2024 Agenda

Day One
February 5, 2024
7:00

Continental Breakfast

7:50

Chairperson’s Welcome

Clay Farris,CEO,Mostly Medicaid

8:00

Taking a Look into the Future of Medicaid: After the Unwinding, Leading Up to the Election…What’s Next?

Clay Farris,CEO,Mostly Medicaid

UNWINDING/REDETERMINATION
8:30

Panel Discussion: Lessons Learned from the Unwinding: Improving Functionalities and Addressing Deficiencies in the Redetermination Process

Moderator:

Kris Vilamaa,Partner and Chief Growth Officer, Mostly Medicaid

Panelists:

Janet Mann, Deputy Director of Health and State Medicaid Director,Arkansas Department of Human Services

Mike Rapach, President and CEO,CareFirst Community Health Plan Maryland

Jim Milanowski, CEO,Genesee Health Plan

Kevin Bagley, DHA, MBA, FACHE,Former Medicaid Director, State of Nebraska

Sebastian Seiguer, JD, MBA, Co-Founder and Chief Executive Officer, Scene Health

HEALTH EQUITY/SDOH/HRSN
9:10

Engaging the Unengaged by Leveraging AI Technology and SDOH Insights

Traci A. Massie, PMP, MBA, CCHW,Senior Director, Outreach, Market Development and SDOH, Sentara Health Plans

9:40

Collaboratively Addressing Community Level Social Care Resource Gaps

  • Leveraging data to identify community strengths and needs proactively
  • Engaging strategically at the grass roots level
  • Operationalizing innovative programs and initiatives

Elizabeth Starr,Executive Director, Social Impact,Aetna, a CVS Company

10:10

Accelerating Health Equity: Unleashing Racial Equity Impact Assessments for Transformative Change in Medicaid

In today's rapidly evolving healthcare landscape, the pursuit of health equity has evolved from being a mere aspiration to a compelling moral imperative. It's time to shift our focus away from merely documenting disparities and redirect our energies towards actively seeking solutions and understanding how to effectively implement them within the Medicaid program. Health disparities have persisted for far too long, undermining access to quality care and perpetuating systemic inequities. This presentation is dedicated to the pivotal task of advancing health equity within Medicaid, introducing a potent tool - Racial Equity Impact Assessments (REIAs) - as a catalyst for transformative change. As we navigate the intricate journey towards achieving health equity in Medicaid, it's crucial to recognize that these inequities often stem from structural racism and, at times, well-intentioned decisions. REIAs, in this context, emerge as the guiding compass that can steer us towards a more equitable healthcare system. Objectives are as follows:

  • Uncover Racial Disparities: Illuminate underlying racial disparities within Medicaid to underscore the urgency of addressing these issues
  • Introduce REIAs Impact: Introduce the practical framework of REIAs as a crucial tool for analyzing racial implications within Medicaid decisions
  • Real-world Applications: Showcase tangible, real-world applications of REIAs to minimize unintended consequences, providing attendees with actionable insights to implement in their daily practices for tangible, meaningful change within the healthcare system

Rosemond Sarpong Owens, CDM/MPH,Director, Health Equity Integration, Blue Cross Blue Shield of Minnesota

10:40

Morning Refreshment Break

11:10

Panel Discussion: Improving Cultural Responsiveness to Reduce Health Disparities: Identifying and Removing Barriers to Care and Improving Outreach to Historically Marginalized Populations

Moderator:

Jim Milanowski, CEO,Genesee Health Plan

Panelist:

John Pardalos, MD,Neonatologist, University of Missouri Health Care

Dawn Godbolt, PhD, Director of Health Equity, Maven

Eric Hazzard, PhD,Senior Director of Business Development, NourishedRx

Cameual Wright, MD, MBA,Vice President, Market Chief Medical Officer, Indiana Market, CareSource

Jennifer Sisto Gall, MPH, Vice President of Government Programs,Twill

11:50

Building Health Literacy and Overcoming SDoH Barriers: Delivering Highly Tailored, Meaningful Interactions That Inspire Behavior Change and Impactful Outcomes

Reva Sheehan,Director, Customer Insights, mPulse

Greg Gould,Sr., Solution Design, mPulse

12:20

Advancing Data Collection Partnerships with Community Based Organizations: Aligning Social Services and Healthcare through Community Care Hub

Learn about the Inland Empire’s Community Information Network and how it:

  • Provides opportunities for underserved communities to self-report, race, ethnicity and language (REAL) and sexual orientation, gender identity/expression (SOGIE) data to health and social care providers
  • Supports efforts for NCQA Health Equity standards and accreditation
  • Provides linkage between clinical and community settings to address documented social drivers of health within a member’s record

Gabriel Uribe​, DSW,Director, Community Health, Independent Living & Diversity, Inland Empire Health Plan

12:50

Luncheon

1:50

Panel Discussion: Assessing Members for SDoH and Developing Targeted Plans to Address Unmet Needs: Collecting Data, Prioritizing Interventions, and Implementing a Unified Approach Across Care Settings

Moderator:

Kalin Scott, Principal, K. Scott Concepts

Panelists:

Caroline Yaun, RN, BSN, LNC, Executive Director, SNP Programs, ATRIO Health Plans

Tim Conroy, National VP, Government and Healthcare Partnerships, Mom’s Meals

Brielle Osting, Senior Manager, Social Impact Growth and Innovation, Aetna, a CVS Company

Chantel Neece DNP, MBA, APRN, FNP-BC, GERO-BC, CPHQ, SSBBP, Sr. Director- Maternal/Child Services & Member SDOH, Sentara Health Plans

Angela Smith-Hietikko, LMSW, Executive Consultant, Behavioral Health, Clearlink Partners

2:30

Getting to the H.E.A.R.T of the Matter - Advancing Health Equity and ROI through Simple, Multi-Touch Approaches to Engagement

Tiffany Davis, Executive Director, Quality Improvement and Health Equity,Health Care Service Corporation

Shameet Luhar, CEO, Vheda Health

Jean Drummond, President and CEO, HealthCare Dynamics International

3:00

Maximizing Claims Data to Support Policy and Improve Health Equity in Orphan Population

Daniel B. Bruzzini, MD, MBA, CPE,CEO,Pronchorus Advising, LLC

3:30

Afternoon Refreshment Break

4:00

Solving SDOH: Implementing Interoperable Clinical Exchange to Close Care Gaps

Health information exchanges (HIEs) are essential in facilitating clinical exchange by enabling providers, private-public entities & payors access to the comprehensive & up-to-date patient information needed to provide high-quality, cost-effective care. SHARE, a statewide HIE, will demonstrate how they partnered with entities such as best-in-class trusted private-public partners HARK NWA of Excellerate Foundation, a community foundation serving NW Arkansas & others, to create an interoperable exchange process that integrates clinical & appropriate SDOH data to health plans, care management platforms, ACOs, CINs, & provider-hospitals EMRs, to achieve work-flow centric interoperable exchange across the community. SHARE is assisting public-private organizations to close the loop on care gaps inclusive of SDOH, enabling better-informed decisions & timely responses to address social factors-needs & ultimately improve patient outcomes.
Presentation Objectives are as follows:

  • Define key SDOH stakeholders and their roles, including SDOH data contributors’ clinics, CINs, ACOs, hospitals, clinical exchange private partners, and the SDOH screening/connector facility that helps SHARE make patient critical information part of the holistic chart.
  • Conduct technical scoping with SDOH vendors, including establishing standards-based exchange methods to include Direct Secure Messaging (DSM), ADT data/notifications, query-based exchange (QBE), and integrated exchange (IE), to determine provider/plan data requirements.
  • Explain the Query Based Exchange (QBE) connections process and model needed to acquire and push clinical/SDOH data to improve Transitions of Care (TOC) and Transition Care Management (TCM).
  • Describe the value of bi-directional interoperable exchange and how clinical data delivered in the right way at the right time informs stakeholders of data to improve health equity and population health strategies.

Anne Santifer, Director, Arkansas Office of Health Information Technology

Justin Villines, HIT Policy Director, Arkansas Office of Health Information Technology

CARE COORDINATION/HEALTH ACCESS
4:30

Solutions from Hospital to Home: Supporting Caregivers and Families

  • Recognize caregiver needs in hospitals and in homes
  • Provide an overview of the health consequences of infant crying and sleep deprivation.
  • Identify innovations designed to support caregivers in hospitals and homes.
  • Colleen A. Kraft, MD, MBA, FAAP, Vice President of Medical Affairs, Happiest Baby, Inc.

    Rachel Dawkins, MD FAAP, Medical Director, Johns Hopkins All Children’s Care Network

5:10

Improving Value for Underserved Populations with a Community-Based Intervention

  • Learn how a scalable peer to peer based solution is building trust and restoring the community fabric across the U.S.
  • Learn how that solution is moving the needle for folks enrolled in Medicaid and reducing cost whilst improving quality.
  • See the rigorous scientific approach behind those published results.
  • Claude Pinnock MD, MPH, Chief Medical Officer, Wider Circle

5:40

Strengthening and Monitoring Network Adequacy: Facilitating Access for Low Income and Medically Underserved Consumers

  • Describe the elements that support access outside of the clinical setting
  • Review HPSM's multifaceted approach to primary care engagement
  • Describe the elements of HPSM's primary care investment strategy
  • Chris Esguerra, MD, Chief Medical Officer,Health Plan of San Mateo

6:10

Cocktail Reception

Sponsored by:

Day Two, Tuesday,
February 6, 2023
7:00

Continental Breakfast

8:00

Panel Discussion: Improving Care Management Models for Underserved Populations: Taking a Hybrid Approach to Reduce Gaps in Care, Enhance Access, and Address Physical, Behavioral and Social Needs

Moderator:

Rob Summitt, Business Development Director, Regulated Markets, Evernorth Health Services

Panelists:

Chris Esguerra, MD, Chief Medical Officer,Health Plan of San Mateo

Glory Dole, BSN, MA, RN,Section Manager, Medicaid Contracts and Compliance, Medicaid Programs Division, Washington State Health Care Authority

Dean Koskinas,Executive Sales Consultant, Outcomes

Mark Christian, Senior Sales Executive of National Payer Segment,Quest Analytics

Mindi Knebel,CEO,Kaizen Health

8:40

Washington State HCA's Hospital Complex Discharge Project: A Case Study Featuring the Role of Medicaid Managed Care

Washington State’s Complex Discharge Program leverages the power of managed care in a collaborative approach to create solutions in the health care system. Our most vulnerable populations often experience challenges to access, and these disparities can create complexities that lengthen a member's hospitalization. Care coordination through managed care in Washington State has successfully reduced health disparities, hospital length of stay, and improved health outcomes.

Glory Dole, BSN, MA, RN, Section Manager, Medicaid Contracts and Compliance, Medicaid Programs Division, Washington State Health Care Authority

9:10

Addressing the Caregiver Crisis: The Idaho Department of Health and Welfare Case Study

Because there is always an adventure waiting in the woods, learn how Idaho didn’t miss the forest for the trees by globally and creatively addressing the Caregiver Crisis by carefully planting seeds. Their approach includes working collaboratively with stakeholders to build a one-of-a-kind, web based skills training platform that is free for all required training for caregivers, a successful statewide marketing campaign designed specifically to enlist more caregivers and one of a kind conference and ambassador program for outstanding Direct Care Professionals.

Ali Fernandez, Bureau Chief, Bureau of Long Term Care Idaho Department of Health & Welfare

Chris Barrott, Program Manager, Bureau of Long Term Care, Idaho Department of Health & Welfare

9:40

Advancing Collaborative Care in North Carolina: Leveraging a Multidisciplinary, Multipayer Team of Leaders to Drive the Implementation of the Collaborative Care Model and Improve Access to Care

Across the nation, public payers are working to enhance the integration of physical and behavioral health in the medical home. In this session, NC will share strategies other states might consider to:

  • Create partnerships with other statewide partners to advance the Collaborative Care Model
  • Focus on provider supports that can nudge reluctant providers and advance innovative providers further into the model
  • Create unique approaches to measurement and investments to drive equity in the provision of the model
  • Share a broad approach to measuring “integration” of physical and behavioral health

Shannon Dowler, MD, FAAFP, CPE, Chief Medical Officer, North Carolina Medicaid, Assistant Secretary for Health Access, North Carolina Department of Health and Human Services

10:10

Leveraging Telehealth to Deliver Primary and Behavioral Care: Providing Care to Hard-to- Reach Populations and Supporting Network Adequacy Requirements

Nikki Hungate, MS, MHA, Government Programs Industry Leader,

10:40

Morning Refreshment Break

11:10

Programs, Partnerships and Perspectives in Medicaid that Support Improved Maternal Health Outcomes: How Innovation in Prenatal and Postpartum Programs and Benefit Design Can Improve Care for Moms and Babies

This session will:

  • Review the reasons why maternal health is a public health crisis in the United States today
  • Discuss opportunities for Medicaid plans to drive improved health outcomes by focusing on health equity and innovation
  • Examine unique programs implemented by CareSource to address maternal health, including targeted care management, expanded postpartum care, leveraging doulas and advanced practice nurses, and community and cross sector partnerships
  • Cameual Wright, M.D., MBA, Vice President, Market Chief Medical Officer, Indiana Market,CareSource

    11:40

    Alternate Format Documents - A Workflow Challenge

    Regulatory mandates to provide alternate formats — such as translations, braille, large print, and more — are growing and hit a critical point in 2023. Health plans are challenged to meet these requirements within the varied document production workflows they manage. This panel discussion will identify the key challenges posed by the latest regulations and discuss best-in-class solutions for efficient production workflows for alternate format documents.
    This session will discuss:

    • The importance of alternate formats to STAR ratings
    • Understanding the common workflow challenges with alternate formats
    • Learning best practices for optimal alternate format production

    Steve Keca, Director of Solutions Development,RRD Healthcare Solutions

    12:10

    Improving LTSS Delivery: Simplifying Access to HCBS and Expanding the HCBS Provider Network

    • Overall Network Strategy
      • Data-Driven Approach
      • Strategic Relationships
      • Intentional Recruitment and Retention
    • Workforce Development Strategies
      • Data Collection and Analysis
      • Provider Incentives and training
    • HCBS in Rural Counties
      • Maximizing Resources
      • Engagement, support, and educational techniques

    Sarah Spiekermeier, MBA, Chief Operations Officer,Banner Health Plans

    12:40

    Luncheon

    1:40

    Leveraging Cross-Cabinet Collaboration: Improving Health Outcomes and Reducing Medicaid Spend through the Health Information Exchange

    • Leveraging a Health Information Exchange to save Medicaid dollars
    • Supporting the foster child population through health technology integration--collaboration, setup, metrics
    • Reducing Medicaid cost through the use of an Image Exchange
    • Social Determinants of Health work supporting Hospital Rate Improvement Plan (HRIP) Quality Incentive Program facilitated by the State of Kentucky

    Andrew C. Bledsoe, Deputy Executive Director, Office of the Inspector General, Kentucky Health Information Exchange

    2:10

    Developing a Transition of Care Program Focused on Addressing Social Determinants of Health

    • Considerations – Transition of Care Program for underserved and low socioeconomic status members following hospital discharge
    • Areas of Focus
    • What is SDoH
    • Population
    • Community Health Workers
    • Data Analysis
    • Results

    Alketa Mezini, MD, MBA,Director of Operations and Strategy, Primary Care, Neighborhood Health Plan of Rhode Island

    2:40

    Coordinating Care for the D-SNP Population: Leveraging Collaboration and Innovation to Improve the Member Experience for the Most Vulnerable

    Caroline Yaun, RN, BSN, LNC, Executive Director, SNP Programs,ATRIO Health Plans

    3:10

    Using a Social Determinants of Health Framework to Analyze Behavioral Health Stigma

    Healthcare professionals often work with individuals, families and communities who are stigmatized. The World Health Organization (WHO) defines stigma as a mark of shame, disgrace or disapproval that results in an individual being rejected, discriminated against, and excluded from participating in a number of different areas of society. As professionals, we often speak of reducing stigma and addressing the trauma associated with it. This presentation will focus on the Social Determinants of Health (SDOH) as the framework to utilize we further explore stigma. The presentation will highlight strategies to address stigma through the SDOH lens, focusing on:

    • Define and examine behavioral health stigma and how it is impacting those in lower socioeconomic status
    • Examine SDOH and how it is impacting those in a lower socioeconomic status
    • Examine social and community context aspects of SDOH framework
    • Explore best practices around approaching and supporting underprivileged communities to addressing behavioral health stigmas

    JaQuoia (JQ) Sylvester, LMSW, MBA, Clinical Strategy and Practice Lead, Medicaid Behavioral Health, Humana

    3:40

    Conclusion of Conference