Agenda

The Medicaid Managed Care Leadership Summit brings 20+ key perspectives on pressing topics, an early bird think tank, two knowledge-packed tracks, and an abundance of networking opportunities to Medicaid professionals of all levels. 

April 29, 2019

7:30 AM

Registration and Networking Breakfast

7:30 AM

Pre-Conference - VIP Executive Interactive Think Tank

An invite only exclusive think tank allowing the opportunity for Medicaid leaders from across the country to analyze critical topics and the future of Medicaid.

Sponsored by: Leavitt Partners

9:00 AM

Chairperson's Opening Remarks

Clay Farris, Senior Healthcare Executive
Mostly Medicaid

9:10 AM

Panel Discussion: CEO Outlook for Medicaid 2020

• An overview of Medicaid issues at the plan, State, and National levels
• Examine the evolving landscape from 2018 and identify areas of growth in 2019
• Identifying best practices from the CEO level that can enhance operations within your plan
• The focus on Social Determinants and the return on investment

Moderator:
Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

Panel Members:
Jim Milanowski, President and CEO
GENESEE HEALTH PLAN

John Lovelace, President, President of Government Programs and Individual Advantage Products
UPMC HEALTH PLAN

Thomas Duncan, MBA, Chief Executive Officer
TRUSTED HEALTH PLAN

10:20 AM

Case Study: Implementation of Integrated Health Homes in Illinois

  • Examining the process of preparing for the new Integrated Health Home (IHH) program in Illinois, which offers fully-integrated form of care coordination for all members of the Illinois Medicaid population.
  • Identifying members diverse and changing needs over time for the IHH to craft a flexible care delivery approach 
  • Discussing potential evolution and growth areas in Medicaid in Illinois, using the IHH as an example of Illinois' commitment to being innovative with new provider type and services to comprehensive integration of behavioral and physical health.

Samantha Olds Frey, MPPA, Executive Director
ILLINOIS ASSOCIATION OF MEDICAID HEALTH PLANS

Alaina Kennedy, Associate Director
ILLINOIS ASSOCIATION OF MEDICAID HEALTH PLANS

11:10 AM
Networking Break

11:25 AM

Case Study: Arkansas - Examining Potential Outcomes of the Medicaid Work Requirements

  • Examining the implementation process of work requirements in Arkansas and other states
  • Dissecting the Data- Has the program been successful thus far?
  • Identifying the hurdles that Arkansas has had to overcome
  • Discussing the status of approved and pending waivers across the states

Libby Hinton, MSPH, Senior Policy Analyst
KAISER FAMILY FOUNDATION

12:25 PM
Networking Luncheon

1:15 PM

Concurrent Sessions

1:15 PM

Track A: Payment Risks in Medicaid Managed Care

  • Estimating payment risks in managed care—what’s included and what isn’t
  • Assessing the risks of improper payments in managed care from the standpoint of (1) states’ payments to managed care organizations, and (2) managed care organizations payments to providers.
  • Strategies to ensure accurate data and payment to avoid improper payments
 
 
Carolyn Yocom, Director, Health Care
U.S. Government Accountability Office

Chairperson
Clay Farris, Senior Healthcare Executive
Mostly Medicaid

1:15 PM

Track B: Community Health Innovation Region Model to Address Emergency Department Utilization and the Social Determinants of Health

  • Collaboration between a community backbone organization, Patient Centered Medical Home (PCMH) practices, and Medicaid Health Plans to identify high, inappropriate, and preventable Emergency Department utilizers
  • Implementing a community-wide strategy to address the Social Determinants of Health
  • Utilizing community-based social workers, nurses, and community health workers to facilitate clinical community linkages for Medicaid patients
  • Utilizing health informatics tools to facilitate clinical and community service referrals between healthcare and non-healthcare entities 
 
Jim Milanowski, President and CEO
Genesee Health Plan

2:15 PM

Concurrent Sessions

2:15 PM

Track A: Strategies to Reduce the Financial Impact of Opioid Addiction on Medicaid

  • Strategies to manage the ever-growing costs of drugs related to opioid addiction
  • Maximizing Medicaid Section 1115 Waivers to maximize treatment for members with opioid addiction
  • Identifying success of treatments through data analytics 
  • Evaluating early intervention and educational practices that can be used to reduce the opioid addiction crisis. 
  • Identifying how Medicaid MCO’s can impact SDoH for opioid addicted members
  • Maximizing engagement with incarcerated/recently released Medicaid members 
 
John Lovelace, President, President of Government Programs and Individual Advantage Products
UPMC Health Plan
 
Cynthia Reilly, MS, BS Pharm, Senior Vice President
Academy of Managed Care Pharmacy

 

 Dr. Kim Lenz


Chairperson
Clay Farris, Senior Healthcare Executive
Mostly Medicaid

 

2:15 PM

Track B: Case Study- Maximizing Communication through Test Messaging and Community Health Worker In-Home Visits

  • Analyzing the impact of communication through text messaging
  • Examining the data to show progression and improvement in member engagement
  • Identifying additional areas to improve levels of communication with members 
3:00 PM
Networking Break

3:15 PM

Concurrent Sessions

3:15 PM

Track A: Moving Alternative Payment Methods (APM) and Value-Based Reimbursement (VBR) from Concept to Reality for Mental Health and Substance Use Treatment Providers

  • Identify challenges in defining value in mental health and substance use treatment services 
  • Evaluating quality metrics on which to base a VBR
  • Define technology to support value-based methodology 
  • Outline an alternative payment model that incorporates value-based reimbursements
 
David Johnson MSW, ACSW, CEO
Fletcher Group

Chairperson
Clay Farris, Senior Healthcare Executive
Mostly Medicaid

3:15 PM

Track B: Maximizing Community Engagement with Members Living in Areas with Limited Resources

  • Identifying unique strategies to incentivizing participation in community engagement activities for your members
  • An overview of the Medicaid policies for designing community programs
  • Evaluating current programs that are producing successful outcomes
 
 
Karin VanZant, Vice President/Executive Director, Life Services
CareSource

4:15 PM

Concurrent Sessions

4:15 PM

Track A:Improving Outcomes and Reducing Costs for Medicaid Recipients through Evidence-Based Program Integration

  • Discussing the chronic disease self-management, falls prevention, physical activity and behavioral health evidence-based programs that are commonly offered across the country, as well as the health-related outcomes and cost savings achieved with these programs.
  • An overview of the two-venue approach - community workshops and digital - to deliver the Chronic Disease Self-Management Program to older adults and other Medicaid recipients with one or more chronic conditions.
  • Highlighting the value and impact of Evidence Based Programs on managed care organizations' quality and performance outcomes, member activation and satisfaction and the positive impact on healthcare costs.
  • Examining examples from state Medicaid programs that are funding evidence-based programs for Medicaid recipients with chronic illnesses or at high risk for falls.
 
Kathleen Cameron, Senior Director, Center for Healthy Aging
National Council on Aging
 
Sharon R. Williams, CMCE, CEO 
Williams Jaxon Consulting, LLC
NCOA Consultant

Chairperson
Clay Farris, Senior Healthcare Executive
Mostly Medicaid

4:15 PM

Track B: Case Study: Rhode Island - Re-calibrating managed care for value-based payment

  • How a mature managed care program is transitioning to MCO-led accountable care organizations
  • How a fresh infusion of DSHP funding for infrastructure is enticing provider engagement 
  • Lessons learned about designing for a balance between standardization and innovation, about the important role of change management, and about which fundamental issues need to be addressed early
Lauretta Converse, Director of Payment Reform and Financial Analytics
Rhode Island Medicaid Program

 

 

5:15 PM
Networking Cocktail Reception

April 30, 2019

7:30 AM
Networking Breakfast

8:00 AM

Chairperson's Recap of Day One

Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

8:10 AM

AMUsing High-Tech to help Medicaid MCOs Achieve the Triple Aim

  • Analyzing the most innovative technologies serving the Medicaid space
  • Identifying how to accelerate use of technology to help MCO’s
  • Evaluating new technologies on the horizon in the next 2 years

 

Binoy Bhansali, Vice President
Sandbox Industries
 
Vikram D. Bakhru, MD/MBA, Chief Operating Officer
ConsejoSano, Inc.

9:00 AM

AM Examining the Political Environment Impact on the Future of Medicaid Programs

  • Exploring the results of the mid-term elections 
  • Examining opportunities for Medicaid expansion
  • Overcoming real world obstacles and challenges for Medicaid programs
 
Hank Osowski, Managing Partner
Strategic Health Group LLC
 

9:45 AM

AM Maximizing MLTSS to Improve Inclusion, Quality and Efficiency for your Members

  • Increasing quality and efficiency by promoting community inclusion 
  • Managing care transitions to improve outcomes
  • Best practices to improve relationships and communication with community-based providers. 
 
Moderator
Jim McInnis, CFO & COO, Consumer Directed Services Strategy & Business Execution
 
Panel Members
 
Merrill Friedman, Senior Director, Disability Policy Engagement
Anthem, Inc.
 
Camille Dobson, Deputy Executive Director
The National Association of States United for Aging and Disabilities (NASUAD)
 
Sharon R. Williams, CMCE, CEO 
Williams Jaxon Consulting, LLC
NCOA Consultant
 
10:45am
Networking Break

11:00 AM

Case Study: Strategies to Improve Medicaid Encounter Data

  • Key CMS requirements intended to improve data reliability
  • Variation in states’ practices for ensuring data reliability
  • Actions that could improve CMS’s understanding of state data reliability 

 Carolyn Yocom, Director, Health Care
U.S. Government Accountability Office

 

11:30 am

Lessons from the Front Line – Medicaid Encounters Done Right; Using real-world examples, we will showcase how to:

  • Reduce state-levied SLA penalties
  • Improve encounter data accuracy, completeness and timeliness
  • Ensure continuous compliance
  • Streamline and optimize encounter operations in one state or several
 
Herb Larsen, Senior Director, Solution Consulting 
Edifecs
12:00 PM
Networking Luncheon

1:00 PM

Improving Provider Network Adequacy

  • Person centered planning: encouraging inter-agency collaboration
  • Maximizing reach and value through adult day services and other home and community-based services
  • Provider Relations: collaborations supporting innovative approaches
  • Balancing self-determination and network adequacy
Camille Dobson, Deputy Executive Director
NASUAD
Lisa Peters-Beumer MPH, Aging and Disability Service Consultant, 
& Immediate Past Chair,
National Adult Day Services Association

1:45 PM

Social Determinants of Health - Practical Uses to Improve Quality of Life for Your Members

  • Utilizing data and member experiences to prioritize needs
  • Examining current SDoH Menu and how to improve it to benefit populations and communities
  • Identifying success on improving quality of life and reducing unnecessary hospitalizations
 
Moderator
 
Ted Jones, VP of Government Engagement
Medecision
 
Panel: 
Merrill Friedman, Senior Director, Disability Policy Engagement
Anthem, Inc.
Ray Prushnock, Business Development
UPMC Health Plan
Jessica Grabowski, AM, LCSW, Executive Director 
Coordinated Care Alliance

2:45 PM

An Overview of the CMS Re-Released Regulations for Managed Care

  • Identifying how the CMS Changes will impact your current provider network including time and distance standards
  • Evaluating how the regulation changes will affect current capitation rates
  • Preparing for change- Best practices to identify which areas are in need of change in advance
  • Discussion of the recent revisions to identify what CMS is striving for

3:30 PM

Chairperson's Closing Remarks

Clay Farris, Senior Healthcare Executive
Mostly Medicaid
3:50pm
Conference Adjourns