully support long-term care facilities, an often-overlooked
stakeholder in interoperability efforts. By leveraging existing Medicaid investments in
technology infrastructure, 97% of LTCs seamlessly connected to the HIE in just 6
months—an unmatched rapid deployment for this provider cohort.
Today, NJHIN connects and streamlines actionable patient information and this real-time
connectivity between public health and the private healthcare industry is key to enhancing
information sharing, improving coordination, enabling proactive measures, and supporting
data-driven decision making—ultimately leading to more effective and efficient public health
ecosystem.
In this presentation, Jennifer D’Angelo, Chief Operating Officer and the Executive Vice
President of NJII Healthcare Division will discuss how New Jersey collaborated to leverage
established Medicaid funded infrastructure to support the most vulnerable patients across
the care continuum. They will also share how other states can model their approach and
stretch Medicaid grounded investments to expand interoperability programs to other
stakeholders and support new use cases.
Jennifer D’Angelo,
Chief Operating Officer & Executive Vice President, Healthcare,
New Jersey Innovation Institute (NJII)
HEALTH EQUITY/HRSN
Panel Discussion: Operationalizing Health Equity Efforts in Medicaid: Identifying and Eliminating Barriers to Health Equity, Reducing Racial and Ethnic Disparities, and Closing Gaps to Accessing Essential Services
Panelists:
Gabriel Uribe, DSW,
Director, Health Equity Operations,
Inland Empire Health Plan
Chris Esguerra, MD,
Chief Medical Officer,
Health Plan of San Mateo
Sufian Chowdhury,
Co-Founder and CEO,
Kinetik
Morning Refreshment Break
Cultural Innovations for Advancing Health Equity in Medicaid: Lessons from African Principles
This presentation will explore how African cultural practices and principles can play a
transformative role in Medicaid innovations to advance health equity. With a focus on the
integration of values such as Sankofa, Eban, Ubuntu, and Sawubona, we will demonstrate
how these principles can be adapted into healthcare practices to reduce health disparities
and improve the quality of care for Black, Indigenous, and Medicaid populations. By sharing
stories of systemic issues in healthcare, this session will demonstrate how cultural values
can foster trust, build community-driven solutions, and drive culturally competent care,
creating a more equitable Medicaid system.
Application in Medicaid:
Medicaid could adopt a community-centered approach, providing a sense of security around
patients. Incorporating community health workers who understand the cultural contexts and
needs of Medicaid populations will build stronger bonds of trust, ensuring patients feel
protected and respected within the system. Medicaid must create systems where patients,
especially from marginalized communities, feel seen, heard, and valued so that healthcare
providers can acknowledge and respond to the full humanity of each patient.
By the end of this presentation, participants will:
- Develop a deep understanding of how key African cultural principles can be applied to innovate Medicaid services and improve healthcare delivery for marginalized populations
- Learn how these values can serve as tools to foster cultural competency, helping healthcare providers to better connect with and serve Medicaid patients from diverse backgrounds
- Learn how to implement cultural frameworks that foster trust and respect within Medicaid, resulting in more equitable healthcare outcomes for Black, Indigenous, and Medicaid populations
Rosemond Sarpong Owens, CDM/MPH,
Director, Health Equity Integration,
Blue Cross Blue Shield of Minnesota
CASE STUDY: Building a Community-Based Social Service Network: Partnering with CBO’s to Deliver Specific Social Needs
Gabriel Uribe, DSW,
Director, Health Equity Operations,
Inland Empire Health Plan
BEHAVIORAL HEALTH
Panel Discussion: Building Out the Behavioral Health Continuum of Care: Integrating Behavioral and Physical Health, Improving Mobile Crisis Services, and Advancing Substance Use Services and Supports
Moderator:
Diane Arms,
Director, Community Behavioral Health,
The Council on Recovery
Panelists:
Alyssa M. Ward, Ph.D., LCP,
Behavioral Health Clinical Director, Virginia Medicaid Line of Business,
Anthem HealthKeepers Plus
Christina Eyman, DBH, MHA,
Behavioral Health Integration Manager,
The Council on Recovery
Milla Jones, M.Soc.Sc.,
Program Coordinator, Strategic Initiatives, Medicaid & Long-Term Care,
Nebraska Department of Health and Human Services
Luncheon
Providing Behavioral Health Services to Medicaid Patients in Primary Care: A Payer/Provider Collaboration
Margaret Paroski, MD, MMM,
President & CEO and Chief Medical Officer,
Catholic Medical Partners
Barry Stelmach,
Chief Financial Officer,
Catholic Medical Partners
Carmela Costiniuk, B.Sc. OT, MHA, D. EdD (C),
Vice President, Population Health and Clinical Operations,
Catholic Medical Partners
OhioRISE: Youth Behavioral Health System of Care Coordination
- History and goals of OhioRISE
- View of the first 18 months of the program
- Projecting the future of OhioRISE in meeting the needs of youth with complex BH needs
Marti Taylor,
CEO, OhioRISE, Vice President,
Aetna/Medicaid
Supplementing and Expanding SUD Services: Leveraging On-site MMCO SUD Licensed Care Managers and Non-Licensed Peer Specialists
Stella V. Pappas, LCSW-R, ACSW,
Vice President, Behavioral Health,
Healthfirst
Graisy M. Pichardo, LMSW,
Director, Behavioral Health,
Healthfirst
Outreach, Engagement and Whole Health for SMI: A Peer-Led Approach for Individuals Disconnected from Mainstream Services
Joe Parks, MD,
Chief Medical Officer, firsthand, Medical Director,
National Council for Mental Wellbeing