Agenda

Medicaid is an incredibly complex program, with wide state variation in structure, benefits, payments, and policies. Even experts lack a complete understanding of how the program works in each of the 50 states and Washington, DC. That’s why HMA is happy to offer a special Pre-Conference Workshop called Medicaid 101: A Primer on the Medicaid Landscape. During this interactive workshop, HMA consultants will provide attendees with an understanding of the basic building blocks of Medicaid and an update on the changing landscape for Medicaid programs and policies. Topics of discussion will include Medicaid waivers and State Plan Amendments, Medicaid managed care, delivery system reform and practice transformation initiatives, payment and funding models, and more.

This Live activity, Medicaid 101: A Guided Tour with the HMA Experts, with a beginning date of 09/30/2018, has been reviewed and is acceptable for up to 3.25 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Does Medicaid represent the future of healthcare in America?
The truth is that no other program is seeing more experimentation or garnering more populist attention, including voter-driven demands for Medicaid expansion; calls for Medicaid buy-ins; integrated initiatives to serve high-cost aged, disabled, and chronically ill populations; and a wide variety of efforts to test concepts involving community engagement, work requirements, value-based payments, delivery system redesign, substance-abuse treatment, healthy behaviors, community-based care, social determinants health, and other important components of coverage and care delivery.

During this keynote address, a leading healthcare expert will discuss the growing and changing role of Medicaid and how it is likely to impact the broader direction of healthcare in America for years to come.

Speaker

Alan Weil, Editor-in-Chief, Health Affairs

Moderator

Carl Mercurio, Principal and Publisher, HMA Information Services

The past few years have been marked by a flurry of expected – and unforeseen – alterations, innovations, and experiments among state Medicaid programs. Given the growing emphasis on member accountability, it’s obvious states would explore initiatives like work requirements, premiums, and health savings accounts. But there has also been an uptick in the number of Medicaid expansion states, heightened interest in Medicaid buy-ins, and growing use of state waivers to test innovative new care delivery and coverage models. Meanwhile, states continue to gravitate toward Medicaid managed care, which has consistently gained market share versus fee-for-service. During this keynote session, leading Medicaid directors will outline opportunities and pitfalls of these efforts, as well as provide a roadmap for the likely direction of Medicaid innovation at the state level.

Speakers

Stephanie Bates, Deputy Commissioner, Kentucky Department for Medicaid Services

Mari Cantwell, Chief Deputy Director, Health Care Programs, California Department of Health Care Services

Mandy Cohen, MD, Secretary, North Carolina Department of Health and Human Services

Doug Elwell, Medicaid Director, Illinois Department of Healthcare and Family Services

Jami Snyder, Director, Arizona Health Care Cost Containment System

Moderator
Kathleen Nolan, Vice President, HMA

Medicaid managed care plans are playing a growing role in the lives of the nation’s most vulnerable citizens – not just administering healthcare, but also attempting to become a force for good in the communities they serve. Increasingly, this means helping to address hunger, homelessness, job training, education and other social determinants that impact a person’s health and well-being.  During this keynote address, Paul Tufano, chairman and CEO of AmeriHealth Caritas, will discuss his organization’s investments in whole-person care, wellness centers, and other pathways to prosperity and independence for members. Tufano will also outline how health plans, providers, and local governments can best work together to address the needs of families and individuals enrolled in Medicaid.

Speaker
Paul Tufano, Chairman, CEO, AmeriHealth Caritas

Moderator
Jay Rosen, President, HMA

Managed care continues to take center stage in efforts by states to improve the quality and efficiency of their Medicaid programs. That’s good news for managed care plans, which continue to enjoy growing market share in a wide variety of Medicaid programs. But Medicaid plans also face significant challenges, including the adequacy of capitated payment rates, increased demands to ensure quality while simultaneously controlling costs, and the ability to adjust to the type of change and uncertainty inherent in state Medicaid programs. During this session, leading Medicaid managed care executives will address some of the most pressing challenges facing health plans as they participate in government-sponsored healthcare programs and strive to meet the needs of vulnerable member populations.

Speaker

Deb Bacon, Regional Vice President, West/Other Region, Aetna Medicaid

Heidi Garwood, President, Medicaid, Health Care Service Corp.

Janet Grant, Regional Vice President, Great Plains Region, Aetna Medicaid

Joanne McFall, Market President, Keystone First Health Plan

Dennis Mouras, CEO, UnitedHealthcare Community Plan of Michigan

Patrick Sturdivant, President, Amerigroup Texas, Anthem, Inc.

Moderator
Donna Checkett, Vice President, HMA

As the federal government prepares to spend billions of dollars battling opioids, it’s important to recognize that the opioid epidemic is part of a broader pattern of substance abuse in America. Effectively treating opioids means addressing the historical structure of the nation’s approach to addiction treatment and identifying pathways at the state, provider, and health plan level for fostering an effective addiction treatment eco-system. During this session, leading addiction experts will discuss existing barriers to successful opioid addiction treatment as well as outline a new way forward for addressing both the opioid epidemic and substance abuse overall.

Speakers
Corey Waller, MD, Principal, HMA

Carole Johnson, Commissioner, New Jersey Department of Human Services

The number of states that have expanded Medicaid since 2016 has risen to 37, with several others considering expansion options. There have also been efforts at the state and local level to increase healthcare coverage for underserved populations through Medicaid, universal care initiatives, and the growing use of state waivers. During this breakout session, state and local leaders will discuss some of the most interesting and innovative coverage expansion options as well as which states are most likely to pursue expansion and why. Panelists will also discuss the use of 1332 waivers to broaden healthcare coverage through the Affordable Care Act Exchanges.

Speakers

Fred Cerise, MD, President, CEO, Parkland Health & Hospital System

Theresa Eagleson, Director, Illinois Department of Healthcare and Family Services

Jimmy Lewis, CEO HomeTown Health, LLC

Dennis Smith, Senior Advisor, Medicaid and Health Care Reform, Arkansas Department of Human Services

Moderator
Matt Powers, Principal, HMA

State Medicaid programs are engaging in some outside-the-box thinking on the best way to manage drug costs and utilization, including concepts of value-based purchasing and adapting to drug spending in a managed care environment. During this breakout session, experts from state government, health plans, and pharmacy organizations will discuss some of the most innovative concepts and initiatives in the intersection of value-based purchasing and drug spending.

Speakers

John Coster, Director, Division of Pharmacy Center for Medicaid and CHIP Services, CMS

Terry Cothran, Director, Pharmacy Management Consultants, University of Oklahoma College of Pharmacy

Josh Fredell, Senior Director, Specialty Product Development, CVSHealth

Darren Moore, Senior Director, Value and Market Access, Melinta Therapeutics

Moderator
Anne Winter, Principal, HMA

State Medicaid programs, health plans, and providers are beginning to implement a series of concrete strategies to address social determinants of health (SDOH), including poverty, homelessness, food insecurity, and education. These include standardized SDOH screenings, community engagement, payer-provider partnerships, and payment strategies that incentivize the delivery of SDOH services to members. During this session, industry leaders from states, health plans, and providers will outline some of the recent breakthroughs and strategic developments that have led to measurable improvement in member health through services aimed at addressing SDOH.

Speakers

Brad Lucas, MD, Senior Medical Director, Buckeye Health Plan

Kevin Moore, VP, Policy – Health & Human Services, UnitedHealthcare Community & State

Sharon Raggio, President, CEO, Mind Springs Health

Betsey Tilson, MD, State Health Director, Chief Medical Officer, North Carolina Department of Health and Human Services

Moderator
Heidi Arthur, Principal, HMA

Innovative Delivery Models in Medicaid-Focused Healthcare Services
Investment firms are deploying billions of dollars in capital in search of innovative organizations serving Medicaid, Medicare and other publicly sponsored healthcare markets. Much of the activity is focused on emerging opportunities in areas like autism, opioid use disorder, primary care, and even dental services. During this breakout session, speakers from private-equity backed companies will discuss innovative delivery models in each of these growing segments. Speakers will assess the market opportunity, prospects for sustainable growth, and key differentiators of success.

Speakers

Keith Jones, President & CEO, Blue Sprig Pediatrics

Mark Lashley, CEO, Caregiver, Inc.

Cari Lee, VP, Government Affairs, Quest Analytics

Timothy Murphy, CEO, The Stepping Stones Group

Nestor Plana, Chairman, CEO, Independent Living Systems

Moderator

Whit Knier, Director, Harris Williams Healthcare & Life Sciences Group

It’s been over a year since states like Indiana, Arkansas, and New Hampshire began to implement Medicaid work requirements. Meanwhile, several other states have applied for approval of work requirements, premiums, health savings accounts, and other forms of community engagement and member accountability. During this session, representative from state Medicaid programs, health plans, providers, and advocates will discuss some of the lessons learned from these early community engagement initiatives and whether they are successfully helping members achieve self-sufficiency.

Speakers

Natalie Angel, Healthy Indiana Plan Director, Indiana Office of Medicaid Policy and Planning

Jean Caster, HIP Program Director, Anthem Indiana Medicaid

Ray Hanley, President and CEO, AFMC

Moderator
Kaitlyn Feiock, Senior Consultant, HMA MMS

State foster care is expected to undergo dramatic change following the enactment of new federal regulations aimed at keeping children in family settings instead of in group homes. The rules emphasize substance abuse prevention, mental healthcare, parenting advice, and other services to help keep families together. During this webinar, foster care experts will discuss how states are preparing to implement these monumental changes and what this means for foster care programs going forward.

Speakers

Christine Beyer, Commissioner, NJ Department of Children and Families

Alyssa Brown, Deputy Director, Innovation, Research, and Development, Office of Health Care Financing, Maryland Department of Health

Rebecca Jones Gaston, Executive Director, Social Services Administration,
Maryland Department of Human Services

Tracy Wareing Evans, Executive Director, American Public Human Services Association

Moderator

Uma Ahluwalia, Principal, HMA

Payers and providers are making great strides forward in the successful integration of medical and behavioral healthcare, while also attending to social determinants of health. No one model has emerged as preeminent. Instead, a variety of approaches, variations and unique solutions are serving to empower patients and caregivers in understanding the complex interplay of depression, substance abuse disorder, and other mental health conditions with a person’s overall health status. During this session, leading medical and behavioral health experts will highlight some of the most innovative approaches to behavioral health integration, including a look at the foundational components of successful integration efforts. They will share important lessons learned along the way in terms of successes and pitfalls.

Speakers

Deepu George, Assistant Professor of Family Medicine, Division Chief – Behavioral Medicine, Department of Family & Preventive Medicine, UTHealth

Elise Pomerance, MD, Senior Medical Director, Practice Transformation, Inland Empire Health Plan

Walter Rosenberg, Director, Social Work and Community Health, Rush University Medical Center

Deborah Weidner, MD, Vice President, Safety and Quality, Behavioral Health Network, Hartford HealthCare

Moderators

Emily Brandenfels, Principal, HMA
Jeff Ring, Principal, HMA

Virtual Patient Interaction: The Future is Now
Telehealth holds the promise of fundamentally transforming healthcare delivery in America and offers huge opportunities for patients, providers and technology companies. During this session, private-equity backed telehealth companies will discuss the growing momentum of telehealth, with an emphasis on how new technologies are enhancing the patient-provider relationship and improving care.

Speakers

Abner Mason, CEO, ConsejoSano

Steve Sidel, Founder & CEO, Mindoula Health

Neil Solomon, MD, Co-founder, Chief Medical Officer, MedZed

Moderator

Marshall Jackson, Jr., Associate, McDermott Will & Emory LLP

With more than 21 million enrollees, Medicare Advantage plans manage care for more than a third of all Medicare beneficiaries, and that percentage is rapidly growing. Coupled with gains in other government programs, the growth in Medicare Advantage puts health insurers in the driving role to shape the future of publicly sponsored healthcare. During this session, policy and industry experts will assess the future of both Medicare Advantage and the Medicare program in general, with a special emphasis on how changes in Medicare will impact the overall market for healthcare services in America, including state Medicaid programs.

Speaker
Jonathan Blum, Managing Principal, HMA; former CMS Deputy Administrator for Medicare

States are increasingly turning to managed care to serve high-cost, dual eligible Medicaid-Medicare beneficiaries. Yet no single managed care model has emerged as preeminent – whether it involves Capitated Financial Alignment Demonstrations, Dual Eligible Special Needs Plans (D-SNPs), Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs), or provider-led initiatives. Furthermore, state and federal policies are evolving in ways that will dramatically impact the roles and responsibilities of participating plans. During this session, industry experts will provide an overview of the complex landscape for integrated Medicare-Medicaid managed care. Speakers will also discuss how health plans and providers can best develop integrated models that effectively serve members and successfully compete regardless of which models emerge.

Speakers

Matthew Behrens, Integrated Care Policy Supervisor, Virginia Department of Medical Assistance Services

Jack Dailey, HCA Coordinator, Director of Policy and Training, Consumer Center for Health Education and Advocacy, Legal Aid Society of San Diego, Inc.

Allison Rizer, Vice President, Strategy and Health Policy – Medicare/Medicaid Integration, UnitedHealthcare Community & State

Lois Simon, EVP, Policy and Programs, Seniorlink

Moderators

Sarah Barth, Principal, HMA
Karen Brodsky, Principal, HMA

Providers have played a growing role in Medicaid managed care efforts through various accountable care organizations, risk-sharing arrangements, and Delivery System Reform Incentive Payment programs. With several years of experience under their belts, states and providers can begin to evaluate the success of these efforts and decide upon next steps. During this session, leading providers will address the future of provider-led Medicaid managed care, with an emphasis on the lessons learned from existing programs and the likelihood that these types of initiatives will continue to gain momentum.

Speakers

Mitchell Katz, MD, President and CEO, NYC Health + Hospitals

Moderator

Pat Terrell, Vice President, HMA

Some of the most innovate care delivery initiates involve new models to treat high-cost, high-acuity patients in integrated local settings. These providers employ models that include patient-centered medical homes, primary care, wrap-around services, and high-touch community-based care for the highest risk patients. During this session, some of the most innovative organizations discuss their approaches to care and results to date. Speakers will also provide insights on how care models for the nation’s sickest and most vulnerable individuals will likely evolve.

Speakers

Alan Cohn, CEO, President, AbsoluteCARE Inc.

Rebecca Kavoussi, President, West, Landmark Health

Sarita Mohanty, MD, VP, Care Coordination, Kaiser Permanente

Erica Murray, President and CEO, California Association of Public Hospitals

Moderator

Betsy Jones, Managing Principal, HMA