Monday, February 1, 2021: 10:00-1:05 ET
THE SHAPE OF THE NEW MEDICAID MARKET | |
10:00 |
Chairperson’s Welcome |
10:05 |
CASE STUDY: Accelerating Investments in SDoH to Close Gaps: Implementing Programs that Drive Care Coordination Among Physical Health, Behavioral Health and Social Services
George M. Aloth, JD, CHC,President & CEO,CareFirst BlueCross BlueShield Community Health Plan DC |
10:30 |
Mitigating the Effects of Increased Enrollment at a Time of Declining State Revenue
Henry W. Osowski,Managing Partner,Strategic Health Group |
10:55 |
Panel Discussion: Exploring the Impacts of the 2020 Election on the Future of Medicaid
Moderator:Leonard Kirschner,Immediate Past President,AARP Arizona Panelists:Clay Farris,Managing Editor,Mostly Medicaid Henry W. Osowski,Managing Partner,Strategic Health Group |
11:30 |
Virginia's Efforts in Effectively Working with MCO's During COVID-19
Jason Rachel, Ph.D., Director of Integrated Care,Virginia Department of Medical Assistance Services |
11:55 |
Five Critical Steps to Digitally Engage Medicaid Members & Achieve Quality Improvement Outcomes
Amy Lung,Chief Operating Officer, HealthMine |
12:20 |
Leveraging Home and Community Based Services to Serve Members and Support Physical Distancing
Merrill Friedman, Senior Director, Disability Policy Engagement, Anthem |
12:45 |
CASE STUDY: Advancing Telehealth in the Commonwealth: Providing Oversight, Guidance, and Direction to Healthcare Providers Delivering Care Using Telehealth
Robert E. Putt, Executive Director, Office of Health Data and Analytics,Kentucky Cabinet for Health and Family Services Donna Veno, Acting Director, Division of Telehealth Services, Office of Health Data and Analytics, Kentucky Cabinet for Health and Family Services |
1:05 |
Close of Module One
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Monday, February 1, 2021: 2:00-5:40 ET
CARE DELIVERY INNOVATIONS DURING COVID-19 | |
2:00 |
Chairperson’s Welcome |
2:05 |
Panel Discussion: Ensuring Patient-Centered Care Based on Member Values and Preferences for Those with Complex Care Needs During COVID-19
Panelists:Jean Kveberg, PharmD, Pharmacy Services Manager, My Choice Wisconsin Kathryn A. Teng, MD, MBA, FACP, Vice-Chair, Operations, Department of Medicine Service line Director, Adult Health & Wellness Service Line,The MetroHealth System Snezana Mahon, Pharm.D., Vice President and General Manager, Care Solutions, Evernorth Mark Gregory, RPH, Director, Pharmacy Consultant, Population Health Services, EnlivenHealth Moderator:Clay Farris, Managing Editor, Mostly Medicaid |
2:40 |
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.
Sarah Rubin, National Director, Policy and Strategy,UnitedHealthcare Community and State |
3:05 |
CASE STUDY: SPIAA - A Population Health Management FrameworkDr. Arakawa will share the new Population Health model, SPIAA, which is focusing on these key elements:
Gordon Arakawa, MD, PhD,Medical Director,Central California Alliance for Health |
3:40 |
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
Bill Clark, Medicaid Compliance Officer,Department of Vermont Health Access |
4:05 |
Population Health and Care Management Strategies: Leveraging Data and Technology to Proactively Target Care Coordination Efforts and Outreach During a Pandemic
Karissa Smith, LPC, CADC I,Director of Care Coordination,CareOregon Summer Sweet,Triage and Data Integration Manager of Population Health,CareOregon |
4:30 |
CASE STUDY: Leveraging Claims and Clinical Data to Identify High-Risk Members and Deploy Resources Accordingly
Joanne Scillia, Vice President, Medical Management, Affinity Health Plan Michelle Squire, MSN, RN, CCM,Director, Medical Management, Affinity Health Plan |
4:55 |
CASE STUDY: Prioritizing Preventative Care and Chronic Disease Management During a Pandemic
Jim Milanowski, President & CEO,Genesee Health Plan |
5:20 |
CASE STUDY: Maryland’s Innovative Approach to Telehealth to Improve Access to Care During COVID-19
Melanie Cavaliere, Chief, Innovative Care Delivery, Center for Health Information Technology & Innovative Care Delivery,Maryland Health Care Commission |
5:40 |
Close of Module Two
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Tuesday, February 2, 2021: 9:00-1:30 ET
SOCIAL DETERMINANTS OF HEALTH AND COMMUNITY PARTNERSHIPS | |
9:00 |
Chairperson’s Welcome |
9:05 |
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:Lauren Flynn Kelly, Managing Editor, AIS Health, an MMIT company Panelists:Jim Milanowski, President & CEO,Genesee Health Plan Amy Riegel, Director, Housing, CareSource Chris Norwood, Founder and Executive Director,Health People: Community Preventive Health Institute Eric Beane, Vice President of Regulatory and Government Affairs,Unite Us |
9:50 |
Integrated Care in The Next Generation Of State Programs: Exploring The Future Of Population Management In State Medicaid Programs, The Cal AIM ExampleCalifornia, 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:
In this session, ILS, a care management organization that runs integrated programs in multiple states and is currently engaged with a number of plans and programs in the California market, will present:
James Henderson, Chief Innovation Officer, Independent Living Systems Maureen LillisChief Operating Officer, Independent Living Systems Carol Lee Thorpe Executive Director, Independent Living Systems |
10:15 |
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:
Lauren Wetzlau, BSN RN, Population Health / Community Liaison, United Healthcare Community Plan Louisiana Catherine Macpherson, MS, RDN Vice President, Product Strategy and Development and Chief Nutrition Officer, Mom’s Meals |
10:40 |
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
Preeti Nakrani, MPH, Be Healthy Medicaid ACO Program Manager,Health New England |
11:05 |
Whole-Person Care Starts with Whole-Person Data: How Non-Traditional Data Sources Can Power Your SDOH Efforts
Diana Zuskov, Director, Market Planning, Government Healthcare & Public Health,LexisNexis Risk Solutions |
11:30 |
CASE STUDY: Addressing Implicit Racial Bias as a Systems Intervention to Improve Access to Care and Health Outcomes
Nancy Wongvipat Kalev, MPH,Director, Health Education/Wellness/Cultural and Linguistic Services,Health Net |
11:55 |
CASE STUDY: Developing Partnerships with Community Based Organizations to Reduce Social Barriers and Improve Health Literacy
Amy Riegel, Director, Housing, CareSource |
12:20 |
Integrating Data Sources that Measure SDoH to Effectively Treat the Whole Person
Dorthy Young, PhD,Chief Health Data, Operations and Research Officer,Mississippi State Department of Health |
12:45 |
CASE STUDY: Housing Instability: The Role of Medicaid Payers in Addressing Health Disparities
Lisa Holden,Vice President, Accountable Care, Independent Care Health Plan |
1:10 |
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 |
1:30 |
Close of Module Three
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Tuesday, February 2, 2021: 2:00-4:40 ET
Opioid/SUD Management and Pharmacy Innovations | |
2:00 |
Chairperson’s Welcome |
2:05 |
Hidden Dangers: What Opioid Management Programs Are Missing
Kendra Karagozian, AVP, Business Development,Tabula Rasa Healthcare |
2:40 |
CASE STUDY: Taking a Multidisciplinary Approach to Prevention and Treatment of Opioid Overdose and Opioid Use Disorder
Kelly Verrall, R.Ph., Director of Pharmacy Quality and Medication Therapy Management,Independent Health Joshua Sawyer, PharmD, Clinical Pharmacist – MTM – HIV/Behavioral Health,Independent Health |
3:05 |
Developing a Low-Barrier Approach to Medication for Opioid Use Disorder—Washington State Hub & Spoke
Stephanie S. Endler, MPA, Project Director, State Opioid Response Grant, Division of Behavioral Health and Recovery,Washington State Health Care Authority |
3:30 |
CASE STUDY: Developing an Opioid Management Strategy for Vulnerable, Higher Frequency Populations
Jennifer Strohecker, Director, Bureau of Healthcare Policy and Authorization, Utah Department of Health |
3:55 |
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
Allana M. Alexander, PharmD, MSMTM, BCMTMSr, Pharmacy Director, Alabama Care Network, Viva Health, Inc. |
4:20 |
Expanding Coverage for Non-Opioid Pain Treatments for Chronic Pain Management
Cynthia Mulder, Administrative Director of Pain Management & Palliative Medicine,, Englewood Hospital and Medical Center |
4:40 |
Close of Module Four
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Wednesday, February 3, 2021: 10:00-12:45 ET
BEHAVIORAL HEALTH | |
10:00 |
Chairperson’s Welcome |
10:05 |
Panel Discussion: Integrating Behavioral and Primary Care: Providing Prevention, Treatment, and Recovery Support Services to Improve Outcomes
Moderator:Henry W. Osowski, Managing Partner,Strategic Health Group Panelists:Garry Welch, PhD, Co-Founder and Chief Scientific Officer,Silver Fern Healthcare Michelle Squire, MSN, RN, CCM, Director, Medical Management,Affinity Health Plan Anna Hall, PHARMD, BCACP, Director of Quality Services,Enhanced Medication Services |
10:40 |
CASE STUDY: Increasing Access for Telemental Health During the Pandemic and Beyond to Ensure Continuity of Care
Stephanie Shushan, MHA, Senior Analyst, Integrated Programs and Strategic Initiatives,Community Health Plan of Washington |
11:05 |
CASE STUDY: Florida Medicaid’s Behavioral Health Flexibilities During the COVID-19
Tim Buehner, Ph.D., Program Administrator, Behavioral Health,Florida Agency for Health Care Administration |
11:30 |
CASE STUDY: Engaging Medicaid, Behavioral Health and Developmental Disabilities Stakeholders During the COVID-19 Pandemic
Michelle Laws, PhD, MA, Assistant Director for Consumer Policy and Community Stakeholder Engagement, Division of Mental Health/Developmental Disabilities and Substance Abuse Services, NC Department of Health and Human Services Suzanne B. Thompson, MBA/MHA, Community Engagement and Empowerment Team, Division of MH/DD/SAS, NC Department of Health and Human Services |
11:55 |
Nebraska Heritage Health Adult Expansion Demonstration
Todd Baustert, Administrator, Nebraska Department of Health and Human Services |
12:20 |
CASE STUDY: Transformation in the Last Frontier: Lessons Learned in Implementing a Comprehensive 1115 Waiver for Behavioral Health
Albert E. Wall, Deputy Commissioner, Alaska Department of Health and Human Services |
12:45 |
Close of Module Five
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Wednesday, February 3, 2021: 1:45-5:15 ET
Member-Facing Medicaid Technology and Engagement | |
1:45 |
Chairperson’s WelcomeJames Haskins, Director of Government Programs,HealthMine, Inc. |
1:50 |
Panel Discussion: Using a Wide Variety of Digital Tools and Apps to Improve Member Satisfaction and Support Better Health
Moderator:Jan Smith ReedDirector, US Healthcare,T-Base Communications Panelists:Lex Gillette,Paralympic Track and Field Athlete,Team USA James Haskins,Director of Government Programs,HealthMine, Inc. John J. Sweeney,Strategy and Business Development Director, Public Sector,WEX Health Sarenka Smith,Director, Marketing & Communications, emocha Health Laura Aiello, Director of Business Development and Strategic Partnerships,LifeStation |
2:35 |
Telehealth Offerings to Expand Health Access: Exploring Different Modalities to Tele-Triage Members and Deliver Care Remotely
Jackie Prokop, PhD, MHA, RN,Director, Program Policy Division, Medical Services Administration,Michigan Department of Health and Human Services |
3:00 |
Thinking Omnichannel? Stop Until You Hear This
Annemieke Umberg, Director of Strategic Accounts and Engagement,HealthCrowd |
3:25 |
CASE STUDY Leveraging Digital Outreach, Telehealth, and Text Message Technology to Engage Members
Marty Janssen, Senior Director of RAE Communications and Programs,Colorado Access Ana Brown-Cohen, MPH, Senior Manager of Health Programs,Colorado Access |
3:50 |
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!
Lakshmi Dhanvanthari, MD, Chief Medical Officer, Health Plan of San Joaquin |
4:15 |
Keeping Members Engaged with their Health and their Community During the Pandemic
Sandrine Blake,Assistant Director, Member Events, Amida Care Alex Fontanez, Manager – Member Engagement, Amida Care Melissa Morales,Strategic Account Director, mPulse Mobile |
4:50 |
CASE STUDY Using Digital Strategies to Ensure Member Health, Safety, and Welfare During COVID-19
Pamela Tropiano,Vice President, Healthcare Services, Molina Healthcare of Ohio |
5:15 |
Close of Module Six
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Thursday, February 4, 2021: 9:30-11:45 ET
INNOVATIONS IN OPERATIONAL TECHNOLOGY | |
9:30 |
Chairperson’s Welcome
|
9:35 |
CASE STUDY Advancing Electronic Data Exchange and Care Coordination to Make Data More Actionable While Reducing Administrative Burdens
William Golden, MD,Medical Director,Arkansas Office of Health Information Technology and Arkansas Medicaid Anne Santifer,Director,Arkansas Office of Health Information Technology |
10:00 |
Automating Medicaid Benefit Plan Management Increases Efficiency and Claims Accuracy
Mohammed Vaid,CEO/Chief Solution Architect,Simplify Healthcare |
10:25 |
Panel Discussion: Status of State Medicaid/CHIP Agency and Medicaid MCO Implementation of the CMS Final Rule on InteroperabilityState 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:Elena Nicolella, Executive Director,New England States Consortium Systems Organization Panelist:Mary Arcenas, PhD, RN, MBA, CPHQ, Manager, MMIS Modernization,NJ Division of Medical Assistance and Health Services Enrique Martinez-Vidal, Vice President for Quality and Operations,Association for Community Affiliated Plans |
11:00 |
COVID-19 Vaccine Outreach & Intervention Best PracticesBy attending this session, attendees will learn:
Gary Call, MD,Chief Medical Officer,HMS Ellen Harrison, RN,SVP, Market Strategy & Operations, Population Health Management,HMS |
11:25 |
CASE STUDY Why Buy it When You Can Build It? Idaho's Blueprint for Building a Custom Complaint and Critical Incident SystemIdaho 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. Alexandra (Ali) Fernández, Bureau Chief. Bureau of Long Term Care, Division of Medicaid, Idaho Department of Health and Welfare Chris Barrott Medicaid Program Policy Analyst, Idaho Department of Health and Welfare |
11:45 |
Conclusion of Module Seven
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