2023 Agenda

Speaker Presentation
Day One, Thursday
July 27, 2023

Continental Breakfast


Chairperson’s Welcome

Kris Vilamaa,Partner and Chief Growth Officer,Mostly Medicaid


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

Michael Bagel,Associate Vice President of Public Policy,Alliance of Community Health Plans


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

Mike Rapach,President and CEO,CareFirst Community Health Plan Maryland


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

Ralph Choate,Chief Operating Officer, Colorado Health Care Policy and Finance Office


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

Kris Vilamaa,Partner and Chief Growth Officer, Mostly Medicaid


Morning Refreshment Break


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


Kacey Dugan, Director,Faegre Drinker Consulting


Ryan Schwarz,Chief, Office of Payment & Care Delivery Innovation,MassHealth (Massachusetts Medicaid and CHIP)

Jon Hamdorf, MBA,Former Kansas Medicaid Director, Market PresidentUCare


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.

Derek Fretheim Senior Director, Innovation,Transdev

Stephanie Boschenreither Director, National Operations,Transdev

Mike Sears Vice President, Business Development, NEMT,Transdev


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

Robert Krebbs, VP, Value Based Care and Provider Enablement,Sentara Health Plans


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

Shannon Dowler, Chief Medical Officer, North Carolina Medicaid,North Carolina Department of Health and Human Services




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


Kalin Scott, Principal,K. Scott Concepts


Karen Dale,CEO AmeriHealth Caritas DC and Chief DEI Officer,AmeriHealth Caritas Family of Companies

Shannon Dowler,Chief Medical Officer, North Carolina Medicaid,North Carolina Department of Health and Human Services

Chris Esguerra, MD,Chief Medical Officer,Health Plan of San Mateo

Sebastian Seiguer, JD, MBA,Co-Founder and Chief Executive Officer, Scene Health


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

Christine Bernsten, Director of Strategic Initiatives and Communications, Health Share of Oregon

Cat Livingston, MD, MPH, Medical Director, Health Share of Oregon


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

Jim Milanowski, CEO,Genesee Health Plan


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


Jim Milanowski,CEO,Genesee Health Plan


Cindy Ehlers, MS, LCMHC,Chief Operations Officer,Trillium Health Resources

Dawn Godbolt, PhD,Director of Health Equity, Maven Clinic

Chris Esguerra, MD,Chief Medical Officer,Health Plan of San Mateo


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

Merrill Friedman, Regional Vice President, Inclusive Policy and Advocacy,Elevance Health


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

Cindy Ehlers, MS, LCMHC, Chief Operations Officer, Trillium Health Resources


 Cocktail Reception

Sponsored by:

Day Two, Friday
July 28, 2023

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.

Cameual Wright, M.D., MBA,Vice President, Market Chief Medical Officer, Indiana Market,CareSource


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


Kris VilamaaPartner and Chief Growth OfficerMostly Medicaid


Amy AldighereVice President, Retiree Markets SolutionsEvernorth Health Services

Angela Smith-HietikkoExecutive Consultant, Behavioral Health Practice Clearlink Partners


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

Deniz Soyer, MBA, MPH, Division Director, Digital Health, Health Care Reform & Innovation Administration,District of Columbia Department of Health Care Finance


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

Adrienne Tyler Fegans,Deputy Director of Programs, Virginia Department of Medical Assistance Services


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

Chris Esguerra, MD, Chief Medical Officer, Health Plan of San Mateo


Morning Refreshment Break


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


Kris Vilamaa,Partner and Chief Growth Officer, Mostly Medicaid


Jennifer Joyce,LICSW, MBA Behavioral Health Coordinator, District of Columbia Department of Health Care Finance

Steven Girardeau, Psy.D.,Director of Clinical Services,Mental Health Systems


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.

Katherine Rogers, Director, Long-Term Care Administration, District of Columbia, Department of Health Care Finance


Conclusion of Conference