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Agenda

Speaker Presentation
Module #1
Monday, February 1, 2021: 10:00-1:05 ET
THE SHAPE OF THE NEW MEDICAID MARKET
10:00

Chairperson’s Welcome

10:05

CASE STUDY: Accelerating Investments in SDoH to Close Gaps: Implementing Programs that Drive Care Coordination Among Physical Health, Behavioral Health and Social Services

  • Illustrating how to execute investments in safe and useful Health & Wellness and Strategic Resource Centers in the communities where members live with programs that really help
  • Adapting a business model during and post-pandemic that allows for more virtual programming that still attracts members and yields results.
  • Investing in technology to greater predict and mitigate the social needs that are impacting the health of our members.
  • Developing staffing models to target teams who can drive the coordination between social, behavioral and physical health, thereby, really moving the needle.

George M. Aloth, JD, CHC,President & CEO, CareFirst BlueCross BlueShield,Community Health Plan DC

10:30

Mitigating the Effects of Increased Enrollment at a Time of Declining State Revenue

Henry W. Osowski,Managing Partner,Strategic Health Group

10:55

Panel Discussion: Exploring the Impacts of the 2020 Election on the Future of Medicaid

Moderator:

Leonard Kirschner,Immediate Past President,AARP Arizona

Panelists:

Clay Farris,Managing Editor,Mostly Medicaid

Henry W. Osowski,Managing Partner,Strategic Health Group

11:30

Virginia's Efforts in Effectively Working with MCO's During COVID-19

Tammy J. Whitlock, MSHA, Deputy Director of Complex Care and Services,Virginia Department of Medical Assistance Services

11:55

Combining 1135 Waivers with 1115 Waivers to Reconfigure Medicaid to Expand Eligibility, Improve Coverage, and Promote Flexible Care Arrangements during COVID-19

12:20

CASE STUDY: Leveraging Home and Community Based Services to Serve Homebound Members and Support Social Distancing

Merrill Friedman, Senior Director, Disability Policy Engagement, Anthem

12:45

CASE STUDY: Advancing Telehealth in the Commonwealth: Providing Oversight, Guidance, and Direction to Healthcare Providers Delivering Care Using Telehealth

Robert E. Putt, Executive Director, Office of Health Data and Analytics,Kentucky Cabinet for Health and Family Services

Donna Veno, Acting Director, Division of Telehealth Services, Office of Health Data and Analytics, Kentucky Cabinet for Health and Family Services

1:05

Close of Module One

Module #2
Monday, February 1, 2021: 2:00-5:25 ET
CARE DELIVERY INNOVATIONS DURING COVID-19
2:00

Chairperson’s Welcome

2:05

Panel Discussion: Ensuring Patient-Centered Care Based on Member Values and Preferences for Those with Complex Care Needs During COVID-19

Panelists:

Jean Kveberg, PharmD, Pharmacy Services Manager, My Choice Wisconsin

Kathryn A. Teng, MD, MBA, FACP, Vice-Chair, Operations, Department of Medicine, Service line Director, Adult Health & Wellness Service Line, The MetroHealth System, Associate Professor,CWRU School of Medicine

2:40

CASE STUDY Developing Integrated Care Models to Address the Gaps in Care for Duals: Exploring the Future of Dual Eligible Demonstrations

There are roughly 12 million individuals dually eligible for Medicare and Medicaid in the U.S. Known as ‘duals’, they are typically medically and socially complex requiring a coordinated set of health care and social services. CMS is continuing to expand flexibilities through the financial alignment demonstration and permanently authorized Dual Eligible Special Needs Plans (DSNPs) to support coordination and integration efforts. As coordination and integration requirements continue to evolve, states and other stakeholders will benefit from increased understanding of and comfort with the various dual eligible programs. Identifying current gaps in care and state priorities will influence programmatic design to achieve stated goals.

By attending this session, the audience will learn:

  • The breadth of programs available for dual eligible.
  • Trends in care for dual eligibles and the emphasis on improved coordination and integration.
  • How integrated care models can promote priorities related to rebalancing to home and community-based services, beneficiary independence, improved outcomes, and decreased costs.

Sarah Rubin, National Director, Policy and Strategy,UnitedHealthcare Community and State

3:05

CASE STUDY: SPIAA - A Population Health Management Framework

Dr. Arakawa will share the new Population Health model, SPIAA, which is focusing on these key elements:

  • Stratify
  • Problem List
  • Interventions
  • Assignment
  • Assessment

Gordon Arakawa, MD, PhD,Medical Director,Central California Alliance for Health

3:30

CASE STUDY: COVID-19 Transportation:  Vermont's Process for Leveraging In-Network Ambulance and Public Transit Providers for Transportation to Keep Positive Individuals Out of Public Transportation and Congregate Housing

Bill Clark, Medicaid Compliance Officer,Department of Vermont Health Access

3:55

Population Health and Care Management Strategies: Leveraging Data and Technology to Proactively Target Care Coordination Efforts and Outreach During a Pandemic

Karissa Smith, LPC, CADC I,Director of Care Coordination,CareOregon

Summer Sweet,Triage and Data Integration Manager of Population Health,CareOregon

4:15

CASE STUDY: Leveraging Claims and Clinical Data to Identify High-Risk Members and Deploy Resources Accordingly

Joanne Scillia, Vice President, Medical Management, Affinity Health Plan

Michelle Squire, MSN, RN, CCM, Manager, Case Management, Affinity Health Plan

4:40

CASE STUDY: Prioritizing Preventative Care and Chronic Disease Management During a Pandemic

Jim Milanowski, President & CEO,Genesee Health Plan

5:05

CASE STUDY: Maryland’s Innovative Approach to Telehealth to Improve Access to Care During COVID-19

Melanie Cavaliere, Chief, Innovative Care Delivery, Center for Health Information Technology & Innovative Care Delivery,Maryland Health Care Commission

5:25

Close of Module Two

Module #3
Tuesday, February 2, 2021: 10:00-1:05 ET
SOCIAL DETERMINANTS OF HEALTH AND COMMUNITY PARTNERSHIPS
10:00

Chairperson’s Welcome

10:05

Panel Discussion: Evaluating the Impact of Social Determinants of Health on COVID-19 Outcomes: Coordinating Efforts with Community Programs and Resources to Address Inequalities and Disparities

Moderator:

Lauren Flynn Kelly, Managing Editor, AIS Health, an MMIT company

Panelists:

Jim Milanowski, President & CEO,Genesee Health Plan

Amy Riegel, Director, Housing, CareSource

Chris Norwood, Founder and Executive Director,Health People: Community Preventive Health Institute

Chenelle Harris, Founder,Count My Health

10:40

CASE STUDY: Leveraging Community Health Workers During the Pandemic: Utilizing Virtual and In-Person Workers as Agents of Change in the Community and to Maintain Healthcare Service Delivery

Preeti Nakrani, MPH, Be Healthy Medicaid ACO Program Manager,Health New England

11:05

CASE STUDY: Addressing Implicit Racial Bias as a Systems Intervention to Improve Access to Care and Health Outcomes

Nancy Wongvipat Kalev, MPH,Director, Health Education/Wellness/Cultural and Linguistic Services,Health Net

11:30

CASE STUDY: Developing Partnerships with Community Based Organizations to Reduce Social Barriers and Improve Health Literacy

Amy Riegel, Director, Housing, CareSource

11:55

Integrating Data Sources that Measure SDoH to Effectively Treat the Whole Person

Dorthy Young, PhD,Chief Health Data, Operations and Research Officer,Mississippi State Department of Health

12:20

CASE STUDY: Housing Instability: The Role of Medicaid Payers in Addressing Health Disparities

  • The limitations for Medicaid plans to address complex health disparities
  • Advantage of partnering with Community Based Organizations
  • The imperative of “Referral and Follow” vs. “Referral and Forget”

Lisa Holden,Vice President, Accountable Care, Independent Care Health Plan

12:20

CASE STUDY: Aligning Social Determinants of Health with Quality and State Pay for Performance Programs

    Daniel Weaver, Vice President, Medicare and Medicaid Quality Programs, Gateway Health

1:05

Close of Module Three

Module #4
Tuesday, February 2, 2021: 2:00-4:40 ET
OPIOID/SUD MANAGEMENT
2:00

Chairperson’s Welcome

2:05

Panel Discussion: Eliminating the Treatment Barriers for Opioid Use Disorder in the Medicaid Population: Expanding Access and Coordinating Care for Vulnerable Populations

2:40

CASE STUDY: Taking a Multidisciplinary Approach to Prevention and Treatment of Opioid Overdose and Opioid Use Disorder

Kelly Verrall, R.Ph., Director of Pharmacy Quality and Medication Therapy Management,Independent Health

Joshua Sawyer, PharmD, Clinical Pharmacist – MTM – HIV/Behavioral Health,Independent Health

3:05

Developing a Low-Barrier Approach to Medication for Opioid Use Disorder—Washington State Hub & Spoke

Stephanie S. Endler, MPA, Project Director, State Opioid Response Grant, Division of Behavioral Health and Recovery,Washington State Health Care Authority

3:30

CASE STUDY: Developing an Opioid Management Strategy for Vulnerable, Higher Frequency Populations

Jennifer Strohecker, Director, Bureau of Healthcare Policy and Authorization, Utah Department of Health

3:55

Enhancing the Capacity of SUD/OUD Treatment Workforces

4:20

Expanding Coverage for Non-Opioid Pain Treatments for Chronic Pain Management

Cynthia Mulder, Administrative Director of Pain Management & Palliative Medicine,, Englewood Hospital and Medical Center

4:40

Close of Module Four

Module #5
Wednesday, February 3, 2021: 10:00-12:40 ET
BEHAVIORAL HEALTH
10:00

Chairperson’s Welcome

10:05

Panel Discussion: Integrating Behavioral and Primary Care: Providing Prevention, Treatment, and Recovery Support Services to Improve Outcomes

10:40

CASE STUDY: Increasing Access for Telemental Health During the Pandemic and Beyond to Ensure Continuity of Care

Stephanie Shushan, MHA, Senior Analyst, Integrated Programs and Strategic Initiatives,Community Health Plan of Washington

11:05

CASE STUDY: Florida Medicaid’s Behavioral Health Flexibilities During the COVID-19

Tim Buehner, Ph.D., Program Administrator, Behavioral Health,Florida Agency for Health Care Administration

11:30

CASE STUDY: Engaging Medicaid, Behavioral Health and Developmental Disabilities Stakeholders During the COVID-19 Pandemic

Michelle Laws, PhD, MA, Assistant Director for Consumer Policy and Community Stakeholder Engagement, Division of Mental Health/Developmental Disabilities and Substance Abuse Services, NC Department of Health and Human Services

Suzanne B. Thompson, MBA/MHA, Community Engagement and Empowerment Team, Division of MH/DD/SAS, NC Department of Health and Human Services

11:55

CASE STUDY: Implication of Adverse Childhood Experiences (ACE) and Trauma Informed Care for Medicaid

Betsy Chang Ha, RN, MS, MBB,Executive Director, Quality & Population Health Management, CalOptima

12:20

CASE STUDY: Transformation in the Last Frontier: Lessons Learned in Implementing a Comprehensive 1115 Waiver for Behavioral Health

Albert E. Wall, Deputy Commissioner, Alaska Department of Health and Human Services

12:40

Close of Module Five

Module #6
Wednesday, February 3, 2021: 2:00-4:15 ET
MEMBER-FACING MEDICAID TECHNOLOGY
2:00

Chairperson’s Welcome

2:05

Panel Discussion: Using a Wide Variety of Digital Tools and Apps to Improve Member Satisfaction and Support Better Health

Moderator:

Jan Smith ReedDirector, US Healthcare,T-Base Communications

Panelists:

Lex Gillette,Paralympic Track and Field Athlete,Team USA

2:40

Telehealth Offerings to Expand Health Access: Exploring Different Modalities to Tele-Triage Members and Deliver Care Remotely to Decrease Volume in Facilities

Jackie Prokop, PhD, MHA, RN,Director, Program Policy Division, Medical Services Administration,Michigan Department of Health and Human Services

3:05

CASE STUDY Leveraging Digital Outreach, Telehealth, and Text Message Technology to Engage Members

Marty Janssen, Senior Program Director, Colorado Access Ana Brown-Cohen, MPH, Senior Manager of Health Programs,Colorado Access

3:30

CASE STUDY Leveraging a Multi-Dimensional Campaign to Deliver Member-Provider- Community Engagement and Outreach Messages Relating to COVID-19 … During the Historic California Fires!

  • From HPSJ IS STILL IN BUSINESS FOR YOU & HERE’S HOW TO STAY SAFE – to launch of phase two, STEP UP! HELP US RESTORE OUR COMMUNITY
  • How we stood up this sophisticated campaign in quick order with minimal costs
  • Our essential partners: HPSJ members, providers, medical society leaders, community-based organizations and county/state public health experts and scientists
  • Leaving no one behind – Health Equity, our ongoing commitment now a heightened public priority
  • Layered Outreach for COVID-19 & Flu Season … amidst historic California Fires & Bad Air

Lakshmi Dhanvanthari, MD, Chief Medical Officer, Health Plan of San Joaquin

3:55

CASE STUDY Using Digital Strategies to Ensure Member Health, Safety, and Welfare During COVID-19

Pamela Tropiano,Vice President, Healthcare Services, Molina Healthcare of Ohio

4:15

Close of Module Six

Module #7
Thursday, February 4, 2021: 10:00-12:20 ET
INNOVATIONS IN OPERATIONAL TECHNOLOGY
10:00

CASE STUDY Advancing Electronic Data Exchange and Care Coordination to Make Data More Actionable While Reducing Administrative Burdens

William Golden, MD,Medical Director,Arkansas Office of Health Information Technology and Arkansas Medicaid

Anne Santifer,Director,Arkansas Office of Health Information Technology

10:25

Automating Medicaid Benefit Plan Management Increases Efficiency and Claims Accuracy

Mohammed Vaid,CEO/Chief Solution Architect,Simplify Healthcare

10:50

Panel Discussion:  Status of State Medicaid/CHIP Agency and Medicaid MCO Implementation of the CMS Final Rule on Interoperability

State Medicaid/CHIP agencies and Medicaid Managed Care Organizations are among the payers impacted by the CMS Final Rule on Interoperability.  This rule requires payers to enable members or beneficiaries to access and download their claims data through third party applications.  This panel will provide information on the readiness of States and MCOs to implement by July 1, 2021, when CMS enforcement of the rule begins.

Moderator:

Elena Nicolella, Executive Director,New England States Consortium Systems Organization

11:05

CASE STUDY Why Buy it When You Can Build It? Idaho's Blueprint for Building a Custom Complaint and Critical Incident System

Idaho is eager to share with other public entities the opportunities and hardships of building a custom complaint and critical incident system. In 2018 Idaho Medicaid faced the reality of a disjointed system, with varying reporting mechanisms, three separate software platforms, and significant gaps in processing. Idaho's need for a system that would both promote its use by community members and streamline management across several business units required a custom, home-grown approach. Specific business needs coupled with severe budgetary constraints forced Idaho to pursue an in- house system design and construction. The resulting system transformation enabled the statewide team to improve its investigation resolution timeframe and allowed for lateral integration of managed care vendors. This system, named a best practice by CMS, is available for states and other public entities to adopt.

Alexandra (Ali) Fernández, Bureau Chief. Bureau of Long Term Care, Division of Medicaid, Idaho Department of Health and Welfare

Chris Barrott Medicaid Program Policy Analyst, Idaho Department of Health and Welfare

11:35

Leveraging Technology to Combat Provider Fraud, Waste, and Abuse

12:00

Modernizing IT Infrastructure to Handle a Surge in Claims and Enroll the Newly Eligible More Quickly

12:20

Conclusion of Module Seven

Module #8
Thursday, February 4, 2021: 2:00-4:20 ET
PHARMACY BASED INTERVENTIONS
2:00

Chairperson’s Welcome

2:05

Panel Discussion: Developing Strategies for Lowering Medicaid Drug Spending While Ensuring Safe and Effective Utilization

2:40

A Managed Care Pharmacy Perspective on COVID-19: Advancing the Pharmacist’s Role in Outpatient Management, Immunization Recommendations, and Health Disparities as They Relate To COVID-19

3:05

Evaluating the Impact of Line Extensions on COVID-19 Treatments

3:30

Maximizing Drug Rebates: Coordinating Obligations Under the MDRP and 340B and Negotiating with Manufacturers for Supplemental Rebates on Prescription Drugs

3:55

Ensuring State Drug Pricing Transparency: Enacting Regulations that Require Documentation, Processes and Controls to Drive Reliable and Consistent Price Reporting

4:20

Conclusion of Conference