Agenda

Chairperson’s Welcome

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.

Mitigating the Effects of Increased Enrollment at a Time of Declining State Revenue

Panel Discussion: Exploring the Impacts of the 2020 Election on the Future of Medicaid

Moderator:

Panelists:

Virginia's Efforts in Effectively Working with MCO's During COVID-19

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

Leveraging Home and Community Based Services to Serve Members and Support Physical Distancing

CASE STUDY: Advancing Telehealth in the Commonwealth: Providing Oversight, Guidance, and Direction to Healthcare Providers Delivering Care Using Telehealth

Close of Module One

Chairperson’s Welcome

Panel Discussion: Ensuring Patient-Centered Care Based on Member Values and Preferences for Those with Complex Care Needs During COVID-19

Panelists:

Moderator:

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.

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

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

Population Health and Care Management Strategies: Leveraging Data and Technology to Proactively Target Care Coordination Efforts and Outreach During a Pandemic

CASE STUDY: Leveraging Claims and Clinical Data to Identify High-Risk Members and Deploy Resources Accordingly

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

CASE STUDY: Maryland’s Innovative Approach to Telehealth to Improve Access to Care During COVID-19

Close of Module Two

Chairperson’s Welcome

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:

Panelists:

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.

• 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

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.

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

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

CASE STUDY: Addressing Implicit Racial Bias as a Systems Intervention to Improve Access to Care and Health Outcomes

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

Integrating Data Sources that Measure SDoH to Effectively Treat the Whole Person

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”

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

Close of Module Three

Chairperson’s Welcome

Hidden Dangers: What Opioid Management Programs Are Missing

CASE STUDY: Taking a Multidisciplinary Approach to Prevention and Treatment of Opioid Overdose and Opioid Use Disorder

Developing a Low-Barrier Approach to Medication for Opioid Use Disorder—Washington State Hub & Spoke

CASE STUDY: Developing an Opioid Management Strategy for Vulnerable, Higher Frequency Populations

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

Expanding Coverage for Non-Opioid Pain Treatments for Chronic Pain Management

Close of Module Four

Chairperson’s Welcome

Panel Discussion: Integrating Behavioral and Primary Care: Providing Prevention, Treatment, and Recovery Support Services to Improve Outcomes

Moderator:

Panelists:

CASE STUDY: Increasing Access for Telemental Health During the Pandemic and Beyond to Ensure Continuity of Care

CASE STUDY: Florida Medicaid’s Behavioral Health Flexibilities During the COVID-19

CASE STUDY: Engaging Medicaid, Behavioral Health and Developmental Disabilities Stakeholders During the COVID-19 Pandemic

Nebraska Heritage Health Adult Expansion Demonstration

CASE STUDY: Transformation in the Last Frontier: Lessons Learned in Implementing a Comprehensive 1115 Waiver for Behavioral Health

Close of Module Five

Chairperson’s Welcome

Panel Discussion: Using a Wide Variety of Digital Tools and Apps to Improve Member Satisfaction and Support Better Health

Moderator:

Panelists:

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

Thinking Omnichannel? Stop Until You Hear This

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

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

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

CASE STUDY Using Digital Strategies to Ensure Member Health, Safety, and Welfare During COVID-19

Close of Module Six

Chairperson’s Welcome

CASE STUDY Advancing Electronic Data Exchange and Care Coordination to Make Data More Actionable While Reducing Administrative Burdens

Automating Medicaid Benefit Plan Management Increases Efficiency and Claims Accuracy

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:

Panelist:

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

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.

Conclusion of Module Seven