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Conferences

AHIP 2025

Dates:
Jun 16 - 18, 2025
Location:
Las Vegas, NV

Be part of AHIP’s flagship event that brings together the people, ideas, and solutions guiding greater health for years to come. **On-site registration is not available.**

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Sessions

8:30 am - 7:15 pm Jun 16 • 2025

8:30 am – 6:30 pm
, Registration and Information Desk Open

8:30 am – 12:00 pm
, Welcome Refreshments

11:30 am – 12:45 pm
, Lunch & Learns

  • Lunch will begin at 11:30 am. Speaking Sessions will begin promptly at 12:00 pm.

    • Behavioral Health and Medical Costs: Leveraging Innovation for Better Outcomes

      Presented by Optum – An AHIP Select Member
      Speakers
      Details

      The growing need to support mental health and substance use disorders among diverse populations is pushing health plans to be more strategic in facilitating access to behavioral health services. Recent innovations have created new opportunities to address both niche and widespread needs. However, plans often struggle to deliver these innovations effectively. Gain insights into sophisticated contracting strategies to ensure comprehensive coverage and successful delivery of behavioral services to members.

    • New Interoperability Solutions to Close Care Gaps and Drive Improved Outcomes

      Presented by Surescripts, LLC
      Speakers
      Details

      Health plans often lack the clinical insights and integrations needed to effectively close gaps in care for high-risk members. Providing high quality data and communicating needed actions within provider workflows is essential to improve outcomes. Explore how new interoperability solutions can streamline data exchange to ensure that providers have timely, accurate information to deliver better care, and ultimately improve member outcomes.

    • Delivering Integrated Behavioral Health for Plans, Care Teams, and Members

      Presented by CredibleMind
      Speakers
      Details

      Mental health symptom prevalence remains stubbornly high and is responsible for rising costs and poor quality of life. Although care teams and health plan leaders seek to transform behavioral health access, 3 in 4 members prefer to address symptoms on their own, and those seeking care often don’t know where to start. Join this discussion to explore new integrated behavioral health models to better serve members, and improve navigation and quality outcomes.

    • Leveraging Data to Improve Health Equity, Member Engagement and Gaps in Care

      Presented by LexisNexis Risk Solutions
      Speakers
      Details

      Member journeys that are informed by members’ social and economic challenges can be further enhanced with targeted, personalized interventions. However, reliable and up-to-date contact data is critical to reach members in order to provide relevant support in an efficient manner. Join this session to learn how health plans can leverage clean contact data to reduce communication and care gaps, facilitate preventive outreach and adherence, and drive better outcomes.

    • Reimagining Utilization Management Ecosystems: A Path to CMS Rule Compliance

      Presented by MCG Health
      Speakers
      Details

      Solving for compliance with the CMS Interoperability and Prior Authorization Final Rule is much more than an IT project, it requires significant changes to authorization processes and a reimagining of UM ecosystems. Join this session to discuss lessons learned from implementing provider APIs with various payers across diverse care settings. Gain insights from real-world experience that will enable health plan executives to anticipate challenges and navigate the best path to compliance.

    • Assessing Health Care Program Investments: Key Methods to Measure Effectiveness

      Presented by Milliman, Inc.
      Speakers
      Details

      With growing investments in health care programs and value-based care, measuring effectiveness is critical for payers and providers alike. Explore best practices from actuarial, clinical, and program evaluation perspectives and evaluate real-world impact using RTCs, observational studies, and alternative models. Learn to select the right evaluation method, navigate ethical and financial challenges, and leverage real world data to drive improved outcomes and support value-based decisions.

    • Guiding Members to Virtual Care in a System Built for Local Geographic Access

      Presented by Oshi Health
      Speakers
      Details

      Virtual specialty care networks are addressing major population health priorities – from provider shortages and preventive care gaps, to avoiding urgent care escalations, to improving outcomes and health economics. If only members knew about them. Marketing virtual care programs is complicated by legal, structural and technology barriers. Join this panel discussion with population health leaders to learn how to inform and guide members to virtual value-based care options in key moments of need.

    • Achieving Data-Driven Improvements on Time-Sensitive HEDIS Measures

      Presented by InterSystems
      Speakers
      Details

      Providing time-sensitive care for qualifying events tracked by HEDIS is critical, especially for high-risk members at vulnerable points in their care journey. Learn how to collaborate with providers and use near real-time visit data to automate identification of qualifying events for time-sensitive HEDIS measures. Explore an award-winning case study of how a health plan used interoperability and clinical data to improve HEDIS adherence.

1:00 pm – 3:30 pm
, Keynote Sessions

3:30 pm – 7:30 pm
, Exhibit Hall Open

3:30 pm – 4:15 pm
, Coffee Break with Solutions Providers

Presented by CCS Medical – An AHIP Select Member

3:35 pm – 4:10 pm
, Presentation Theater

  • 3:35 pm – 3:50 pm

    • AI-agents in Action: Revolutionizing Navigation Driving Personalized Care

      Presented by Pager
      Speakers
      Details

      The way members access care today is fragmented, overwhelming, and impersonal. It’s time to move beyond outdated tools. With AI-driven agents at the core, health plans can guide members to the right care in real time—across triage, provider search, benefits, and solutions. Combining AI with clinical support, this hybrid model builds trust and drives better outcomes. Discover how leading health plans are redefining care navigation with intelligent, personalized guidance.

    • Tackling Cost and Access Challenges for Cancer Patients

      Presented by OncoHealth
      Speakers
      Details

      Cancer rates continue to rise, and members with cancer face unique challenges that traditional care management often struggles to address. Gain insights into how enhanced cancer care management and virtual supportive care can immediately improve member satisfaction, increase access to care, and optimize value. Health plan and oncology leaders will also share perspectives on oncology trends and how plans can offer unique services to their employers.

  • 3:55 pm – 4:10 pm

    • Cancer Care Reimagined: Health Plans Driving Better Outcomes

      Presented by Color Health
      Speakers
      Details

      Cancer care costs are rising, and health plans face pressure to manage medical spend without sacrificing quality. Cancer is a complex journey—from detection to survivorship. A proactive, coordinated approach is key to improving outcomes. Join this discussion to explore today’s biggest care gaps and share practical strategies to drive better clinical and financial results.

    • Reducing Costs and Enhancing Quality for the Seriously Ill with AI-Driven Care

      Presented by Vynca
      Speaker
      Details

      Health plans face rising costs and care fragmentation for seriously ill members. This session explores how AI-driven care orchestration and hybrid palliative care models reduce acute care utilization and deliver cost-effective, high-quality care aligned with patients’ goals. Gain insights into real-world results from a proven value-based model that blends AI, remote monitoring, and interdisciplinary care to close palliative care gaps—especially in underserved communities.

4:30 pm – 5:15 pm
, Concurrent Sessions

  • 4:30 pm – 5:15 pm

    SERIES 1

    • Promoting Prevention & Population Health

      Achieving Optimal Health for All Populations in an Evolving Environment

      Speakers
      Details

      Explore strategies to improve outcomes for diverse populations amid changing regulatory, economic, and social landscapes. This session will highlight innovative approaches, data-driven insights, and collaborative models that drive sustainable, population-wide impact.

    • AI, Data Analytics & Interoperability

      Portfolio Management of AI – Ensuring Strategic Alignment with Enterprise Goals

      Speakers
      Details

      Learn how health plans can effectively manage their portfolio of AI initiatives to ensure strategic alignment with enterprise-wide goals and regulatory expectations. This session will explore governance models, prioritization frameworks, and real-world examples that drive value, accountability, and responsible AI adoption.

    • Advancing Value & Transforming Care Delivery

      Strengthening Primary Care: Assessing Payvider Models for Sustainability

      Speakers
      Details

      Payvider models are reshaping the primary care landscape by aligning financial incentives with care quality and access. This session will examine how these integrated approaches are enhancing care coordination, improving patient outcomes, and driving greater value. Explore lessons learned, key success factors, and what it takes to build sustainable, high-performing models that truly strengthen primary care.

    • Medicare, Medicaid, & Commercial Markets

      Navigating Politics and Policy Shaping the Future of Medicare Advantage

      Speakers
      Details

      This session will explore the evolution of Medicare Advantage (MA) over the last decade and key political and policy issues currently impacting the program. Speakers will also discuss opportunities and challenges affecting the future growth of MA and the ability of MA plans to innovate and adapt to the changing health care landscape.  

    • Advancing Value & Transforming Care Delivery

      Elevating Patient, Provider, and Payer Outcomes in an Oncology Medical Home

      Presented by Carelon
      Speakers
      Details

      Current incentives for cancer treatment are not well aligned between providers, payers, and patients. Join this session to explore an Oncology Medical Home model that combines data-driven provider, patient, and payer solutions that aligns incentives through enhanced patient and practice support. Learn how this model can foster streamlined care coordination, improved patient outcomes, and provider-payer alignment while containing total cost of care.

    • Closing Gaps in Coverage & Care

      How Closing Gaps in Communication Leads to Closing Gaps in Care

      Presented by Relay Network
      Speakers
      Details

      In today’s landscape, even the most well-intentioned digital tools can create complexity for members. What if the key to engagement is reducing content overload and focusing on channel enhancement – leveraging tools that remove friction and meet the member where they are? Explore how to reimagine the member experience by simplifying communications and personalizing outreach to drive member behavior, leading to improved satisfaction, increased digital adoption, and critical care gap closure.

    • Market Trends & Business Insights

      Beyond Prescriptions: The Value of Personalized Nutrition and Lifestyle Support

      Presented by CVS Healthspire Payor Solutions
      Speakers
      Details

      As the demand for GLP-1s continues to surge, health plans are navigating the challenges of balancing patient outcomes with cost, access, and long-term sustainability. Join this discussion to explore actionable insights into the evolving landscape of obesity treatment and how to create a comprehensive program to address patient needs. Learn how to develop effective lifestyle interventions that significantly enhance member outcomes and satisfaction for improved health.

    • Consumer Experience & Engagement

      Managing Experience in a Volatile Consumer Marketplace

      Presented by Press Ganey
      Speakers
      Details

      As consumer expectations evolve, health plans are working harder than ever to build trust, enhance satisfaction, and deliver exceptional experiences. Hear from leaders that will dive into the data from a 2025 Market Intelligence survey and gain insights into trends in consumer experience and resulting implications for quality and Stars programs. Learn firsthand how health plans are working to improve consumer sentiment in a volatile consumer marketplace.

  • 5:30 pm – 6:15 pm

    SERIES 2

    • Closing Gaps in Coverage & Care

      Leveraging Data to Achieve Whole Person Health

      Speakers
      Details

      Learn how health plans can harness modernized data strategies—including enhanced self-reported data collection—to drive whole person health. Explore innovative use cases that demonstrate how to leverage person-centered data to improve outcomes and close gaps in care.

    • Advancing Value & Transforming Care Delivery

      Best Practices to Build High-Impact Value-Based Partnerships

      Speakers
      Details

      Explore best practices for building high-impact value-based partnerships through the lens of a four-state transformation model driving improved care delivery and payment innovation. Gain insights into partnership frameworks, scalable strategies, and lessons learned to help health plan leaders achieve successful value-based care models.

    • Market Trends & Business Insights

      Reimagining Benefit Design to Deliver Whole-Person Health

      Speakers
      Details

      As expectations shift, health plans and employers are rethinking benefit design to support the full spectrum of employee well-being—physical, mental, financial, and beyond. This session will explore how innovative benefit strategies can drive healthier populations, stronger organizational performance, and a more resilient workforce. Hear how leading organizations are aligning benefits with evolving employee needs to build a health-first culture that delivers long-term value.

    • AI, Data Analytics & Interoperability

      Transforming Payment Integrity: The Path to Payment Precision

      Presented by Optum – An AHIP Select Member
      Speakers
      Details

      Payment integrity in health care is at a critical inflection point—facing unprecedented challenges, but also extraordinary opportunity. Join this discussion to unpack key trends and explore opportunities to begin the shift from traditional payment integrity toward payment precision. Discover how real-time interventions at claim submission can help make healthcare payment transactions more accurate the first time, every time, to drive more affordable and seamless healthcare for everyone.

    • Promoting Prevention & Population Health

      Building Sustainable Primary Care Partnerships for Older Populations

      Speakers
      Details

      Examine how health plans can build sustainable primary care partnerships tailored to the unique needs of older populations. This session will delve into the architectural elements and effective partnership structures between plans and providers that support continuity, coordination, and long-term value for older adults.

    • Consumer Experience & Engagement

      Ambient Listening GenAI: Optimizing Care Delivery and Member Experience

      Presented by Kyndryl
      Speakers
      Details

      Health care payers and providers are increasingly leveraging ambient listening GenAI to address clinician burnout and to improve member experience. Discover how health care payers can best implement these technologies to transform care delivery by enhancing workflows, productivity, and satisfaction for members and clinicians.

    • Emerging Tech & Digital Health Innovation

      Leveraging Data & Evidence-Based Models to Address the Maternal Health Crisis

      Presented by Pomelo Care
      Speaker
      Details

      Access, quality, chronic disease, disparities, mental health, and a fragmented system fuel the maternal health crisis. Yet health plans, providers, and employers can collaborate to tackle these complex issues during pregnancy and postpartum. Join this session to explore these themes, their intersections, and collaborative strategies to improve outcomes and reduce costs. Learn how evidence-based interventions, team-based care models, and digital health can advance maternal and infant health.

6:15 pm – 7:30 pm
, Reception with Solutions Providers

6:20 pm – 6:55 pm
, Presentation Theater

  • 6:20 pm – 6:35 pm

    • Helping Prepare Employees for Health Care Costs Now and in Retirement

      Presented by Fidelity Investments
      Speaker
      Details

      Many employees may not be prepared for current and future health care costs. In a first of its kind initiative, Fidelity Health Thought Leadership surveyed health professionals to understand clinicians' views on employee benefits. One key finding is clinicians report cost as the biggest concern for employees. Join us to explore ways to bridge the gap between the reality of financial preparedness for health costs and employees' expectations.

    • Leveraging Technology to Drive Cost Savings and Improve the Member Experience

      Presented by Best Buy Health
      Speaker
      Details

      Discover how health plans are using technology-enabled care-at-home solutions to lower costs and enhance the member experience. This session explores real-world strategies for reducing utilization, improving engagement, and delivering more connected, consumer-friendly care.

  • 6:40 pm – 6:55 pm

    • Using AI-Enhanced Chronic Care to Improve Member Outcomes

      Presented by Verily
      Speaker
      Details

      Health plans are looking to AI-enabled chronic care solutions to scale support for members with diabetes, obesity, and heart disease. This session will explore how AI, when integrated with clinical expertise and human coaching, can drive meaningful change in nutrition and lifestyle behaviors. Gain insights into how dynamic care models engage members and improve outcomes, and how to evaluate AI-enhanced care strategies that support your goals.

8:00 am - 6:00 pm Jun 17 • 2025

8:00 am – 6:00 pm
, Registration and Information Desk Open

8:45 am – 9:15 am
, Keynote Sessions

10:45 am – 7:15 pm
, Exhibit Hall Open

10:45 am – 11:30 am
, Coffee Break with Solutions Providers

10:50 am – 11:25 am
, Presentation Theater

  • 10:50 am – 11:05 am

    • Acing VBC Goals: Closing Gaps in Care Delivery with Enhanced Interoperability

      Presented by Healow
      Speaker
      Details

      Leveraging data from providers, health plans, and patients in combination with enhanced interoperability solutions can improve outcomes and help to achieve VBC goals. Join this session to advance beyond the multiple screens, spreadsheets, and disconnected systems that impede progress toward improved outcomes. Learn how to leverage FHIR standards and deeper intelligence to improve star ratings, accurate risk stratification, and higher member satisfaction.

    • Improving a Day in the Digital Life: Predicting and Eliminating Member Churn

      Presented by Whereoware
      Speaker
      Details

      Member journeys often break down between critical milestones—between choosing a plan and understanding it, between needing key plan information and knowing where to turn. This session follows a typical digital day from the member's perspective, highlighting the friction points and moments most likely to drive churn. Learn how behavioral data, AI, and smart interoperability can surface risks early—and trigger proactive experiences that build trust, improve retention, and lower service costs.

  • 11:10 am – 11:25 am

    • Food is Health: Advancing the New Standard of Care

      Presented by Nourished RX
      Speaker
      Details

      Amid a growing crisis in chronic disease and maternal health, health care must look beyond pharmaceuticals and address root causes—starting with nutrition. Explore how Food is Health is redefining the standard of care, backed by data on clinical, cost, and behavioral outcomes. Through video storytelling and real-world program insights, attendees will learn how connecting food, health, and care can transform lives—and health care itself.

    • What’s Holding You Back? Build the Experiences Your Members Expect Today

      Presented by RadiantGraph
      Speakers
      Details

      74% of health plan leaders say they feel stalled or uncertain about their progress in preparing for AI initiatives. In this dynamic session, we’ll tackle the perceived barriers and unknowns preventing health plans from unlocking the full potential of AI-driven personalization. We'll showcase solutions designed to boost engagement and clinical outcomes, close care gaps, improve Medicare retention, and reduce call center strain. Let’s bust through the AI myths that are holding you back!

11:40 am – 12:25 pm
, Concurrent Sessions

  • SERIES 3

    • Closing Gaps in Coverage & Care

      Optimizing Chronic Condition Care: Personalization, Equity and Outcomes

      Presented by Omada Health
      Speakers
      Details

      In today’s fragmented health care landscape, health plans must balance scalable chronic care programs with personalized support. How can solutions serve diverse populations while ensuring high-quality, efficient care? Can virtual care bridge the gap between “one size fits all” and “one size fits one”? Gain insights into how a health plan employed a virtual-first solution to tackle barriers, advance health equity, and improve outcomes for Medicaid and Medicare Advantage members.

    • Advancing Value & Transforming Care Delivery

      Advancing Value: Transforming Care Delivery Together

      Presented by Ovia Health – An AHIP Select Member
      Speakers
      Details

      Join a dynamic discussion exploring innovative partnership strategies for advancing value and transforming care delivery. Gain strategies for collaborative approaches to enhance patient outcomes, engage patients through personalization, and streamline health care processes. Discover how data-driven insights can improve care and patient engagement and ultimately facilitate a more effective care model that prioritizes quality and efficiency.

    • Promoting Prevention & Population Health

      Obesity in Focus: Intervention Strategies to Improve Outcomes

      Speakers
      Details

      Gain insights into effective intervention strategies health plans can deploy to address obesity and its related health impacts across diverse populations. Learn how cross-sector partnerships, data-driven models, and targeted approaches improve care delivery, advance health outcomes, and support long-term health improvement.

    • AI, Data Analytics & Interoperability

      Modernizing Demographic Data Standards to Improve Access and Outcomes

      Speakers
      Details

      Health plans and providers invest significant resources in collecting patient demographic data to understand how and why health and outcomes vary by population. Yet, the data are often incomplete or inaccurate. Learn about the national, multi-stakeholder Demographic Data Element Modernization (DEMo) Initiative and results from patient and clinician testing of the proposed data standards. Gain insights into how to join the effort and help to advance interoperability across the ecosystem.

    • Medicare, Medicaid, & Commercial Markets

      The Evolving Landscape of Medicaid

      Speakers
    • Emerging Tech & Digital Health Innovation

      The Great Digital Health Pricing Showdown: PEPM vs Claims-Based Billing

      Presented by Solera Health
      Speakers
      Details

      Is participant pricing dead—or just getting started? In this high-energy debate, industry leaders go head-to-head on the future of digital health contracts. Is claims-based billing the new gold standard, or can participant-based pricing still deliver meaningful ROI at scale? This session promises sharp insights, bold perspectives, and a few hot takes you won’t want to miss.

    • Market Trends & Business Insights

      Beyond Compliance: Innovation to Solve Authorizations for Good

      Presented by Availity
      Speakers
      Details

      Health plans are working on compliance for CMS’s Interoperability and Prior Authorization Final Rule, but these mandates can also be strategic advantages. Learn how AI and advanced automation offer a holistic, end-to-end approach to solve prior authorizations for good—seamlessly integrating real-time submissions, status updates, clinical attachments, and determinations. Gain insights to reduce provider abrasion, lower costs, and improve member satisfaction through intelligent decision-making.

    • Consumer Experience & Engagement

      Combining AI & Human Intelligence for Improved Member and Provider Experience

      Presented by Sagility – An AHIP Select Member
      Speakers
      Details

      GenAI is moving fast and has the potential to greatly improve member and provider experience. Join this session to explore how AI combined with human intelligence can best be applied to different health plan workflows. Gain insights into GenAI adoption decisions, risk mitigation strategies and what innovative strategies have worked well for health plans.

12:25 pm – 1:35 pm
, Lunch & Learns

  • 12:25 pm – 1:35 pm

    Lunch will begin at 12:25 pm. Speaking Sessions will begin promptly at 12:50 pm.

    • Reimagining Benefit Design to Deliver High-Value Diabetes Care

      Presented by CCS Medical – An AHIP Select Member
      Speakers
      Details

      Diabetes care is drowning in complexity, with fragmented solutions and underutilized education programs leaving patients and providers overwhelmed. Gain insights to unpack systemic challenges in delivering effective, holistic chronic care management programs to patients. Explore how health plans can reimagine benefit design and integrate medical device education, lifestyle coaching, and clinician support to drive high-value chronic care outcomes.

    • Protecting Newborns From RSV: Opening a Reimbursement Pathway

      Presented by Sanofi – An AHIP Select Member
      Speaker
      Details

      CDC recommends newborns be immunized against RSV within one week of birth, ideally during the birth hospitalization to support uptake and prevent missed opportunities. This session will explore how payers can support access by engaging hospitals to increase inpatient immunization rates for infants born during the RSV season, decreasing risk of RSV infection in the first months of life and reducing total cost of care.

    • Quiet the Chaos of Data Overload: Surfacing Actionable Insights within the EHR

      Presented by athenahealth
      Speakers
      Details

      In the complex world of health care, the financial arrangements between payers and providers have evolved amid challenges, with ongoing efforts to enhance alignment and collaboration. This session will explore how clinical interoperability and data exchange between payers and providers can address existing problems as well as create opportunities to enhance patient care and simplify the future of health care.

    • Improving Mental Health & Workforce Well-Being Through Digital Platforms

      Presented by Calm
      Speaker
      Details

      Emerging technologies are transforming business, but investing in mental health and well-being is a business imperative. Explore how employers and health plans are using cutting-edge digital platforms to address unmet mental health needs and bridge mental health care gaps at scale. Gain real insights into industry collaborations that prioritize mental health and well-being to drive a healthier, more productive, and fulfilled workforce.

    • Optimize Business Operations by Ensuring Provider Data Integrity

      Presented by HealthEdge
      Speakers
      Details

      Health plans require integrated provider data management solutions as they grow and respond to market pressure. Join this session to learn how to utilize a robust provider management tool to enhance the integrity and reliability of provider data from multiple sources used for accurate upstream and downstream payments. Gain insights to ensure scalability with SaaS platforms to reduce pended claims and authorizations, resulting in improved member and provider experience.

    • Democratizing Cardiovascular Care: Blending In-Home and Virtual-First Care

      Presented by Signify Health
      Speakers
      Details

      Join this discussion to explore innovative models integrating in-home and virtual-first care to address the challenges of cardiovascular disease detection and management amidst a growing health care dilemma. Through real-world examples, learn how various approaches can scale to expand access, address staffing and technology challenges, improve outcomes for diverse populations, and tackle care gaps. Gain insights to create a more sustainable, equitable, and patient-centric health care system.

    • Smarter Utilization Management for Positive Member Outcomes

      Presented by Evernorth Health Services
      Speakers
      Details

      Effective utilization management (UM) can ensure that members receive all of the health care they need, and none that they don’t. When applied properly, UM helps deliver a better quality of life to members by closing gaps in care and avoiding unnecessary services. Gain insights into recent patient stories where direct preventive care outreach and site of care optimizations have led to significant improvements in member outcomes.

    • Better Networks Require Better Data: Insights from a Survey of Health Plan Executives

      Presented by Quest Analytics
      Speakers
      Details

      Despite significant investments in network design, health plans face unreliable data, limiting insights into provider performance and network competitiveness. Join this session to explore findings from a survey of 100 health plan executives, highlighting pervasive data issues and their impact on organizational priorities. Gain insights into claims-based validation, improving provider quality, enhancing competitive positioning, and how network design is critical to achieving success.

1:35 pm – 2:25 pm
, Dessert Break with Solutions Providers

1:50 pm – 2:25 pm
, Presentation Theater

  • 1:50 pm – 2:05 pm

    • Make Your Star Ratings Shine with Adherence-Focused Medication Management

      Presented by Anew Health
      Speaker
      Details

      Medication-related challenges are one of the top cost drivers and performance risks for health plans. If not addressed, these challenges can lead to decreased member health, higher utilization, poor adherence, and higher total cost of care. In this fast-paced session, gain insights into how data driven, pharmacy led interventions can reduce adverse drug events, increase medication adherence, and directly impact measures tied to Star Ratings, HEDIS, and medical loss ratios.

    • Reimagining Health Economics: Actionable Insights from Real World Evidence

      Presented by PCORI
      Speaker
      Details

      Research has not traditionally addressed the evidence needs of patients and payers. PCORI developed and is evolving a new approach to collecting data on patient-centered burdens and economic outcomes relevant to consumers and payers. Join this session to learn more about where PCORI is in evolving thinking around health economics and help inform PCORI on how to enhance responsiveness to payer economic data needs.

  • 2:10 pm – 2:25 pm

    • Next-Gen Engagement: Transforming How Payers, Providers, and Consumers Connect

      Presented by Carelon
      Speakers
      Details

      Join us to learn about how health care organizations can leverage technology advancements to enhance and personalize engagement capabilities to exceed rapidly evolving consumer expectations. Learn about drivers of change, technology enablers, and workforce implications. Prominent global health care leadership will outline the strategies and capabilities required for next-generation consumer engagement that align with current and future market trends.

    • Medicare Prescription Payment Plan: A Force for Good in the Medicare Market

      Presented by Optum – An AHIP Select Member
      Speakers
      Details

      The Inflation Reduction Act introduced the Medicare Prescription Payment Plan (M3P), allowing consumers the option to spread their prescription costs over monthly installments. Join us to examine the opportunity M3P presents to better support Medicare members and explore the development of a solution deployed with pharmacy automation. Hear from product innovation experts about M3P and new products for Medicare as well as Medicaid and commercial clients.

2:35 pm – 5:15 pm
, Concurrent Sessions

  • 2:35 pm – 3:20 pm

    SERIES 4

    • Closing Gaps in Coverage & Care

      Cross-Industry Collaboration Driving Improved Maternal Health Outcomes

      Speakers
      Details

      Learn how cross-industry collaboration is transforming maternal health through a groundbreaking 14-state initiative focused on improving access and outcomes. This session will share actionable insights, key strategies, and lessons learned that health plan leaders can apply to drive meaningful change in maternal care.

    • Advancing Value & Transforming Care Delivery

      Powering Primary Care Partnerships: Lessons Learned from a Multi-Payer Collaboration

      Speakers
      Details

      Discover how a multi-payer collaboration in Washington has strengthened primary care through aligned goals, shared investments, and coordinated strategies. Explore key lessons learned and practical insights to build impactful, sustainable primary care partnerships.

    • AI, Data Analytics & Interoperability

      Interoperability 2.0 - Optimizing API-Based Systems to Power Data Exchange

      Speakers
      Details

      Explore the future of interoperability through API-based systems that enhance data exchange, streamline workflows, and improve patient care. This session will provide health plan leaders with actionable strategies for optimizing APIs to drive seamless integration across platforms and achieve a more connected health care ecosystem.

    • Market Trends & Business Insights

      Beyond the Breach: Fortifying Health Care’s Digital Defenses

      Speakers
      Details

      Recent cyberattacks have exposed vulnerabilities in the health care system’s digital infrastructure. This session explores lessons learned from high-profile incidents and offers practical strategies to strengthen resilience. Hear how health plans are advancing risk management, improving incident response, assessing vendor vulnerabilities, and collaborating across the ecosystem to ensure business continuity in an evolving threat landscape.

    • Promoting Prevention & Population Health

      Unlocking Hidden Potential: The Next-Gen Care Management Advantage

      Presented by PointClickCare
      Speakers
      Details

      Health plans face unprecedented challenges, with traditional cost control measures yielding diminishing returns. Although often overlooked, care management is an underutilized strategy to combat market pressures. Explore innovative approaches to leverage real-time data during health inflection points to improve operational efficiency and outcomes. Gain insights to supercharge care management teams, building member trust and driving behavior change for improved outcomes.

    • Consumer Experience & Engagement

      Transforming Medicare Advantage Member Experiences and Engagement

      Presented by Vitality
      Speaker
      Details

      In the evolving Medicare Advantage landscape, member engagement and experience are paramount to improving health outcomes and plan performance. Join this dynamic discussion to explore real-world engagement and experience challenges, from member onboarding to retention. Gain actionable insights to overcome these challenges and learn how to use data and technology to enhance Stars performance, boost risk adjustment accuracy, and close care gaps.

    • Emerging Tech & Digital Health Innovation

      Innovative Approaches to Drug Pricing Strategies for Greater Transparency

      Presented by CVS Health
      Speaker
      Details

      For years, the pharmacy industry managed drug costs through cross-subsidization–lowering the cost of brand drugs by shifting value from generic drugs. Yet, in today’s market, high deductible health plan members are exposed to the full cost of medications. Join this session to understand the evolving pharmacy pricing landscape and new strategies to contain health plan and member costs. Gain insights into transparency tools and data to oversee plan costs and manage fiduciary responsibilities.

    • Medicare, Medicaid, & Commercial Markets

      Designing Health Care Infrastructure to Support an Aging Population

      Speakers
      Details

      As demand for coordinated, cost-effective care grows among older adults, health plans have a key opportunity to strengthen infrastructure and benefits that support whole-person care and community connection. Speakers in this session will explore strategies to support aging members through preventive care, home-based services, and integrated supports that reduce utilization and enhance quality of life.

  • 3:30 pm – 4:15 pm

    SERIES 5

    • Closing Gaps in Coverage & Care

      The ROI of Member Trust: How Trust Improves Quality, Retention, and Performance

      Presented by Wider Circle
      Speaker
      Details

      Trust, developed through community activation, is the foundation which enables sustained member engagement and loyalty. In this session, learn how a health plan is building meaningful relationships with members through in-person, personalized support and peer-based community programs. Gain insights into how trusted communities with strengthened social fabric drive improved outcomes, duals and program alignment, boost retention, and increase HEDIS and STARS scores with a significant ROI.

    • Advancing Value & Transforming Care Delivery

      Overcoming Stagnation in VBC: Challenges and Opportunities

      Presented by Optum – An AHIP Select Member
      Speakers
      Details

      A decade after the implementation of the Affordable Care Act, value-based contracting and care models have become largely standardized. While adoption grows steadily, innovation has plateaued due to systemic challenges. Yet, emerging trends in regulation and technology are creating an environment ripe for VBC innovation. Join this session to explore innovations at the intersection of technology, operational workflows, and actuarial sciences advancing how the industry pays for and delivers care.

    • Promoting Prevention & Population Health

      Improving Cardiovascular Outcomes: Partnerships that Drive Community Impact

      Speakers
      Details

      Cardiovascular disease remains a leading driver of health care costs and disparities across populations. This session will highlight innovative partnerships that are moving the needle on heart health. Hear how health plans, providers, and community organizations are working together to improve outcomes through locally driven interventions, effective data exchange, and culturally responsive outreach strategies.

    • AI, Data Analytics & Interoperability

      Unlocking the Power of Integrated Data: Optimizing Well-Being Program Engagement

      Presented by WebMD Health Service
      Speaker
      Details

      Analytics are crucial to assess the effectiveness of well-being programs, track member health improvement, and identify and activate members in targeted programs. Explore how to best integrate health data for a more complete picture of member health to enable personalized interventions. Learn how to leverage claims data, human capital data, and employ advanced analytic models to gain actionable insights to enhance engagement platforms and improve overall performance of wellness programs.

    • Medicare, Medicaid, & Commercial Markets

      Strengthening Medicaid Engagement Through Community-Based Collaboration

      Speakers
      Details

      Discover how health plans can strengthen Medicaid engagement by fostering community-based collaborations that reduce access barriers and deliver sustainable solutions directly within communities. Speakers in this session will highlight successful partnership models and strategies for cultivating relationships that improve care delivery and enhance member outcomes.

    • Consumer Experience & Engagement

      Improving the Member Journey: Simplified Navigation for Better Access and Experience

      Speakers
      Details

      Navigating health care can be complex and frustrating for members. This session explores how health plans are streamlining access, reducing friction, and guiding individuals to the right care at the right time. Learn how digital tools, personalized support, and coordinated strategies are enhancing engagement, outcomes, and trust throughout the member journey.

    • Emerging Tech & Digital Health Innovation

      The Future of Post-Acute Care: Technology as a Catalyst for Better Outcomes

      Speakers
      Details

      Technology is redefining the post-acute care experience—improving coordination, reducing readmissions, and supporting better recovery. This session explores how health plans are using digital tools, data analytics, and virtual care to strengthen partnerships, streamline operations, and drive improved outcomes for post-acute patients.

    • Market Trends & Business Insights

      Breaking the Cycle: Innovations to Improve Provider Data Accuracy

      Presented by CAQH
      Speakers
      Details

      Accurate provider directories present a strategic opportunity to drive operational efficiency, reduce friction in care navigation, and enhance member satisfaction. By investing in better data and smarter tools, plans can turn a common challenge into a point of strength, making it easier for members to find the right care at the right time. Join this session to hear insights from industry leaders on how future-forward innovations are improving provider data accuracy and care access.

  • 4:30 pm – 5:15 pm

    SERIES 6

    • Closing Gaps in Coverage & Care

      Value-Based Innovation to Transform Care Delivery for Vulnerable Populations

      Presented by Imagine Pediatrics
      Speakers
      Details

      Vulnerable populations face interconnected medical, behavioral, and social challenges that traditional models struggle to address. Learn how innovative, personalized care approaches—combining multiple delivery modalities with engaged caregivers—can transform outcomes and reduce costs. Explore practical strategies to implement risk-based care models that effectively serve diverse populations with unique needs while improving quality and efficiency of care.

    • Advancing Value & Transforming Care Delivery

      Behavioral Health Integration to Expand Access and Improve Care Quality

      Speakers
      Details

      Explore how integrating behavioral health into primary care and community settings can expand access, enhance care quality, and improve outcomes. Learn from successful models and implementation strategies and understand the role of health plans in driving effective behavioral health integration.

    • Promoting Prevention & Population Health

      Smarter Care: Using AI to Drive Behavior Change, Outcomes, and Affordability

      Presented by PWC
      Speakers
      Details

      Discover how AI, advanced measurement, actuarial science, DTC marketing, and targeted behavior change are transforming health care. Learn how these innovations improve affordability, engagement, and trust with providers and patients. Gain insights to enhance prior authorization, plan operations, and clinical outcomes—driving efficiency, better care, and lower costs without sacrificing quality.

    • AI, Data Analytics & Interoperability

      Streamlining Prior Authorization Through Tech-Enabled Innovations

      Speakers
      Details

      While prior authorization remains a vital tool for promoting appropriate, evidence-based care, the administrative complexity it introduces often creates friction throughout the care continuum. Join this session to explore how emerging technologies are transforming prior authorization into a strategic lever for value-based care.

    • Medicare, Medicaid, & Commercial Markets

      Innovative Models to Deliver Complex Care to Vulnerable Members

      Speakers
      Details

      Health plans have a unique opportunity to lead the way in advancing more integrated, effective care for members with complex medical, behavioral, and social needs. This session will highlight forward-thinking models that are successfully improving outcomes for vulnerable populations. Discover how innovative partnerships and holistic approaches are creating meaningful impact and driving sustainable value across the care continuum.

    • Consumer Experience & Engagement

      Business Case for Engagement: Driving Value Through Consumer Connection

      Speakers
      Details

      Effective consumer engagement isn’t just a member experience strategy—it’s a business imperative. This session explores how leading health plans are quantifying the impact of engagement on cost, quality, and retention. Learn how to make a strong case for investment in tools and tactics that deepen member relationships, improve outcomes, and drive organizational value

    • Emerging Tech & Digital Health Innovation

      Reimagining Behavioral Health: A Platform Model for Outcomes, Access, and ROI

      Presented by Spring Health
      Speakers
      Details

      Behavioral health solutions have often prioritized volume over value—adding providers without solving for access, outcomes, or cost. For health plans, that means rising spend with limited impact. Join this discussion to explore a bold, product-led model built for alignment across members, providers, and health plans—delivering faster care, better outcomes, and proven cost savings.

    • Market Trends & Business Insights

      Advancing Maternal Health: Data-Driven Partnerships in Action

      Presented by Lucina
      Speakers
      Details

      Maternal health outcomes in the U.S. are worsening, raising concerns for health care leaders. Explore how advanced maternity analytics can reveal key trends, risks, and provider performance. Learn how health plans can use data-driven tools like provider scorecards to partner with OB providers, reduce disparities, and improve outcomes. Gain actionable strategies to drive change and improved outcomes through informed collaboration and value-based care.

5:30 pm – 6:15 pm
, Keynote Session

6:15 pm – 7:15 pm
, Reception with Solutions Providers

6:20 pm – 7:15 pm
, Presentation Theater

  • 6:20 pm – 6:35 pm

    • Case Study: Improving Provider Network Management

      Presented by salesforce
      Speakers
      Details

      Payers recognize that legacy systems lack the scalability and efficiency to address the growing administrative burden of managing an increasingly complex provider ecosystem. But what if you could optimize that network with a single, compliant platform? Learn how one payer is improving the end-to-end provider lifecycle and building stronger provider relationships with the #1 AI CRM.

8:00 am - 4:30 pm Jun 18 • 2025

8:00 am – 3:30 pm
, Registration and Information Desk Open

8:45 am – 10:10 am
, Keynote Sessions

10:10 am – 1:00 pm
, Exhibit Hall Open

10:10 am – 11:00 am
, Coffee Break with Solutions Providers

11:00 am – 11:45 am
, Influencer Series

  • ,

    Transforming Health Care Through Community and Connection

    ,

    Loneliness and social isolation are growing public health challenges with profound impacts on health outcomes and costs. This session explores how health plans can play a vital role in addressing these issues through innovative approaches like social prescribing and community-based partnerships. Learn how leading organizations are leveraging connection as a form of care—improving wellbeing, reducing utilization, and strengthening the fabric of community health.

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  • ,

    Strategic Opportunities in Employer-Provided Health Care

    ,

    As health care costs rise and employee expectations evolve, employers face new challenges and opportunities. Join this session to explore innovations in health plan design, from care navigation and primary care integration to new products, data-driven personalization, and the impact of high-cost drugs like GLP-1s and cell gene therapies. Learn how leading organizations are addressing unmet needs to better support their workforce.

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  • ,

    State of Health Tech 2025

    ,

    The health technology landscape is undergoing transformative shifts, driven by advancements in artificial intelligence, value-based care models, and evolving regulatory environments. This session will feature a panel of seasoned venture capitalists who will share their perspectives on the current state of health tech, highlighting emerging trends, investment strategies, and the implications for health plans and health care delivery.

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  • ,

    An Rx for Frictionless Care

    ,

    Join this session for an exclusive conversation on how technology, data, and customer obsession are reshaping the future of health care. Speakers will explore a consumer-centric vision for frictionless care—what it means for access, affordability, and adherence—and how health plans can partner to deliver simpler, more personalized member experiences. Gain insider insights into scalable innovations and bold strategies redefining pharmacy and beyond.

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  • ,

    Building a Healthier Generation: Health Plans Driving Public Health Impact

    ,

    Health plans play a critical role in shaping the future of public health—starting with children and adolescents. This session explores how plans are addressing early health risks, investing in prevention, and tackling social drivers of health. Hear how targeted initiatives and cross-sector partnerships are improving outcomes and laying the foundation for a healthier, more resilient generation.

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11:45 am – 1:00 pm
, Networking Lunch with Solutions Providers

1:00 pm – 1:00 pm
, Exhibit Hall Closes

1:00 pm – 1:45 pm
, Concurrent Sessions

  • 1:00 pm – 1:45 pm

    SERIES 7

    • Closing Gaps in Coverage & Care

      Improving Transitional Care Services to Close Care Gaps for Medicaid Members

      Speakers
      Details

      Transitions of care for Medicaid members between health settings often presents challenges. Medicaid beneficiaries may have multiple comorbidities and social determinants of health that may be overlooked in the discharge process that can lead to fragmented care and poor outcomes. Gain insights to improve transitions of care to ensure that patients receive the appropriate level of care and avoid preventable complications, readmissions, and gaps in care.

    • Market Trends & Business Insights

      Driving Better Health Through Pharmacy Innovation

      Speakers
      Details

      Explore strategies for designing formularies that better align cost-effectiveness with clinical value, supporting higher-quality care and greater member satisfaction. Discover how AI-enabled tools are helping plans personalize medication access, promote adherence, and support whole-person health.

    • Advancing Value & Transforming Care Delivery

      Real-World AI Use Cases - Best Practices to Improve Plan Performance

      Speakers
      Details

      Explore real-world AI applications that are transforming health plan operations, from improving member service to enhancing care management. This session will highlight best practices and proven strategies to harness AI for improved efficiency, outcomes, and member experience.

    • Consumer Experience & Engagement

      Harnessing Sensor Intelligence and Remote Data for Predictive, Preventive Care

      Speakers
      Details

      Join this session to explore how emerging sensor technologies and remote data streams are shaping a future where predictive, preventive care is the norm. Gain insights into the evolving role of wearables, ambient monitoring, and analytics to drive a more personalized, proactive model of care.

    • AI, Data Analytics & Interoperability

      AI That Delivers Results: Separating Health Care Reality from the Hype

      Presented by Cohere Health
      Speakers
      Details

      Health plan leaders are under pressure to adopt AI without compromising trust or safety. However, not all models deliver real results. This session cuts through the hype on using specifically trained AI to augment overburdened clinical teams, parse insights from unstructured data, and ultimately drive better care. Gain insights into the key elements of responsible AI, including governance and oversight, and the importance of always having a clinician in the loop.

1:45 pm – 2:00 pm
, Closing Wellness Reception AHIP 2025

2:00 pm – 3:30 pm
, Keynote Sessions