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AHIP
Conferences

AHIP 2025

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

REGISTRATION IS NOW CLOSED - 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 Filters

Sessions

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
      Speakers
      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
      Speakers
      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
      Speakers
      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
      Speakers
      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
      Speakers
      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
      Speakers
      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.