Here are 10 sessions with industry leaders at the Medicaid Managed Care Leadership Summit you won’t want to miss:
1. Confronting the impact of rate suppression and economic headwinds
This session will cover the structural drivers behind rate suppression in Medicaid financing, the inflationary pressures on service utilization and cost trends, and the 2025 rate negotiation landscape and its implications for Medicaid plans. Speakers will include Molly Whittle, VP Medicaid fiscal strategy, WellSense Health Plan, and Michael Bagel, associate vice president, public policy, Alliance of Community Health Plans.
2. Telehealth in Medicaid: Overcoming regulatory barriers and expanding access to care
Neil Batlivala, CEO, Pairteam, will explore innovative telehealth models aimed at reducing disparities in access to care, key opportunities to enhance telehealth reimbursement and quality oversight, and the current regulatory framework surrounding telehealth services within Medicaid.
3. Leveraging data analytics for Medicaid population health management
Throughout the discussion, Sarina Master, director of adult special populations, New York State Department of Health, and Elizabeth Montgomery, national VP, National Kidney Foundation, will review predictive modeling techniques that improve risk stratification and outcomes, state-level initiatives using data-driven approaches to enhance quality of care, and how data integration can enhance care coordination and reduce disparities.
4. Medicaid redeterminations: Overcoming challenges in coverage continuity
For this session, Nissa Shaffi, associate director of public policy, Alliance of Community Health Plans, will discuss the operational challenges of redetermining Medicaid eligibility, the use of data from SNAP and tax returns to streamline Medicaid renewals, and strategies for coordinating Medicaid to CHIP and marketplace transitions.
5. Risk adjustment methodologies in Medicaid managed care
This session will evaluate evolving risk adjustment models, with Raphael Cices, head of BOI, coding and billing, Cityblock, covering the impact of social determinants of health on risk-adjusted Medicaid populations and the best practices for optimizing risk adjustment processes to enhance quality of care.
6. Improving maternal health outcomes in Medicaid
This discussion will spotlight integrated care models that promote continuity of care across prenatal, delivery, and postpartum phases; clinical innovations, such as home visiting programs and community-based doulas that support Medicaid covered pregnancies; and strategies to improve maternal health data collection and reporting to enhance outcome tracking and inform evidence-based policy changes. Speakers will include Tiedra Marshall, director of expansion, Parents as Teachers, and Christa Moss, VP, clinical & payer strategy, Maven Health Clinic.
7. Value-based care in Medicaid: Charting the future of managed care innovations
For this session, Jatin Dave, chief medical officer, MassHealth, and John Zweifler, medical director, Central Valley Medical Providers, will discuss payment reform strategies that incentivize quality care and outcomes, barriers and opportunities for expanding value-based care, and state-level initiatives to transition Medicaid programs to value-based models.
8. Leveraging social needs screening to improve outcomes in Medicaid and dual-eligible populations
This session will be a discussion between several speakers on the role of data collection and reporting in supporting ongoing program funding and sustainability, how managed care organizations can offer community-based resources as an extension of traditional benefits, and the strategies for assessing and addressing social determinants. The speakers will be Teresa Hottle, director, CareSource; Joe Lee, founder and principal consultant, Community Health Synergy; and Rebecca Yanniello, vice president of population health, Regal Medical Group.
9. The CalAIM Model: A collaborative approach to social care integration in Medicaid
Meryl Price, president, Health Policy Matters, will cover the operationalization of Cal-AIM's wraparound services, the model's data-sharing strategies to monitor service usage, quality, and outcomes across stakeholders, and actionable insights from Cal-AIM's collaborative approach that can be applied to other state Medicaid programs.
10. Implementing a health equity framework in Medicaid: Standardizing demographic data collection and reporting
This session will explore the current Medicaid guidelines for capturing demographic and social determinant data to inform health equity strategies, best practices to engage providers in demographic data collection and incorporating it into care quality assessments, and strategies for leveraging demographic insights to address disparities and improve health outcomes. Speaker to be announced.
For more information on the Medicaid Managed Care Leadership Summit, a virtual event April 2-3, click here.