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.

The COVID-19 pandemic may have led to a “new normal” for the U.S. healthcare industry, but one thing remains the same: the politics around healthcare are still divisive and difficult to navigate. During this keynote address, Drew Altman, president and chief executive of the Kaiser Family Foundation, will discuss the politics of healthcare at the state and federal level, including a look at how the midterm elections may further complicate efforts to reach a consensus on necessary changes and improvements in the wake of COVID-19.

Speaker
Drew Altman, President and CEO, Kaiser Family Foundation

Moderator
Vernon Smith, Senior Advisor, HMA

State Medicaid programs have shown remarkable resiliency during the COVID-19 pandemic, despite soaring enrollment, rising costs, and system-wide staffing shortages. States also have managed to continue the roll out of innovative Medicaid initiatives aimed at improving quality, addressing inequities, and expanding benefits. During this keynote Q&A session, leading state Medicaid directors will outline key priorities and challenges for Medicaid programs, including eligibility redeterminations, the expiration of enhanced FMAP, the future of telehealth, and continued efforts to reform care delivery and ensure value.

Speakers
Jacey Cooper, Medicaid Director, Chief Deputy Director, California Department of Health Care Services
Dave Richard, Deputy Secretary, North Carolina Medicaid
Jami Snyder, Director, Arizona Health Care Cost Containment System
Allison Matters Taylor, Medicaid Director, Indiana

Moderator
Beth Kidder, Managing Principal, HMA, Tallahassee, FL

The end of the public health emergency will have important implications for Medicaid managed care plans, including the impact of eligibility redeterminations, the end of enhanced federal funding to states, and a likely increase in care utilization. That’s on top of growing pressure to address equity, quality, cost, and social determinants of health, as well as demands that plans participate in value-based payment initiatives. During this keynote Q&A session, leading managed care executives will discuss the strategies, priorities, and concerns they have as they strive to meet the needs of vulnerable member populations during an unprecedented time of healthcare disruption. Speakers will also outline growing opportunities to serve Medicare-Medicaid dual eligibles, foster children, individuals with substance use disorder, and individuals with developmental disabilities, among others.

Speakers
John Barger, National VP, Dual Eligible and Medicaid Programs, Humana, Inc.
Aimee Dailey, President, Medicaid, Elevance Health
Rebecca Engelman, EVP, Medicaid Markets, AmeriHealth Caritas
Brent Layton, President, COO, Centene Corporation
Kelly Munson, President, Aetna Medicaid
Timothy Spilker, CEO, UnitedHealthcare Community & State

Moderator
Donna Checkett, Vice President, HMA, Chicago, IL

Most healthcare organizations recognize the importance of addressing social determinants of health (SDOH) to improve health outcomes and foster equity. Translating that into action is a bidirectional challenge: providers of SDOH interventions are often community-based organizations that are inexperienced or ill-equipped to meet Medicaid managed care contracting expectations, and Medicaid systems often lack the relationships and understanding of how to work with these providers. What’s needed now is an effective implementation strategy that considers payment structures, contract mechanisms, quality requirements, data sharing, and capacity building to launch and operate successful SDOH partnerships. During this session, organizations on the front lines developing and implementing SDOH initiatives will discuss how to structure an effective partnership that all parties can agree to and that drives improved member outcomes.

Speakers
Cindy Cota, Director of Managed Medicaid Growth and Innovation, Volunteers of America
Taylor Nichols, Director of Social Services, Los Angeles Christian Health Centers
Debra Sanchez-Torres, Senior Advisor, Centers for Disease Control and Prevention
Amanda Van Vleet, Associate Director, Innovation, NC Medicaid Strategy Office, North Carolina Department of Health & Human Services

Moderator
Christina Altmayer, Principal, Los Angeles, CA

During this breakout session, representatives of behavioral health organizations will discuss several key challenges and opportunities faced by payers, providers, and regulators of behavioral health services. Foremost are staffing concerns exacerbated by the COVID-19 pandemic and the rising needs of patients seeking behavioral care. Speakers will also address questions concerning the quality and accountability of value-based payment models, the restructuring by states of behavioral health programs, and the emergence of Certified Community Behavioral Health Clinics (CCBHCs).

Speakers
Cristen Bates, Interim Medicaid Director, CO Department of Healthcare Policy & Financing
Michael Brodsky, MD, Medical Director for Behavioral Health and Social Services, L.A. Care Health Plan
Mark Sasvary, Chief Clinical Officer, CBHS, IPA, LLC
Courtnay Thompson, Market President, Select Health of South Carolina, an AmeriHealth Caritas Company

Moderator
Gina Lasky, Managing Director, Behavioral Health, HMA, Denver, CO

The pace of innovation among organizations serving Medicaid, Medicare, and other publicly sponsored healthcare markets has accelerated in recent years. During this breakout session, speakers from early-stage growth companies will present their solutions to improving care delivery and the member experience. A seasoned panel of Medicaid managed care executives will weigh in on each company’s value proposition and how to best to approach managed care partners on value-based contracting solutions.

Speakers
Jesse Hunter, Operating Partner, Welsh, Carson, Anderson & Stowe
Thomas Rim, VP, Product Development, AmeriHealth Caritas
David Rogers, President, Independent Living Systems
Jamo Rubin, CEO, RightSight Health
Megan Thomasch, VP of Clinical Operations, MedArrive
Jaimie White, Senior Vice President, Medicaid Operations, Humana
James Whittenburg, CEO, TenderHeart Health Outcomes

Moderator
Greg Nersessian, Managing Director, HMA Investment Services, New York, NY

State regulators, federal officials, health plans, and providers continue to push forward with efforts to ensure access to effective treatment for addiction and opioid use disorder. During this breakout session, speakers will provide an overview of the current state of addiction in the U.S. and assess the strengths and weaknesses of ongoing efforts to address the problem. Speakers will also provide case studies and best practices for offering addiction treatment across all the ASAM Levels of Care, including hospitals, community-based organizations, prisons, and jails. The focus will be on the upcoming fourth edition of the ASAM Criteria and its impact on quality, cost, and capacity of care throughout the care continuum.

Speakers
To be announced.

As the push to achieve the Quadruple Aim continues, health care providers and payers are having to make critical investments in information management and exchange capabilities. These investments are essential to enable models of care that effectively address physical health, behavioral health, and social determinants of health in a holistic manner. During this session, speakers that represent a wide variety of stakeholders will highlight critical information management and exchange capabilities in which they have invested or are planning to invest, along with the outcomes they expect to derive from those investments.

Speakers
Martin Lupinetti, President, CEO, HealthShare Exchange (HSX)
Todd Rogow, President, CEO, Healthix
Jim Sinkoff, Deputy Executive Officer, CFO, SunRiver Health
Tim Skeen, Senior Corporate VP, CIO, Sentara Healthcare

Moderator
Juan Montanez, Managing Director, HMA IT Advisory Services, Washington, DC

States are playing a central role in promoting health equity, with important implications for health plans and providers. During this breakout session, representative from states, Medicaid managed care plans, and providers will discuss how they are responding to new requirements and demands aimed at making health equity a key component of overall quality efforts. Topics will include how states are driving equity through health plan requirements, health system quality initiatives that include new equity components, and health plan efforts to innovate and prepare for new equity expectations.

Speakers
Kody Kinsley, Secretary, North Carolina Department of Health and Human Services
Andrew Martin, National Director of Business Development (Housing+Health), UnitedHealth Group
Joshua Traylor, Senior Director, Health Care Transformation Task Force
Shannon Wilson, VP, Population Health & Health Equity, Priority Health; Executive Director, Total Health Care Foundation

Moderator
Leticia Reyes-Nash, Principal, HMA, Chicago, IL

The Medicare Advantage program is a bona fide success story, serving more than 45 percent of the total Medicare population and still growing. Medicare Advantage plans have also been expanding their reach, offering coverage and expanded benefits to special needs populations such as dually eligible individuals, those requiring institutional levels of care, individuals with significant chronic conditions, and individuals with end stage renal disease (ESRD). During this session, representatives from some of the nation’s most innovative Medicare Advantage plans will discuss emerging growth opportunities as well as the challenges and solutions associated with serving a growing array of populations with increasingly complex needs.

Speakers
Eric Hunter, President, CEO, CareOregon
Nathan Linsley, SVP, Government and Individual Markets, Health Care Service Corp.
Ghita Worcester, SVP, Public Affairs & Chief Marketing Officer, UCare

Moderator
Julie Faulhaber, Managing Director, Medicare and Dual Eligibles, HMA, Chicago, IL

Healthcare organizations participating in value-based payment programs over the past decade have learned important lessons about what works and what doesn’t when it comes to driving value through financial incentives. During this session, representatives from some of the nation’s most innovative health systems and Federally Qualified Health Centers (FQHCs) will outline best practices for designing and implementing value-based programs, including case studies of several successful value-based initiatives. Speakers will also discuss how to decide which value-based arrangement is best for a particular organization.

Speakers
Daniel Elliott, MD, Medical Director, Christiana Care Quality Partners, eBrightHealth ACO, ChristianaCare Health System
Conrad Flick, M.D., Co-Chief Medical Officer, Community Care of North Carolina, Co-President, Community Care Physician Network Board
Efrain Talamantes, SVP & COO, Health Services, AltaMed Health Services Corporation

Moderator
Doug Elwell, CEO, HMA, Chicago, IL

Medicare has been testing value-based programs for more than 10 years. While results to date have been mixed, there has been significant progress. The Center for Medicare & Medicaid Innovation continues to refine existing value-based models and experiment with new ones to find the right combination of incentives that truly drives value in healthcare. Medicare Advantage plans are helping foster value-based efforts among providers. And CMS continues to view value-based payments as central to helping control costs and improve quality. During this keynote address, a leading Medicare policy expert will provide a frank assessment of what has worked and what hasn’t when it comes to Medicare value-based payments. Key insights will include a roadmap for likely value-based developments in the future and a broad understanding of why value-based payments are still viewed as the future of Medicare.

Speaker
Jennifer Friedman, Former Counselor to the HHS Secretary
Meena Seshamani, M.D., Deputy Administrator and Director, Center for Medicare, Centers for Medicare & Medicaid Services

Moderator
Amy Bassano, Managing Director, Medicare, HMA, Washington, DC

Healthcare programs for the elderly, including hospice, home care, nursing homes, and the Program of All-inclusive Care for the Elderly (PACE), experienced significant operational challenges during the pandemic. The most difficult was maintaining adequate staffing to ensure high-quality care and access to patients. But a variety of other challenges emerged as well, including how to best utilize new telehealth capabilities, navigating new value-based payments models, and ensuring continuity of care. During this panel discussion, representatives from health plans, provider organizations, and regulatory agencies will discuss how their operations changed during the pandemic and what the “new normal” will likely look like for senior care going forward.

Speakers
Brian Cloch, CEO, Transitional Care Management
Paul Ledford, President & CEO, Florida Hospice and Palliative Care Association
Daniel Longoria, President, CEO, Innovative Integrated Health, Inc.
Scott Sarran, MD, Chief Medical Officer, MoreCare IL

Moderators
Don Novo, Principal, HMA, San Francisco, CA
Debby McNamara, Senior Consultant, Tallahassee, FL