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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

Jason Rachel, Ph.D., Director of Integrated Care,Virginia Department of Medical Assistance Services

, ,
11:55

Five Critical Steps to Digitally Engage Medicaid Members & Achieve Quality Improvement Outcomes

Amy Lung,Chief Operating Officer, HealthMine

12:20

Leveraging Home and Community Based Services to Serve Members and Support Physical 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: 2:00-5:40 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

Snezana Mahon, Pharm.D., Vice President and General Manager, Care Solutions, Evernorth

Mark Gregory, RPH, Director, Pharmacy Consultant, Population Health Services, EnlivenHealth

Moderator:

Clay Farris, Managing Editor, Mostly Medicaid

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

3:40

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

4:05

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

4:30

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,Director, Medical Management, Affinity Health Plan

4:55

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

Jim Milanowski, President & CEO,Genesee Health Plan

5:20

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

5:40

Close of Module Two

Module #3
Tuesday, February 2, 2021: 9:00-1:30 ET
SOCIAL DETERMINANTS OF HEALTH AND COMMUNITY PARTNERSHIPS
9:00

Chairperson’s Welcome

9:05

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

Eric Beane, Vice President of Regulatory and Government Affairs,Unite Us

9:50

Integrated Care in The Next Generation Of State Programs: Exploring The Future Of Population Management In State Medicaid Programs, The Cal AIM Example

California, the 5 th  Largest Medicaid program in the country with roughly 12 million enrollees is transforming its healthcare delivery system.  Starting in January 2022, the state intends to implement a new managed care model that holds health plan partners accountable for a whole person care model that will:

  • Keep all members healthy by focusing on preventive and wellness services;
  • Identify and assess member risks and needs on an ongoing basis;
  • Manage member safety and outcomes during transitions, across delivery systems or settings, through effective care coordination; and
  • Identify and mitigate social determinants of health and reduce health disparities or inequities.


In this session, ILS, a care management organization that runs integrated programs in multiple states and is currently engaged with a number of plans and programs in the  California market, will present:
  • How we believe models that we have successfully deployed in other integrated programs can be quickly implemented into a state undergoing transformation
  • How to quickly and sensitively assess the needs of recipients and activate their participation in their own plan of care
  • How to engage often siloed community resources and integrate them into a larger care model
  • How to best integrate social determinants and non-traditional care delivery into plans of care in a quantifiable manner

James Henderson, Chief Innovation Officer, Independent Living Systems

Maureen LillisChief Operating Officer, Independent Living Systems

Carol Lee Thorpe Executive Director, Independent Living Systems

10:15

The Critical Role of Meals in a Health Emergency: Lessons Learned from the COVID-19 Pandemic

“Members are calling because they need food, not because they need a provider appointment or a medication.” The COVID-19 crisis highlighted an acute need of many health plan members: Food. This need was heightened by the pandemic due to closure of community meal sites, strains on food banks and pantries, and risks related to grocery store visits for some members. A rapid food response by health plans depended on two key factors: policy flexibility from Federal and State programs and an existing and robust home-delivered meals program or benefit at the health plan. Regarding policy, this session will discuss flexibilities for Medicaid plans and their ability to provide and pay for meals for members in an emergency. This session will discuss the following learning objectives:

  • Emergencies and Food Insecurity – Attendees will learn how emergency mitigation measures, such as stay-in-place orders and social distancing, can reduce food security among vulnerable populations.
  • Home-Delivered Meals as Emergency Benefit – Speaker will share examples of how Medicaid plans can leverage policy flexibility during public health emergencies to fund and implement a home-delivered meals benefit, proactively supporting the health and well-being of their members. Speaker will share information about a successful program.
  • What to Look for in a Meals Provider – Using real-world examples, attendees will gain a better understanding of how readily a potential meals provider can meet urgent demand and achieve network adequacy during a public health crisis such a pandemic.

Lauren Wetzlau, BSN RN, Population Health / Community Liaison, United Healthcare Community Plan Louisiana

Catherine Macpherson, MS, RDN Vice President, Product Strategy and Development and Chief Nutrition Officer, Mom’s Meals

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

  • COVID mitigation projects, including no contact delivery of goods and supplies
  • Flex Services programs helping the community receive food deliveries, cleaning supplies,
  • and housing supports
  • Screening for Social Determinants of Health and making referrals to Social Service Agencies

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

11:05

Whole-Person Care Starts with Whole-Person Data: How Non-Traditional Data Sources Can Power Your SDOH Efforts

Diana Zuskov, Director, Market Planning, Government Healthcare & Public Health,LexisNexis Risk Solutions

11:30

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

11:55

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

Amy Riegel, Director, Housing, CareSource

12:20

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

12:45

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

1:10

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

1:30

Close of Module Three

Module #4
Tuesday, February 2, 2021: 2:00-4:40 ET
Opioid/SUD Management and Pharmacy Innovations
2:00

Chairperson’s Welcome

2:05

Hidden Dangers: What Opioid Management Programs Are Missing

Kendra Karagozian, AVP, Business Development,Tabula Rasa Healthcare

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

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

Allana M. Alexander, PharmD, MSMTM, BCMTMSr, Pharmacy Director, Alabama Care Network, Viva Health, Inc.

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: 10:00-12:45 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

Moderator:

Henry W. Osowski, Managing Partner,Strategic Health Group

Panelists:

Garry Welch, PhD, Co-Founder and Chief Scientific Officer,Silver Fern Healthcare

Michelle Squire, MSN, RN, CCM, Director, Medical Management,Affinity Health Plan

Anna Hall, PHARMD, BCACP, Director of Quality Services,Enhanced Medication Services

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

Nebraska Heritage Health Adult Expansion Demonstration

Todd Baustert, Administrator, Nebraska Department of Health and Human Services

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

12:45

Close of Module Five

Module #6
Wednesday, February 3, 2021: 1:45-5:15 ET
Member-Facing Medicaid Technology and Engagement
1:45

Chairperson’s Welcome

James Haskins, Director of Government Programs,HealthMine, Inc.

1:50

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

James Haskins,Director of Government Programs,HealthMine, Inc.

John J. Sweeney,Strategy and Business Development Director, Public Sector,WEX Health

Sarenka Smith,Director, Marketing & Communications, emocha Health

Laura Aiello, Director of Business Development and Strategic Partnerships,LifeStation

2:35

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

  • New telemedicine policies Michigan implemented in response to COVID-19
  • Impact on opening up telemedicine to many different types of providers
  • Look at utilization trends for telemedicine

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

3:00

Thinking Omnichannel? Stop Until You Hear This

Annemieke Umberg, Director of Strategic Accounts and Engagement,HealthCrowd

3:25

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

  • The role of Colorado Access, a regional health plan, in Colorado’s Medicaid operations and programming
  • How have digital strategies (i.e. text messages and telehealth) enhanced member outreach and programming
  • Initial outcomes of Colorado Access’ digital engagement programming
  • Vaccine communication and programming next steps from a digital engagement lens

Marty Janssen, Senior Director of RAE Communications and Programs,Colorado Access

Ana Brown-Cohen, MPH, Senior Manager of Health Programs,Colorado Access

3:50

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

4:15

Keeping Members Engaged with their Health and their Community During the Pandemic

  • Best practices and lessons learned when pivoting from in-person community events to a virtual environment 
  • The impact engagement strategy plays in member relationships and keeping members engaged, informed, and well during the pandemic
  • A look at outcomes from conversational engagement programs to see how Medicaid members are engaging today

Sandrine Blake,Assistant Director, Member Events, Amida Care

Alex Fontanez, Manager – Member Engagement, Amida Care

Melissa Morales,Strategic Account Director, mPulse Mobile

4:50

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

5:15

Close of Module Six

Module #7
Thursday, February 4, 2021: 9:30-11:45 ET
INNOVATIONS IN OPERATIONAL TECHNOLOGY
9:30

Chairperson’s Welcome

9:35

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

10:00

Automating Medicaid Benefit Plan Management Increases Efficiency and Claims Accuracy

Mohammed Vaid,CEO/Chief Solution Architect,Simplify Healthcare

10:25

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

Panelist:

Mary Arcenas, PhD, RN, MBA, CPHQ, Manager, MMIS Modernization,NJ Division of Medical Assistance and Health Services

Enrique Martinez-Vidal, Vice President for Quality and Operations,Association for Community Affiliated Plans

11:00

COVID-19 Vaccine Outreach & Intervention Best Practices

By attending this session, attendees will learn:

  • How states and healthcare organizations can engage and equip their populations with the information they need to better understand and access the COVID-19 vaccine
  • How to personalize consumer engagement initiatives using behavioral science-based methodologies, modern consumer data and analytical techniques
  • How to create highly targeted outreach programs that include culturally-adapted content and barrier identification/collection components

Gary Call, MD,Chief Medical Officer,HMS

Ellen Harrison, RN,SVP, Market Strategy & Operations, Population Health Management,HMS

11:25

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

11:45

Conclusion of Module Seven