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Conferences

2024 Medicare, Medicaid, Duals & Commercial Markets Forum

Dates:
Mar 12 - 14, 2024
Location:
Baltimore, MD

The 2024 Medicare, Medicaid, Duals & Commercial Markets Forum focuses on the most pressing policy priorities, emerging issues and regulatory updates for Medicare, Medicaid, Duals, and the commercial market.

Agenda Filters

Sessions

7:00 am - 6:45 pm Mar 12 • 2024

7:00 am – 9:00 am
, Coffee

Key Ballroom Foyer

7:00 am – 5:45 pm
, Registration Desk Open

Key Ballroom South Foyer

8:45 am – 11:00 am
, Welcome and Opening Sessions

11:00 am – 6:30 pm
, Exhibit Hall Open

Holiday Ballroom

11:00 am – 11:45 am
, Break

Holiday Ballroom
Coffee Break with Solutions Providers

11:45 am – 12:30 pm
, Concurrent Sessions

  • Concurrent Series 1

    • Medicare Advantage & Part D

      MA & Part D Program Audits: Best Practices & Lessons Learned

      Location
      Key Ballroom 9-10
      Speakers
      Details

      Speakers will provide insight on practical tools and share best practices that MA organizations and Part D plan sponsors can implement to successfully prepare for program audits and improve performance.

    • Medicaid Managed Care & Medicare-Medicaid Dual Eligibles

      Medicaid Redeterminations: State of Play

      Location
      Peale
      Speakers
      Details

      We will hear from national experts on the current landscape of Medicaid redeterminations, digging in on the policy, political, and rate setting impacts.

    • Commercial Market & Employer-Provided Coverage

      Impacts of ERISA Preemption

      Location
      Johnson
      Speakers
      Details
      ERISA preemption has a significant impact on health insurance providers as it helps to streamline administrative processes and ensure uniformity in plan administration. Join this session to hear from experts on how efforts in several states to erode ERISA preemption may adversely impact labor markets, disadvantage employees based on where they live or work, cause employers to cut back on benefit coverage, and raise the cost of health insurance and retirement plans.
    • Advancing Health Equity

      Leveraging Value-Based Contracts and Technology to Improve Total Health Equity

      Presented by Gray Matter Analytics
      Location
      Key Ballroom 11-12
      Speakers
      Details

      To address health equity disparities, health insurance providers are deploying new strategies to eliminate obstacles to high quality care. Join this session to explore how one health insurance provider is utilizing data analytics to gain insight into social determinants of health and gaps in care to help match outreach and interventions to each patient’s needs. Learn how employing value-based arrangements with providers can maximize timely, preventative care and improve total health equity.

12:30 pm – 1:45 pm
, Lunch & Learns

  • 1:00 pm – 1:45 pm

    Lunch will begin at 12:30 pm. Speaking Sessions will begin promptly at 1:00 pm.

    • The Power of Food as Medicine: Best Practices to Improve Member Health Outcomes

      Presented by Mom's Meals 2022 logo
      Location
      Peale
      Speakers
      Details

      Evidence is mounting on the benefits of food as medicine programs as they gain popularity in managed care. However, few programs report on member outcomes longitudinally. Learn how a comprehensive nutrition program positively impacted dually eligible members with heart failure and achieved health insurance provider cost savings 6 and 12 months after member participation ended. Gain valuable insights on designing a program to support successful long-term behavior change and cost savings.

    • Building Member Trust & Engagement with Community Based Social Support Groups

      Presented by Wider Circle
      Location
      Johnson
      Speakers
      Details

      Establishing trust is key to effectively engaging members in their care. A peer-to-peer approach that builds community and social support for members can have a significant impact on health outcomes, equity, engagement, cost of care, and retention. Join this session to review outcomes of a national community-based solution for MA, DSNP, and Medicaid populations, and share best practices and results from an actuarially validated methodology.

    • Caregiver Activation: Strategies to Drive Improved Outcomes and Well-Being

      Presented by Helpful
      Location
      Holiday 1
      Speaker
      Details

      This session will explore the multifaceted value of caregiver support. Learn how to activate caregivers with an effective care plan to enhance outcomes and positively impact well-being for both members and caregivers. Join us to examine strategies to develop a well-supported caregiver network to engage and align caregivers with health management goals, leading to enhanced patient care.

    • Mobile Strategies to Transform Member Onboarding and Improve Access to Care

      Presented by Relay Network
      Location
      Key Ballroom 9-10
      Speakers
      Details

      Health insurance providers are leveling up standard short message service (SMS) campaigns to personalized mobile experiences that drive members to action. Panelists will discuss mobile strategies, from onboarding to retention, that drive behaviors and usage of plan benefits and identify key parts of a member’s journey that influence critical metrics. Gain insights to improve access to care metrics, drive improvements to Star Ratings, and proactively influence the member experience.

    • A Whole-Person Approach to Manage Frailty & Aging in Place for Older Adults

      Presented by Sagility – An AHIP Select Member
      Location
      Key Ballroom 11-12
      Speaker
      Details

      Improving care for older adults requires a whole-person approach and early interventions to prevent frailty, which can lead to a higher risk of long-term care. Falls, dementia and social determinants of health deficits worsen frailty. Join this session to learn how a comprehensive, multi-disciplinary clinical care plan can improve health and reduce the risk of long-term care. Explore how to engage older adults with a customized care plan and assistive technology for aging in place.

1:45 pm – 2:30 pm
, Break

Holiday Ballroom
Dessert Break with Solutions Providers

2:30 pm – 4:15 pm
, Concurrent Sessions

  • 2:30 pm – 3:15 pm

    Concurrent Session Series 2

    • Medicaid Managed Care & Medicare-Medicaid Dual Eligibles

      Advancing Medicaid Long-Term Services & Supports

      Location
      Johnson
      Speakers
      Details
      In this session, speakers will review the current trends in long-term services and supports (LTSS) and home and community--based services (HCBS) in Medicaid, progress toward rebalancing from facility to home and community settings, and the outlook for policy and technological developments impacting LTSS in the coming year.
    • Advancing Health Equity

      Improving Health Equity Through Better Data Collection

      Location
      Key Ballroom 9-10
      Speakers
      Details

      This session will explore the importance and use of health data in addressing health disparities, the barriers that persist in limiting health data, and policy levers that can improve health data collection and utilization at the federal level including changes to data standards and systems, incentives and requirements, education and technical assistance, and regulation.

    • Whole Person Care Delivery & Innovation

      Cell and Gene Therapies: Regulatory Updates and Coverage Policies

      Location
      Peale
      Speakers
      Details
      Cell and gene therapies hold immense promise for addressing previously untreatable or chronic conditions, however, their high costs pose challenges for the health care system. Speakers in this session will explore the evolving landscape of cell and gene therapies and examine the potential impacts and policy options for these transformative treatments.
    • Market Strategy & Operational Innovation

      How Digital Health Supplemental Benefits Can Close Care Gaps and Improve Quality

      Presented by Hello Heart
      Location
      Holiday 1
      Speaker
      Details

      Sweeping changes to the Medicare program, such as the Inflation Reduction Act and the Health Equity Index for Star Ratings are poised to reshape the MA landscape. These changes place increased emphasis on elevating quality ratings amidst lower CMS payment rates. As a result, health insurers are turning to innovative supplemental benefits to address these challenges. Learn how MA leaders can leverage digital health solutions as a valuable supplemental benefit to close care gaps and boost quality.

  • 3:30 pm – 4:15 pm

    Concurrent Session Series 3

    • Medicaid Managed Care & Medicare-Medicaid Dual Eligibles

      Current and Emerging Trends in Medicaid Managed Care

      Location
      Peale
      Speakers
      Details

      The director of CMS’ Division of Managed Care Policy will review trends and progress in Medicaid and managed Medicaid programs and the Administration’s Medicaid priorities for managed care for the coming year.

    • Commercial Market & Employer-Provided Coverage

      Updates on Risk Adjustment in the Individual Market

      Location
      Johnson
      Speakers
      Details

      This panel will discuss current trends and stakeholder perspectives about the ACA’s individual risk adjustment program and highlight potential areas of interest for the future.

    • Advancing Health Equity

      Best Practices to Collect Sexual Orientation and Gender Identity Data (SOGI)

      Location
      Holiday 1
      Speakers
      Details
      Health insurance providers are increasingly required to collect data on sexual orientation and gender (SOGI) to help identify disparities and inform culturally appropriate care. Hear from one of the nation’s pioneers and experts on SOGI data collection and gain insights to collect SOGI data in patient-centered and respectful ways, incorporate this data collection into workflows, improve communication around SOGI data collection, and promote gender affirming care.
    • Market Strategy & Operational Innovation

      Virtual Care Strategies to Address Emerging Trends in 2024

      Presented by Teladoc Health
      Location
      Key Ballroom 11-12
      Speakers
      Details

      Virtual care and other digital tools have the power to democratize health care access for all, including the underserved. Join us to explore how progressive managed care organizations are elevating the use of virtual care to offer a broader range of solutions to a wider range of Medicare, Medicaid, and Marketplace members. You will also gain insights into the emerging trends of 2024 and learn how virtual care and AI can refine personalization and engage hard-to-reach populations.

    • Whole Person Care Delivery & Innovation

      Leveraging Home-Based Care to Improve Outcomes and STAR Ratings

      Presented by Evernorth Health Services
      Location
      Key Ballroom 9-10
      Speakers
      Details

      This session will highlight CMS’s recent changes to STAR ratings, including new measures and changes to how various factors are weighted. Join us to learn how leading health insurance providers are using an integrated strategy with home-based care to ensure optimal outcomes and address whole person care, and how to leverage best practices to enhance and improve your STAR ratings.

4:30 pm – 5:45 pm
, General Session

5:45 pm – 6:45 pm
, Reception

Holiday Ballroom
Welcome Reception with Solutions Providers

8:00 am - 6:30 pm Mar 13 • 2024

8:00 am – 9:00 am
, Coffee

Key Ballroom Foyer

8:00 am – 5:00 pm
, Registration Desk Open

Key Ballroom South Foyer

8:45 am – 10:30 am
, General Session

10:30 am – 6:30 pm
, Exhibit Hall Open

Holiday Ballroom

10:30 am – 11:15 am
, Break

Holiday Ballroom
Coffee Break with Solutions Providers

11:15 am – 12:00 pm
, Concurrent Sessions

  • Concurrent Series 4

    • Medicare Advantage & Part D

      Value of Medicare Advantage

      Location
      Peale
      Speakers
      Details

      Speakers in this session will discuss the growth, popularity and value of the Medicare Advantage program that serves millions of older adults and people with disabilities.

    • Commercial Market & Employer-Provided Coverage

      Employer Perspectives on Value-Based Arrangements

      Location
      Johnson
      Speakers
      Details
      Adoption of value-based payment arrangements in the commercial insurance market lags behind other lines of business. Since nearly half of Americans receive coverage through their employer, employers are a critical partner to drive systemwide transformation toward care models that focus on quality and affordability. Join this session to hear panelists discuss how the employer market is unique and how value-based payment arrangements can be successfully implemented in the employer market.
    • Whole Person Care Delivery & Innovation

      Best Practices to Support Aging in Place

      Location
      Key Ballroom 9-10
      Speakers
      Details
      Join this session to explore innovative strategies health insurance providers are employing to facilitate aging in place. Learn how health plans are adapting population health models and addressing individualized needs by implementing place-based supports and delivering advanced care at home.

12:00 pm – 1:15 pm
, Lunch & Learns

  • 12:30 pm – 1:15 pm

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

    • Current Issues in Medicaid: Insights from State Medicaid Directors

      Location
      Peale
      Speakers
      • Amir Bassiri, New York State Department of Health (DOH)
      • Kelly Cunningham, Illinois Department of Healthcare & Family Services
      • Jay Ludlam, NC Department of Health and Human Services
      • Kate McEvoy, National Association of Medicaid Directors (NAMD)
      Details
      This session will explore trends and emerging issues in Medicaid programs and priorities of state Medicaid directors. Learn how health insurance providers can partner with states to improve outcomes for Medicaid beneficiaries.
    • FDA Unique Device Identification: What Do You Need Know?

      Location
      Johnson
      Speakers
      Details
      The FDA established the unique device identification (UDI) system to adequately identify medical devices sold in the United States from manufacturing through distribution to patient use. Increased use of the UDI could allow payers and providers to improve patient safety and enhance care coordination. Join this session to learn about the benefits of UDI implementation across the health care system for better care delivery and medical device interventions.
    • Making the Case for Coverage: GLP-1s for Cardiometabolic Care

      Presented by Vida Health
      Location
      Key Ballroom 11-12
      Speaker
      Details

      GLP-1s and other anti-obesity medications are changing the treatment landscape for patients and providers. Although literature shows these drugs can be life changing, these products are not universally accessible, including to Medicare and Medicaid beneficiaries. Join us to explore how a managed solution combining behavior change and pharmacotherapy can achieve high-quality outcomes, improve cardiometabolic care, offset near term Rx costs and produce long term medical cost savings.

    • Leveraging a Patient-Centric Approach to Solve Gaps in Care

      Presented by Nomi Health
      Location
      Holiday 1
      Speakers
      Details

      Closing gaps in care continues to be a critical concern for the U.S. health care system. Join this session to gain insights on using data analytics to create a robust, patient-centric program and examine the regulatory environment for dual eligible populations and patients with multiple chronic conditions. Learn how to solve for multiple points of failure within complex care to not only increase patient engagement and success, but ultimately challenge and improve the entire ecosystem.

    • Achieving Improved Engagement and Outcomes through Innovative Partnerships

      Presented by Tivity Health
      Location
      Key Ballroom 9-10
      Speakers
      Details

      The future of health care will require new partnerships to support innovative member engagement strategies. Effective solutions will be community-focused and culturally sensitive, both in-person and through digital channels. Learn how one health insurance provider is evaluating novel partnerships and pilot programs to explore evidence-based engagement models. Gain insights into intervention strategies, reimbursement options, and opportunities to address health equity.

1:15 pm – 2:00 pm
, Break

Holiday Ballroom
Dessert Break with Solutions Providers

2:00 pm – 3:45 pm
, Concurrent Sessions

  • 2:00 pm – 2:45 pm

    Concurrent Sessions Series 5

    • Medicare Advantage & Part D

      Impacts of Inflation Reduction Act on Part D Program*

      Location
      Peale
      Speakers
      Details

      *This session is closed to the Press.

      Speakers will discuss the Inflation Reduction Act (IRA) implementation priorities and impacts on Part D plans.

    • Commercial Market & Employer-Provided Coverage

      ACA Marketplace: Lessons Learned from State Exchanges

      Location
      Johnson
      Speakers
      Details

      The ACA Marketplaces reached a record high number of sign-ups during 2024 open enrollment, with over 20 million people enrolling in coverage in the Federally facilitated and State-based Marketplaces. Join this session to explore unique efforts, successful strategies, and key learnings from State-based Marketplaces to grow enrollment and support coverage transitions through Medicaid unwinding. Examine the impact temporary enhanced subsidies have had on access to affordable health care.

    • Advancing Health Equity

      Addressing Health-Related Social Needs Through 1115 Waivers

      Location
      Holiday 1
      Speakers
      Details
      More states are looking to Medicaid 1115 waivers to address health-related social needs by building data infrastructure, fees for non-clinical services, and partnerships with community-based organizations. Hear from health insurance providers in states with transformational Medicaid 1115 waivers to gain insights on those models and the roles of health plans, what is going well with implementation, and what challenges they have faced.
    • Market Strategy & Operational Innovation

      The CMS Health Equity Index: New Measure, New Approaches

      Presented by Inovalon lateral 2020
      Location
      Key Ballroom 11-12
      Speaker
      Details

      Join us as we explore innovative solutions to identify and reduce disparities among socially and economically disadvantaged groups. Explore key elements of the Health Equity Index, how to use data-driven approaches to anticipate how your plan will score and identify areas with largest disparities that can most improve outcomes. Gain insights from one health insurance provider that is proactively preparing for the changes to MA Star Ratings, including reward factor calculations.

    • Whole Person Care Delivery & Innovation

      Realizing Sustainable Growth in Medicare Advantage

      Presented by Advisory Board
      Speaker
      Details

      As the Medicare Advantage landscape faces heightened scrutiny on cost and spend, financial sustainability is more imperative than ever before. Health insurance providers that aim to thrive in the MA market long-term must have a clear understanding of how to create sustainable practices and which levers will deliver greater value and improve outcomes. Join this session for insights on strategies to improve risk adjustment and Star Ratings performance for long-term success.

  • 3:00 pm – 3:45 pm

    Concurrent Sessions Series 6

    • Medicare Advantage & Part D

      MA & Part D Advance Rate Notice: Implications for 2025 and Beyond

      Location
      Key Ballroom 11-12
      Speakers
      Details

      In this session, experts will discuss key elements of the 2025 Advance Notice and Regulations for MA and Part D and share insights on the impact and implications for plans.

    • Medicaid Managed Care & Medicare-Medicaid Dual Eligibles

      MACPAC: Perspectives on the Continuing Evolution of Medicaid

      Location
      Peale
      Speakers
      Details
      In this session, speakers from the Medicaid and CHIP Payment and Access Commission (MACPAC) will comment on the status of the Medicaid program and MACPAC’s initiatives and priorities for 2024.
    • Advancing Health Equity

      Progressing Towards Health Equity: Insights from Health Insurance Providers

      Location
      Johnson
      Speakers
      Details
      Health insurance providers are uniquely positioned to implement innovative strategies both within their organizations, communities, and structural systems to advance health equity and address the unmet social needs of their members. With a focus on sharing lessons learned, this session will explore novel approaches health insurance providers have taken to advance health equity both within their organizations, and among the members and communities they serve.
    • Whole Person Care Delivery & Innovation

      Addressing the Opioid Crisis Through Innovative Population Health Programs

      Location
      Key Ballroom 9-10
      Speakers
      Details

      Progress in combating the opioid epidemic has been slow. Join this session to explore population health-based approaches to improve access to treatment and the quality of care delivered through technologies, innovative clinical models and predictive data analytics. Learn how to facilitate the adoption of telehealth solutions and employ predictive algorithms to address the opioid overdose and SUD epidemics.

    • Market Strategy & Operational Innovation

      Optimizing Member Experience Through Tailored Digital Interventions

      Presented by mPulse Mobile
      Location
      Holiday 1
      Speakers
      Details

      The use of AI and predictive models in health care offers the promise to improve health outcomes at scale. Join this discussion to learn how to build personalized care journeys that factor in risk propensity and social determinants of health. Gain insights on how to use predictive analytics and omnichannel digital outreach to deliver highly tailored, personalized experiences throughout the care continuum.

4:00 pm – 5:30 pm
, General Session

4:45 pm – 6:00 pm
, Reception

Holiday Ballroom
Reception with Solutions Providers

6:00 pm – 6:00 pm
, Exhibit Hall Closes

Exhibit Hall is closed on Thursday, March 14

8:00 am - 4:30 pm Mar 14 • 2024

8:00 am – 9:00 am
, Coffee

Key Ballroom Foyer

8:00 am – 3:00 pm
, Registration Desk Open

Key Ballroom South Foyer

8:45 am – 10:15 am
, General Session

  • 8:45 am – 9:15 am, Key Ballroom 1-8

    CMS Priorities for Medicaid

    ,

    CMS’ Center for Medicaid and CHIP Services lead will review the status of the Medicaid program, the Administration’s priorities for Medicaid in the coming year, and the likely evolution of initiatives that Medicaid programs and Medicaid plans will face together.

  • 9:15 am – 9:45 am, Key Ballroom 1-8

    CMS Priorities for Dual Eligibles

    ,

    In this session, the Director of the CMS Medicare-Medicaid Coordination Office will discuss CMS initiatives and priorities including opportunities to advance integrated care through programs serving Medicare-Medicaid dual eligible enrollees.

  • 9:45 am – 10:15 am, Key Ballroom 1-8

    2024 Policy Priorities for Supporting Employer-Provided Coverage

    ,

    Join this session with a senior official at the Department of Labor to gain insights into key initiatives aimed at enhancing and safeguarding employee benefits and promoting policies to improve affordability and strengthen employer-provided coverage.

10:15 am – 10:45 am
, Break

Concourse Foyer
Coffee Break

10:45 am – 11:30 am
, Concurrent Sessions

  • Concurrent Sessions Series 7

    • Medicare Advantage & Part D

      Current Legal Issues in MA & Part D

      Location
      Key Ballroom 11-12
      Speakers
      Details

      Legal experts will review the current landscape of legal issues affecting the policy and regulatory agenda for Medicare Advantage and Part D plans.

    • Medicaid Managed Care & Medicare-Medicaid Dual Eligibles

      MMCO: New Developments for Dual Eligibles

      Location
      Johnson
      Speakers
      Details
      In this session, staff from the CMS Medicare-Medicaid Coordination Office will review current and planned initiatives to improve integration of care and services for people who are dually eligible for Medicare and Medicaid, and the outlook for integrated care delivery models like dual eligible special needs plans (D-SNPs).
    • Commercial Market & Employer-Provided Coverage

      Surprise Billing: Update and Legal Issues

      Location
      Key Ballroom 9-10
      Speakers
      Details
      The No Surprises Act continues to protect millions of consumers each year, with health insurance provider networks growing despite a continued reliance on the law’s arbitration process by some health care providers. Speakers in this session will discuss lessons learned since the law was enacted, as well as the latest litigation, enforcement, and implementation challenges.
    • Advancing Health Equity

      Advancing Health Equity Through Housing

      Location
      Holiday 1
      Speakers
      Details

      Housing quality, availability, and stability greatly impact health, but many health care organizations are unsure of how best to promote health through housing interventions. This session will present best practice strategies and policy opportunities that health care organizations and health insurance providers can employ to advance health and health equity through housing.

11:30 am – 1:00 pm
, Networking Lunch

Key Ballroom 1-8 and Foyer
Networking Lunch with Dessert

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

  • Concurrent Sessions Series 8

    • Medicare Advantage & Part D

      MA & Part D Marketing Rules: CMS Oversight & Expectations

      Location
      Key Ballroom 11-12
      Speakers
      Details

      In this session, speakers will provide insight on the new Medicare marketing rules and share best practices to protect Medicare enrollees from misleading or inappropriate marketing activities.

    • Medicaid Managed Care & Medicare-Medicaid Dual Eligibles

      All Hands-on-Deck: Keeping People Covered Through Unwinding

      Location
      Key Ballroom 9-10
      Speakers
      Details
      This session will highlight the learnings, challenges and best practices of health insurance providers to ensure that Medicaid beneficiaries are not inappropriately disenrolled from coverage as normal eligibility determination operations have resumed. Learn about innovative work and broad stakeholder efforts to mitigate gaps in care through Medicaid unwinding.
    • Commercial Market & Employer-Provided Coverage

      Expanding Site Neutral Payment: Updates and Implications

      Location
      Holiday 1
      Speakers
      Details
      Join a discussion on how site neutral payments can help reduce costs for patients and increase value across the health care system. Hear from panelists on how site neutral payments have received bipartisan support in Congress and state legislatures and how a broad range of stakeholders support opportunities to drive affordability through site neutral payments.

2:00 pm – 4:30 pm
, General Session

4:30 pm – 4:30 pm
, Conference Adjourns