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

7:30am
Registration and Networking Breakfast

8:30am

Pre-Conference - Medicaid Leadership Think Tank

RISE is proud to announce the Inaugural Medicaid Leadership Think Tank - an idea-exchange platform for senior level decision-makers in the Medicaid field. This is an exclusive, invitation-only breakfast allowing the opportunity for Medicaid leaders from across the country to analyze critical topics and the future of Medicaid. Invitations will be granted based on accomplishments and experience in the Medicaid field. For invitation inquiries, please email Tim Hart, Conference Director at thart@risehealth.org.

9:00am

Chairperson's Welcome Remarks

Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

9:10am

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

10:20am

Case Study: Implementation of Integrated Health Homes in Illinois

• Examine 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
• Identify members’ diverse and changing needs over time for the IHH to craft a flexible care delivery approach
• Discuss 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

11:10am
Networking Break

11:25am

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

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

Libby Hinton, MSPH, Senior Policy Analyst
KAISER FAMILY FOUNDATION

12:25pm
Networking Luncheon

1:15pm

Concurrent Sessions

Track A: Financial Impacts and Outcomes

Payment Risks in Medicaid Managed Care

• Estimate payment risks in managed care—what’s included and what isn’t
• Assess the risks of improper payments in managed care from the standpoint of (1) states’ payments to managed care organizations, and (2) payments of managed care organizations to providers
• Strategies to ensure accurate data and payment to avoid improper payments

Carolyn Yocom, MBA, Director, Health Care
U.S. GOVERNMENT ACCOUNTABILITY OFFICE

Track B: Member Engagement and Compliance

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
• Implement a community-wide strategy to address the Social Determinants of Health
• Utilize 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

2:00pm

Concurrent Sessions

Track A: Financial Impacts and Outcomes

Strategies to Reduce the Financial Impact of Opioid Addiction on Medicaid

• Strategies to manage the ever-growing costs of drugs related to opioid addiction
• Medicaid Section 1115 Waivers to maximize treatment for members with opioid addiction
• Identify success of treatments through data analytics
• Evaluate early intervention and educational practices that can be used to reduce the opioid addiction crisis.
• Identify how Medicaid MCO’s can impact SDoH for opioid addicted members
• Maximize engagement with incarcerated/recently released Medicaid members

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

Track B: Member Engagement and Compliance

Case Study- Maximizing Communication through Text Messaging and Community Health Worker In-Home Visits

• Analyze the impact of communication through text messaging
• Examine the data to show progression and improvement in member engagement
• Identify additional areas to improve levels of communication with members

Carla Zachodni, Clinical Quality Program Manager
ANTHEM INDIANA MEDICAID

3:00pm
Networking Break

3:15pm

Concurrent Sessions

Track A: Financial Impacts and Outcomes

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
• Evaluate 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

Track B: Member Engagement and Compliance

Maximizing Community Engagement with Members Living in Areas with Limited Resources

• Identify unique strategies to incentivizing participation in community engagement activities for your members
• An overview of the Medicaid policies for designing community programs
• Evaluate current programs that are producing successful outcomes

Karin VanZant, Vice President/Executive Director, Life Services
CARESOURCE

4:00pm

Concurrent Sessions

Track A: Financial Impacts and Outcomes

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

• Discuss 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.
• Highlight 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.
• Examine examples from state Medicaid programs that are funding evidence-based programs for Medicaid recipients with chronic illnesses or at high risk for falls.

Kathleen A. Cameron MPH, Senior Director, Center for Healthy Aging
NATIONAL COUNCIL ON AGING

Sharon R. Williams, CMCE, CEO
WILLIAMS JAXON CONSULTING, LLC
NCOA CONSULTANT

Track B: Member Engagement and Compliance

Strategies to Build a Compliant Organization and Medicaid Audit Preparedness

• Strategies to conduct compliance reviews on MCO contracts
• Best practices to implement and document procedures to eliminate fraud, waste and abuse
• Strategies to create a compliant working environment from the top down with incentives
• Discuss the 8 CMS Initiatives to improve Medicaid audits and promote transparency and accountability
• Strategies to prepare for a program integrity audit - Emphasizing the importance of accurate documentation • Install mock audits to prepare your team
• Best practices in preparing Medical Loss Ratio Data

Speaker TBD

5:00pm
Networking Cocktail Reception

April 30, 2019

7:30am
Networking Breakfast

8:00am

Chairperson's Recap of Day One

Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

8:10am

KEYNOTE: Using High-Tech to Help Medicaid MCOs Achieve the Triple Aim

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

9:00am

Maximizing MLTSS to Improve Inclusion, Quality and Efficiency for Your Members

• Increase quality and efficiency by promoting community inclusion
• Manage care transitions to improve outcomes
• Best practices to improve relationships and communication with community-based providers.

Moderator:
Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

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

11:00am

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

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

12:00pm
Networking Luncheon

1:00pm

Improving Provider Network Adequacy

• Examine your current provider network directory standards
• Adhere to the time and distance standards required by CMS
• Identify areas of improvement and gaps within your network
• Best practices in improving provider relations

Lisa Peters-Beumer, MPH, Aging and Disability Service Consultant, & Immediate Past Chair
NATIONAL ADULT DAY SERVICES ASSOCIATION

1:45pm

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

• Utilize data to express which social needs of your members are most important
• Examine your current SDoH menu and how to improve it to benefit your population
• Identify success in leading states and health plans on improving quality of life and reducing costs of hospitalization

Moderator:
Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

Panel Members:
Merrill Friedman, Senior Director, Disability Policy Engagement
ANTHEM, INC.

Dan LaVallee, Director of Government Programs
UPMC HEALTH PLAN

Jessica Grabowski, AM, LCSW, Executive Director
COORDINATED CARE ALLIANCE

2:35
Networking Break

2:45pm

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’ understanding of state data reliability

Carolyn Yocom, Director, Health Care
U.S. GOVERNMENT ACCOUNTABILITY OFFICE

3:30pm

Chairperson's Closing Remarks

Clay Farris, Senior Healthcare Executive
MOSTLY MEDICAID

3:50pm
Conference Adjourns