The HMA Fall Conference: Unlocking Solutions in Medicaid, Medicare, and Marketplace

Sponsored by WellCentric, DC

Chuck Milligan, Chief Executive Officer, HMA

Unlocking Solutions to Today’s Healthcare Challenges Through Innovation
Dr. Darshak Sanghavi is among the first employees of the Advanced Research Projects Agency for Health (ARPA-H), a newly created multibillion dollar agency within the U.S. Department of Health and Human Services. ARPA-H is poised to both disrupt and modernize today’s healthcare landscape – from the modes used to deliver care to services and technology and payment. Dr. Sanghavi will discuss historical challenges to innovation in the healthcare sector and a framework for overcoming these.

Speaker:
Darshak Sanghavi, MD, Advanced Research Projects Agency for Health (ARPA-H), U.S. Department of Health and Human Services

The Long Game: Improving Health Outcomes for All
Solutions that reduce barriers to health and improve outcomes take different forms depending on the politics and cultural priorities of different stakeholders. Federal and state leaders may call it different things, but health equity is really about reducing disparities and improving outcomes for all. This panel will provide a broader viewpoint on these goals, discussing the durability of the commitment, and the roles of federal policy initiatives, multi-disciplinary collaborations, and state program approaches to reduce healthcare disparities.

Speakers:
Andrew (Drew) Martin, MS, MHCDS, Director, WE in the World Institute
Leticia Reyes-Nash, Principal, HMA
Sara Singleton, Principal, Leavitt Partners, an HMA Company

Partnerships, Policy, and Program Strategies for Health Equity
Does better health start with finding a home? Efforts to address the social determinants of health are focusing on the intersection of housing and health. This panel of national leaders will discuss programmatic innovations, policies, partnerships, and funding to overcome the health and housing challenges.  

Speakers:
Catherine Anderson, Senior Vice President, Health Equity Strategy, UnitedHealth Group
Shaun Donovan, Chief Executive Officer, Enterprise Community Partners and former Secretary of the U.S. Department of Housing and Urban Development
Jennifer Leimaile Ho, Commissioner of Minnesota Housing and former Deputy Director at the U.S. Interagency Council on Homelessness
Jeff Olivet, Executive Director of U.S. Interagency Council on Homelessness 

Moderators:
Tia Cintron, Managing Director, Housing Services and Supports Practice, HMA
Robin Preston, Senior Regional Vice President, HMA

Payer Innovation: Scaling Innovations, Tools, and Technology to Achieve Whole Person Care
Our panel of speakers will shed light on solution-oriented approaches health plans are taking to Big Issues of the day. Hear how they plan to adapt to the demands for value-based care, the tools they have and those still needed to deliver, measure, and improve on person level quality initiatives; the future of integrated care for dually eligible individuals; headwinds due to enhanced scrutiny of payment; the rise of AI in healthcare, and other critical topics on the horizon.  

Speakers:
Michael Carson, President and CEO, Wellcare
Lakshmi Emory, MD, MPH, Chief Medical Officer, Aetna Better Health of Illinois
Jeremy Gaskill, Vice President, Central Regional President for Medicare, Humana
Anthony Thompson, Senior Vice President, Healthcare Network Strategy, CDPHP

Moderator:
Christine Rein, Managing Director, Local and Regional Managed Care Organizations Practice, HMA

Sponsored by PointClickCare

Navigating Provider Sustainability Options in Traditional Medicare
Physicians, nurse practitioners, clinical psychologists and other providers participating in Medicare Fee-for-Service are facing reductions in reimbursement while hospitals and other providers remain concerned their annual payment updates are not keeping pace with the cost of delivering care. Workforce shortages across the healthcare system exacerbate these challenges. This session will talk about pathways for Medicare to pay providers sufficiently while ensuring Medicare, beneficiaries and the taxpayer are getting value for their spending. Speakers will consider the role of new technologies, value-based care models, incentives for serving complex populations, and other novel opportunities to better balance access, quality, and reimbursement with program sustainability.

Speakers:
Konstantinos “Kosta” Deligiannidis, MD, MPH, Medical Director, Northwell Health
Stephen Gillaspy, PhD, Director of Health and Health Care, Center for Psychology and Health, American Psychological Association
Heidi Myers, Senior Director, Coverage and Payment of Global Health Economics and Reimbursement, Edwards Lifesciences

Moderator:
Amy Bassano, Managing Director, Medicare Practice, HMA

Innovations to Improve Outcomes for Medicare-Medicaid Dually Eligible Individuals
Join us to explore the transformative impact of the 2024 Medicare Advantage policies on the integrated care landscape for dually eligible individuals. This session will focus on the strategic choices states can pursue to enhance continuous coverage, coordination, and integration efforts for dual eligibles. Speakers will highlight strategies, data, and innovations needed to achieve integrated care for duals, diving into the pivotal policy decisions that offer insights for state leaders, Medicare Advantage and Medicaid managed care plans, providers, and stakeholders.

Speakers:
Michael Carson, President and CEO, Wellcare
Steven R. Counsell, MD, AGSF, FACP, Medical Director, Division of Aging, Indiana Family and Social Services Administration
Linda Kurian, MD, Executive Medical Director for the Center of Excellence of Medicare Duals/D-SNP, Aetna
Juliet Marsala, Deputy Secretary, Office of Long-term Living, Pennsylvania Department of Human Services

Moderator:
Holly Michaels Fisher, Principal, Medicare Practice, HMA

Marketplace Affordability Initiatives
Healthcare costs and affordability of insurance are top of mind concerns for government leaders and consumers as well as the health plans and providers that serve them. More states are undertaking initiatives to address affordability, from the rise of PDABs to cost containment commissions, cost growth benchmarks, transparency, and examining mergers and acquisitions. This discussion will focus on how these broader efforts are showing up in the individual market/ACA marketplace, which provides an increasingly important landing place for consumers.

Speakers:
Sabrina Corlette, JD, Founder, Co-Director, Center on Health Insurance Reforms, Georgetown University
Hunter Kellett, Director of Health Care, Commercial Sector Prices, Arnold Ventures
Kalyani Thampi, Associate Director of Programs, Peterson Center on Healthcare

Moderator:
Patrick Tigue, Senior Vice President, Practice Groups, HMA

Raising the Bar on Health Equity
The Robert Wood Johnson Foundation (RWJF) is funding a program that provides technical assistance to healthcare providers looking to embed equity throughout their workflow to improve health outcomes for all. This discussion will discuss the opportunity this presents, from the point of view of both the funder and the recipients of the RWJF grants, along with the HMA team providing the technical assistance.

Speakers:
Chara Stewart Abrams, MPH, System Director, Community Health and Health Equity, CHRISTUS Health
Aingyea Fraser, Program Officer, Robert Wood Johnson Foundation
Brian Patel, MD, Chief Medical Officer, Sturdy Health

Moderator
Leticia Reyes-Nash, Principal, HMA

Sickle Cell Treatment Innovation & Strategies to Improve Access
The two gene therapies FDA approved to treat sickle cell disease received attention as groundbreaking innovations that may be transformative for individuals with the disease. Certainly, these new treatments raise new model of care considerations, requiring planning and coordination from care providers, health plans, and states in order to harmonize coverage, care, and payment issues. States in particular are also considering the new Cell and Gene Therapy Access Model from the CMS Innovation Center. Yet, a focus on these new treatments should also not obscure a larger reality that we must confront: research shows that Americans with sickle cell disease often lack timely access to high quality care and treatments. About half of Americans with SCD are served by Medicaid. States, health plans, providers, and advocates have made improvements in recent years, but we have much farther to go to improve access, close gaps, reduce stigma, and improve outcomes. This session will present a very timely discussion on the challenges and opportunities improve access to care and treatment that can be a roadmap for the future.

Speakers
Regina Hartfield, President and CEO, Sickle Cell Disease Association of America
Talana Hughes, Executive Director, Sickle Cell Disease Association of Illinois
Connie Piccone, MD, Director, Pediatric Sickle Cell Program and Associate Medical Director, Pediatric Specialties at Carle Foundation Hospital, Urbana
Lizzy Whitehorn, Director of Healthcare and Family Services, State of Illinois

Moderator:
Josh Trent, Managing Principal, Leavitt Partners, an HMA Company

Sponsored by Delta Dental Ohio, Michigan, and Indiana

Meeting New Expectations for Health Equity and Improved Beneficiary Outcomes in Medicare Advantage
CMS is using its regulatory power to put downward pressure on Medicare Advantage rates, while also creating financial incentives to shape supplemental benefits to address equity gaps and improve outcomes for Medicaid beneficiaries. Stakeholders of the Medicare Advantage program need to understand how CMS’ approach to rates might impact them and pathways they can take to meet changing expectations. This discussion will look at value-based payment strategies, opportunities with differentiated supplemental benefits, and the way that both MA and FFS fee-for-service Medicare partners might respond to this call.

Speakers:
Melinda Buntin, Health Economist and Bloomberg Distinguished Professor at the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Carey Business School
Mark Fendrick, Director, University of Michigan Center for Value-Based Insurance Design
Matt Kazan, Vice President of Policy and Government Affairs, SCAN Group

Moderator:
Greg Gierer, Principal, Medicare Practice, HMA

Roadmap for Improving Children’s Behavioral Health and Addressing the National Crisis
During this interactive session you will have an opportunity to learn from a dynamic and inspiring panel including youth with lived experience of mental illness and institutionalization, family members of children with serious mental health conditions, and state leaders who have made significant progress in advancing more equitable access to a comprehensive continuum of behavioral health care for children. You will have the opportunity to participate in four topical discussion groups – governance, service array, financing, and engagement – to develop a blueprint that any entity can leverage to guide transformative child and youth system change.

Speakers:
Jodi Allen, LMFT, LPCC, Behavioral Health Specialist, Department for Medicaid Services
April M. Curtis, MSW, LSW, Foster Care Alumni of America (FCAA) Board President, CWLA Fellow, and Co-Lead for National Foster Care Youth and Alumni Policy Council
Echo Lustig, Patient Advocate
Stephanie Muth, Commissioner, Texas Department of Family and Protective Services

Moderators:
Uma Ahluwalia, Managing Director, Maryland, HMA
Heidi Arthur, Principal, Behavioral Health Practice, HMA
Ellen Breslin, Principal, HMA
Jon Rubin, Principal, HMA

What’s Next for the ACA Individual Insurance Market?
The ACA marketplace is the most stable it has ever been, in terms of interest and participation, with enrollment and carrier participation at an all-time high. However, the future is unstable, as once again we face the potential for major disruption. This session will feature plans that have had market success, discussing the unique considerations of this market, what makes for a successful experience, and how they are planning for the future.

Speakers:
Keith Epperson, Healthcare Actuary, Walnut Grove Consulting
Craig Fisher, Chief Development Officer, Jefferson Health Plan
Wesley Sanders, Founder and Principal Consultant, Evensun Health

Moderator:
Michelle Anderson, Director, Wakely Consulting Group, an HMA Company

Initiatives to Build Workforce Capacity
Healthcare delivery systems have struggled to afford, attract, retain, and engage care providers. These challenges have hit equally hard for public and private systems, regardless of their mission and financial status. This discussion will highlight innovative approaches taken by different leading systems to rethink the workforce that is needed to meet present challenges but also to adapt to future challenges.

Speakers:
Morgan L. Best, MHA, MBA, President, ML Best Consulting
Danielle Jordan-Ellis, System Director of HR, Bon Secours
Kristin Landini, Executive Director of Workforce Culture and Physician Relations, Sinai Chicago

Moderator:
Philip Burton, Vice President, Client Solutions, HMA

Innovation is a Buyer’s Market
Innovation in government-sponsored markets is highly sought after. Hear from former officials and current innovators on effective approaches to understand – and meet — states and payer needs, their processes, where innovators can have impact, and how those priorities translate into purchasing.

Speakers:
Amon Anderson, Managing Partner, Acumen America
Neil Batlivala, Co-founder & Chief Executive Officer, Pair Team
Jami Snyder, CEO, JSN Strategies, LLC, and former Texas Medicaid Director

Moderator:
David Kulick, Managing Director, Strategy and Transformation Practice, HMA

Sponsored by Vheda Health

Providers at Risk: Innovative Community-Driven Care Delivery Strategies
Lessons learned by federally qualified health centers (FQHCs), public hospitals, and entrepreneurial startups on how to better serve populations with diverse acute and ambulatory needs.

Speakers:
Wil Franklin, President and Chief Executive Officer, KC CARE Health Center
Hugh Lytle, Founder, Chairman, and CEO, Equality Health
Andie Martinez Patterson, CEO, Alameda Health Consortium

Moderator:
Warren Brodine, Principal, HMA

Re-examining Coverage Strategies in Behavioral Health
Beyond just expanding capacity, this panel will discuss a behavioral health system designed to serve needs across payers, across agencies, employing updated practices and innovative care strategies.

Speakers:
Jane Beyer, Senior Health Policy Advisor, Washington’s Office of the Insurance Commissioner
Teresa Claycamp, Behavioral Health Strategic Advisor, Division of Behavioral Health and Recovery, Washington’s Health Care Authority
Julie Collins, MSW, LCSW, Vice President of Practice Excellence, Child Welfare League of America
Ann Gillespie, Acting Director, Illinois Department of Insurance

Moderator:
Liz Arjun, Principal, HMA

Medicaid Unwound: Data Informed Strategies to Improve Health Outcomes
Hear from Medicaid Directors implementing different strategies to equitably improve outcome, sustain coverage and improve the customer experience with the Medicaid program. State leaders will share insights on major initiatives underway in their states to address health disparities, manage ongoing crises in mental health and substance use disorders including among children and youth, their perspectives on strategies to integrate care for the Medicare-Medicaid dual eligible population, use of AI and other timely topics.

Speakers:
Amir Bassiri, Deputy Commissioner of the Office of Health Insurance Programs and New York State Medicaid Director
Dana Flannery, Medicaid Director, New Mexico Human Services Department
Elizabeth Matney, Medicaid Director, Iowa Department of Human Services
Kristin Sousa, Medicaid Program Director, Rhode Island Executive Office of Health and Human Services 

Moderator:
Farah Hanley, Managing Principal, HMA and former Michigan Medicaid Director

Planning for the Future: Policymaking in the New Administrative State
As the 2024 presidential election unfolds, the one certainty is that leadership change is on the horizon. Our esteemed panel will explore competing policy agendas, and shine light on new administrative rules that significantly impact how both Congress and the new administration will shape policy. Our panelists include former officials who have held critical positions across all three branches of government serving under different leaders. These experts bring highly informed perspectives on key policy issues of the day, significant litigation that will shape the policy environment, and where the momentum is headed on issues we care about. Their insights will help you prepare and navigate the key issues that will be in play in 2025 and beyond.

Speakers:
Andrew Prins, Partner, Latham & Watkins LLP
Sara Singleton, Principal, Leavitt Partners, an HMA Company
Jonathan Su, Partner, Latham & Watkins LLP and former adviser to two U.S. Presidents
Josh Trent, Managing Principal, Leavitt Partners, an HMA Company

Moderator:
Jennifer Colamonico, Director, Thought Leadership, HMA

Network with new colleagues and partners over a lunch or grab a boxed lunch if you must leave us sooner.