2023 Agenda

Continental Breakfast

Chairperson’s Welcome

Recent Policy Actions in the Medicaid Space

• Medicaid redeterminations – the good, the bad and the ugly
• Through the looking glass – what are the federal policy goals in Medicaid
• ACHP’s perspective on the future of Medicaid & CHIP

CareFirst Community Health Plan Maryland's Redetermination Efforts: Collaboration Between MCOs and the State for Optimal Results

• Mitigating coverage losses during the unwinding of continuous enrollment through an innovative partnership with the state
• Prioritizing member outreach to ensure equitable healthcare access for all
• Connecting members with preventative care and social services through a unique relationship with Live Chair Health

Colorado's Unique Unwinding Process:  A Case Study Three Years in the Making

• Perpetual improvement is a culture
• Like so many innovations, success is the balance of people, tools, and processes in the right combinations. We are...
• expanding consensus amongst our 64 counties, and our peer state agency partners, on unified paths to build efficiencies and inter-county collaboration 
• upgrading systems to reduce workforce needs AND safeguard for a potential next event
• selectively centralizing operations to build redundancy and to support boutique programs that would face dilution across our 64 county system
• Celebrate; celebrate; celebrate

Perspectives from the State Marketplaces: How States are Using Integrated Eligibility Approaches to Return to Normal Operations

Morning Refreshment Break

Panel Discussion: Leveraging 1115 Waivers to Drive Innovation: Examples from Leading Medicaid Agencies

Moderator:

Panelists:

Transparency: The Key to Better Health Outcomes

Improved Transparency in the NEMT Ecosystem (Orders, Trips, Claims, Credentialling) is the building block to better performance.

Transdev’s Health Solutions division is focused on improving Health Outcomes for Managed Care Organizations and Medicaid/Medicare Agency populations. Our core competency is the most fundamental of health care services, transportation. We focus on improving transparency as the key lever in improving the transportation function of both clients and end users. Transparency is knowledge and knowledge drives innovation. Transdev looks to modernize medical transportation, improve the passenger experience, and provide useful data to its partners through innovation and business analytics.

SENTARA CASE STUDY
Value Based Care: What's Working, What's Not, and the Sentara Health Plan Case Study Around VBC and Provider Enablement

A don't-miss case study from Sentara Health on their track record around VBC deployment and provider enablement. Key points discussed include:

• Analysis of Sentara's VBC program progress
• Key lessons learned
• Areas that need improvement and programs to achieve the desired results
• Broader lessons on VBC that everyone should know

Tele-Transformation: Using the Data from Broad Expansions to Drive Permanent Policy and Coverage for Public Payers with an Eye On Equity

The COVID-19 pandemic catalyzed a dramatic rise in the use of telehealth nationwide to deliver services to Medicaid and Children’s Health Insurance Program (CHIP) members. NC Medicaid took early action to promote evidence-based, equitable delivery of Medicaid and CHIP services via telehealth during the COVID-19 pandemic and has transformed its telehealth policy based on this experience. In this session you will see benefit from their lessons learned and how we can drive improvements for the future.
Specifically, it will focus on:

• From 0-60: North Carolina’s Rapid Deployment of Telehealth in the Pandemic
• Lessons Learned: What the Data Taught Us About Who Gave and Received Services
• Keeping the Best, Getting Rid of the Rest: the approach to creating permanent policy and the need for broad change to drive equity

Luncheon

Panel Discussion: Addressing Health-Related Social Needs Through Medicaid Managed Care

Moderator:

Panelist:

Using Upstream Incentive Metrics to Drive System Transformation: Examples from the Oregon CCO Experience

• Discuss the evolution of metrics from process heavy, to clinical outcomes, to population health outcomes
• Highlight two examples of transformative cross-system metrics in the DHS Child Welfare space and improving social emotional services for young children
• Discuss how cross-system and community partnership improve population health outcomes and equity
• Address the tensions and opportunities with health plans to engage with new partners to improve health outcomes

Payer-Led Interventions Toward Health Equity in Vulnerable Groups

• Why working with hard to reach, vulnerable populations improves health equity and outcomes
• What interventions Genesee Health Plan deploys to target vulnerable groups
• A review of our experience and successes so far
• Lessons learned

Afternoon Refreshment Break

Panel Discussion: Improving Cultural Responsiveness to Reduce Health Disparities: Identifying and Removing Barriers to Care and Improving Outreach to Historically Marginalized Populations

Moderator:

Panelists:

Coordinating with Community-Based Organizations to Address Social Drivers of Health and Advance Health Equity

• The value-adding role community-based organizations serve in health care
• Key SDoH initiatives that most benefit from partnerships
• Effective partnership strategies 
• Sustaining programs through challenges and budget constraints

Linking Financial Quality Incentives to Performance Goals that Advance Health Equity

• Establish leadership commitment to doing the right things for the population
• The 3 P’s People, Place and Partnering with Community providers
• Expanding benefits and Increasing Access to care
• Identify Indicators of Success
• Measure Outcomes and Paying for Performance

 Cocktail Reception

Sponsored by:

Continental Breakfast

Making Health Equity an Intrinsic Part of the Corporate Culture: Creating Buy In and Setting the Foundation for the Cultural Shift

• Outline the business, financial and social rationale for managed care organizations to prioritize health equity right now.
• Identify the essential elements of persuasive communication to articulate the need for change and resonate with your audience.
• Explore CareSource’s journey to evolve into a culture of equity by identifying champions, garnering support, creating a vision and executing strategic initiatives to support a diverse membership.

Panel Discussion: Improving Member Accessibility to Care: Meeting Members’ Diverse Needs in Individualized Ways Enabling Them to Achieve their Full Health Potential

Moderator:

Panelist:

Leveraging Disparate Data through the DC Health Information Exchange’s Population Health Analytics Capabilities to Support Patient-Centered Care

• HIE infrastructure can support population-level and panel-level management across providers, managed care organizations, government entities, and other health system stakeholders
• Learn how the District has prioritized the development of basic and advanced analytic population health management capabilities in the DC HIE
• Understand how data from disparate sources are leveraged to populate HIE-based analytic tools, which can enhance a provider’s system-wide understanding of their patient population
• See how HIE-based dashboards supported by clinical, claims, and social needs data can support targeted intervention and care coordination

Mitigating the Maternal Health Crisis through Medicaid: Extending Postpartum Coverage and Increasing Access to High Quality Maternal Health Services

• Discuss operational considerations for extending postpartum coverage to 12 months
• Identify strategies for state Medicaid programs to work with managed care organizations to improve perinatal health outcomes
• Spotlight the creation of a community doula benefit
• Consider alignment of evaluation and quality goals to measure success

Improving Quality of Care and Health Equity for Dual Eligibles: Integrated Benefits and Integrated Models

• Describe the opportunities and challenges of integrated benefits for dually eligible members
• List several tactics that center health equity for dually eligible members
• Describe elements of high quality care models for dually eligible members

Morning Refreshment Break

Panel Discussion: Bolstering the Behavioral Health Workforce: Increasing Reimbursement Rates, Reducing Administrative Burdens, and Improving Access to Care

Moderator:

Panelists:

Leveraging Duals Integration Efforts to Increase HCBS Relative to Institutional Care, Assess LTSS Quality, and Increase Delivery of LTSS Through Managed Care

• The District offers a diverse array of LTSS, including three 1915(c) waivers and a variety of state plan benefits. The District historically has served more beneficiaries in the community than in institutional settings, but continues to explore means for transitions to the community for participants seeking community options.
• Efforts over the last several years to integrate Medicare and Medicaid benefits for dual eligibles enrolled offer the benefit of not only streamlining the experience of coverage for enrollees, but also improving the connection between LTSS and primary / acute care, improving coordination of benefits and services, and enhancing providers’ efficiency in delivering and being paid for services.
• Increasing Medicare-Medicaid coordination and launch of the District’s first capitated programs covering LTSS offer a unique opportunity to improve the District’s LTSS system, offer new care options for seniors and persons with disabilities, and share best practices across a wider stakeholder array.

Conclusion of Conference