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Conferences

National Conference on Health Policy and Government Health Programs

Dates:
Mar 14 - 17, 2022
Location:
Virtual

AHIP’s National Conference on Health Policy and Government Health Programs (Formerly the Medicare, Medicaid & Dual Eligibles Conference) focuses on policy issues and emerging trends surrounding Medicare, Medicaid, and programs serving those who are dually eligible. It also explores the future of employer-sponsored coverage and the individual, small group, and private markets.

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Agenda Filters

Sessions

9:00 am - 6:00 pm Mar 14 • 2022

9:00 am – 6:00 pm
, Break

10:20 am – 10:30 am
, Spotlight Session

    • Sponsored by Mom’s Meals

      Presented by Mom’s Meals Nourishcare – An AHIP Select

10:30 am – 12:45 pm
, Keynote Session

12:45 pm – 1:30 pm
, Break

Break with Solutions Providers

1:30 pm – 3:00 pm
, Concurrent Session

  • 1:30 pm – 2:15 pm

    Concurrent Sessions

    • Government Health Programs Policy, Operations, and Emerging Trends

      *CMS Proposed Part D PBM DIR Changes: What Are Potential Impacts?

      Speakers
      Details

      With CMS’ proposed rule for Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs, the agency included significant revisions to the use of Direct and Indirect Remuneration (DIR) by plan sponsors in the program. This session will explore the ramifications of implementing this proposal for plans and the Medicare prescription drug program if finalized, from the public policy, operational, and actuarial perspectives.

      *This Concurrent Session is closed to the media and will not be available on demand.

    • Employer-Sponsored Health Coverage, Marketplace Policy, and Emerging Trends

      Legal Challenges to the No Surprises Act

      Speakers
      Details

      Speakers in this session will provide an overview of the long-standing issue the No Surprises Act was enacted by Congress to solve; the Federal regulations promulgated to operationalize the program; and the litigation landscape involving (in particular) the factors to be used by arbitrators in addressing payment disputes between health insurance plans and providers.

    • Health Equity, SDOH, and Community Health

      The Road to Health Equity is Paved with Socio-Clinical Risk Adjustment

      Presented by 3M
      Speaker
      Details

      The concept of social determinants of health can be used to augment existing health care risk adjustment tools, which are often used in setting payment rates or calculating performance on quality measures. This session will discuss strategies for incorporating social needs, behavioral and functional health into risk adjustment to address social needs and impact health equity.

    • Technology, Business Solutions and Product Innovations

      Omnichannel Personalization to Drive Outcomes and Reduce Costs

      Presented by Zipari
      Speakers
      Details

      A recent survey asked 1,500 Medicare and Medicaid members about their consumer experiences (CX) and digital consumer experiences with their health plans. Their responses were analyzed to identify significant themes within each population, and to determine how these differ from or align with commercial health plan members. This session gives health insurance providers current and market-specific insights into CX trends to help prioritize digital CX efforts most likely to drive positive outcomes.

  • 2:15 pm – 3:00 pm

    Concurrent Sessions

    • Government Health Programs Policy, Operations, and Emerging Trends

      Time to Double Down on Your Medicaid Strategy!

      Presented by Optum – An AHIP Select Sponsor
      Speakers
      Details

      Medicaid enrollment continues to grow: the program now serves over 80 million people, including 10.8 million dual-eligible enrollees. One in four Americans are covered by Medicaid, and many have complex, costly conditions. This session will offer best practices to help grow your Medicaid business by serving complex populations and explore how enhancing member experience is tied to positive health outcomes.

    • Health Equity, SDOH, and Community Health

      Overcoming Attitudes and Barriers to Behavioral Health for Low-Income Communities

      Presented by Included Health
      Speakers
      Details

      This session will explore perceptions, barriers to care, and utilization patterns of behavioral health services amongst different segments of low-income populations. Gain actionable insights for successfully engaging low-income populations and helping to reduce stigma around behavioral health care.

    • Care Management, Delivery Transformation and Value

      Providing a Patient Focused Pain Management Solution

      Speakers
      Details

      With more than 50% of adults in the U.S. managing pain on a regular basis, and with musculoskeletal (MSK) treatment as a leading health care spend, the time is now to transform the way we deliver MSK treatment to patients. Learn how combining state of the art virtual tools, a nationwide network of non-surgical treatment practitioners, and a physical activity program that incorporates movement therapy can help payors drive down costs, increase patient engagement, and optimize member experience.

    • Technology, Business Solutions and Product Innovations

      Opportunity in Disruption: Navigating the New Health Care Landscape

      Presented by DocuSign
      Speaker
      Details

      The health care industry is ripe for modernization across its segments. Digital transformation will play a key role in satisfying regulatory requirements and exceeding consumer expectations. This session will review emerging trends of the current environment, highlight disruptive influences including new legislation, and explore innovative solutions.

3:00 pm – 3:30 pm
, Break

Break with Solutions Providers

3:30 pm – 4:15 pm
, Concurrent Session

  • 3:30 pm – 4:15 pm
    • Government Health Programs Policy, Operations, and Emerging Trends

      State Perspectives on Medicaid Redeterminations and Exchange Transitions

      Speakers
      Details

      The COVID-19 public health emergency will likely end this year; and with that, states will once again begin conducting redeterminations of eligibility for the nearly 83 million people enrolled in Medicaid. Experts on this panel will explore the challenges states will face and their options for verifying ongoing eligibility for all their Medicaid enrollees, transitioning people no longer eligible to other coverage, and potential impacts on continuity of care for Medicaid enrollees.

    • Health Equity, SDOH, and Community Health

      Culture-Centered Approaches to Advancing Equity

      Presented by SameSky Health
      Speakers
      Details

      This session explores a real-world example of how taking a culture-centered approach to engaging Medicaid members of diverse backgrounds resulted in a marked improvement in one health plan’s 90-day member retention rates and helped to advance the plan’s health equity initiatives. Join us to learn how to remove barriers to health and form meaningful relationships with members from diverse cultures that traditionally have been difficult to reach.

    • Care Management, Delivery Transformation and Value

      When Galaxies Collide: How an Integrated Analytics Strategy Improves Outcomes

      Presented by Inovalon lateral 2020
      Speakers
      Details

      This session will explore the current universe of siloed quality and risk programs and the merits of moving to an integrated approach. Speakers will discuss how an integrated analytics strategy can empower providers and positively impact member experience and outcomes. Join us to learn key steps for fostering successful organizational change and support of an integrated program.

    • Technology, Business Solutions and Product Innovations

      Open Enrollment’s Influence on Member Experience and Health Plan Costs

      Presented by Amwell
      Speaker
      Details

      This session will focus on the impact open enrollment has to reduce leading drivers of healthcare costs for chronic and co-morbid mental health conditions, with emphasis on Medicare and Medicaid given the higher rates of chronic health conditions in these populations. Attendees will learn how digital health tools can empower members to create positive changes in their behavior and mental health while also enabling health plans to address the rising costs related to chronic conditions.

4:30 pm – 5:15 pm
, Keynote Session

9:00 am - 6:00 pm Mar 15 • 2022

9:00 am – 6:00 pm
, Break

10:30 am – 12:15 pm
, Keynote Session

  • 10:30 am – 11:00 am,

    Special Keynote Session: Four Questions with Krista Hoglund

  • 11:00 am – 11:45 am,

    Promoting Provider Competition and Reducing Incentives to Consolidate

    ,

    This session will explore policy efforts to promote provider competition and mitigate the impact of hospital mergers, provider consolidation, and impact of private equity investment in providers on health care spending. A panel of experts will provide perspectives on policy options and recent efforts to promote price transparency, call for transparency around private equity and incent the usage of alternative sites of care. Speakers will also examine potential effects of and opportunities presented by price transparency for patients, physicians, and other health care industry stakeholders.

  • 11:45 am – 12:15 pm,

    Lessons from the Pandemic

    • Learn more about Mark McClellan, MD, PhD
      Mark McClellan, MD, PhD
      ,
      Robert J. Margolis Professor of Business, Medicine, & Policy
      , & Founding Director of the Duke-Margolis Center for Health Policy, Duke University

12:15 pm – 1:00 pm
, Break

Break with Solutions Providers

1:00 pm – 2:30 pm
, Concurrent Session

  • 1:00 pm – 1:45 pm
    • Government Health Programs Policy, Operations, and Emerging Trends

      Medicaid Agility: Addressing the Status Quo of Medicaid Pricing

      Presented by Healthedge
      Speakers
      Details

      Complexities in Medicaid have plans struggling to price claims accurately while payment methodologies, rates, and policies continuously change, leading to millions of dollars in unidentified waste and inaccuracies. We’ll discuss how health plans can adopt a comprehensive payment integrity approach to improve efficiency and accuracy and remain agile amidst constant change.

    • Employer-Sponsored Health Coverage, Marketplace Policy, and Emerging Trends

      Commercial Market Regulatory Landscape: An Environmental Scan

      Speakers
      Details

      Speakers in this session will discuss what regulatory actions are likely over the course of the year. Topics covered include mental health parity, health equity and non-discrimination, the No Surprises Act, rules impacting the individual and small group markets and more.

    • Health Equity, SDOH, and Community Health

      Supporting Vulnerable Members with Meals Can Impact Utilization and Cost of Care

      Presented by Mom's Meals 2022 logo
      Speakers
      Details

      Members with high utilization are more likely to report unmet social needs. A managed care plan developed an innovative pilot to support high-risk members with a behavioral health diagnosis with 12 weeks of home-delivered meals. Speakers will discuss how meeting this basic need contributed to positive outcomes for individuals and the health plan, impacting provider and case manager visits, in-patient stays, readmissions and total cost of care. Attendees will gain insights from lessons learned.

    • Technology, Business Solutions and Product Innovations

      Modernizing Agent Engagement to Drive Growth and Member Experience

      Presented by ZS
      Speakers
      Details

      The agent is an often-overlooked role—yet, improving their experience has a material impact on member growth and satisfaction. Now is the time for health plans to up their game through data and analytics to strengthen agency partnerships in a new hybrid environment. This session will describe techniques health plans can take to better target and engage agents to optimize AEP success, including a recent case study with a leading government-focused plan.

  • 1:45 pm – 2:30 pm
    • Government Health Programs Policy, Operations, and Emerging Trends

      Medicaid Plans at the Forefront of Change

      Speakers
      Details

      The Medicaid program has greatly expanded during the public health emergency due in part to the maintenance of eligibility provisions; there are now more than 83 million individuals served by this safety net program, and approximately 65 million served by managed care organizations. MCOs are being asked to partner with states, innovate, and be flexible to serve the myriad needs of enrollees, ranging from access to behavioral health, improving maternal health outcomes, expanding access to home and community-based services, and continuing to tackle health disparities. In this session, we will hear from a panel of experts leading the charge.

    • Health Equity, SDOH, and Community Health

      Innovative Strategies to Build Impactful and Equitable SDOH Programs

      Presented by Unite Us
      Speaker
      Details

      Government leaders have made strong commitments to advance health equity and address SDOH, and are increasingly using regulatory levers to drive system change. However, the existing Medicaid and Medicare Advantage infrastructure does not fully incorporate SDOH data and community providers. This panel will focus on innovative and concrete ways that health plans can advance health equity, address SDOH, and create systems to shift investments upstream.

    • Care Management, Delivery Transformation and Value

      Transforming UM to Accommodate Growth and Improve Patient Outcomes

      Presented by Cohere Health
      Speakers
      Details

      Health plans are taking on rising utilization as membership grows rapidly. However, regulation and network-related issues may complicate the use of traditional UM, and increase administrative costs. Learn through case studies how your plan can transform UM from a permission-based model to tech-driven, collaborative care coordination that improves patient experience and outcomes.

    • Technology, Business Solutions and Product Innovations

      Want Better Patient Care? Understand the Customer

      Presented by Optum – An AHIP Select Sponsor
      Speakers
      Details

      Health plans carefully review member data captured during visits with health care providers, but social and economic factors we all live with and the physical environment we live in also have impacts on health care costs. This session explores how looking at member data holistically enables plans to improve care and associated outcomes. Using this data responsibly, plans can quantify both historic impacts and projected future impacts across a wide range of applications.

2:30 pm – 3:00 pm
, Break

Break with Solutions Providers

3:00 pm – 3:45 pm
, Concurrent Session

    • Government Health Programs Policy, Operations, and Emerging Trends

      Innovative Plan Interventions Supporting Dual Eligibles

      Speakers
      Details

      In this session, speakers will discuss upstream innovative interventions that MA plans have implemented to improve care and reduce health care costs for the dual eligible patient population.

    • Employer-Sponsored Health Coverage, Marketplace Policy, and Emerging Trends

      Emerging Trends in Employer-Sponsored Coverage

      Speaker
      Details

      Speakers in this session will discuss how employer-sponsored health coverage has changed over the course of the pandemic, and share new data demonstrating how health insurance providers and employers are prioritizing mental health care, incentivizing use of telehealth, and taking steps to make coverage more affordable. They will also discuss emerging trends for employee benefits, and what policymakers should do to continue supporting health coverage for nearly 180 million Americans.

    • Health Equity, SDOH, and Community Health

      Closing Health Equity and Behavioral Health Gaps in Musculoskeletal Care

      Presented by Hinge Health
      Speakers
      Details

      Musculoskeletal (MSK) pain and related behavioral health needs affect populations across income, race, and ethnicity. A panel of health plan and employer speakers will share how they’re leading the way in embedding racial and health equity into MSK and behavioral health.

    • Care Management, Delivery Transformation and Value

      Health Equity Impact on Risk, Quality, and VBC

      Presented by Change Healthcare
      Speakers
      Details

      Increasingly risk, quality and value-based care (VBC) are converging to allow organizations to address critical needs and manage total cost of care, while improving quality of care. Data driven insights help focus care more effectively on populations most at risk. Combined with SDOH data, they could enable transformation of the healthcare industry at scale. This session will explore real world examples from chronic conditions to simple procedures and the opportunities and complexities for each.

3:45 pm – 5:30 pm
, Keynote Session

9:00 am - 6:00 pm Mar 16 • 2022

9:00 am – 6:00 pm
, Break

Registration and Help Desk Open

10:30 am – 12:15 pm
, Keynote Session

  • 10:30 am – 11:00 am,

    Driving Innovation in Employer-Sponsored Health Care

  • 11:00 am – 11:45 am,

    Addressing Health Equity through Quality Measurement, Accreditation, & Better Data Collection

    ,

    COVID-19 has brought into focus the disparities in health and health care in the United States and spurred a call to urgently address health equity. Health plans are taking numerous actions to identify and address disparities and promote health equity. Quality measurement and accreditation have become key levers in addressing disparities and promoting health equity, however, accurate and actionable data on member demographics remains a key challenge.

  • 11:45 am – 12:15 pm,

    CMS Center for Program Integrity Priorities for Protecting Medicare and Medicaid

    ,

    In this session, CPI’s Deputy Administrator and Director will discuss the agency’s priorities for protecting the Medicare and Medicaid programs from fraud, waste and abuse.

12:15 pm – 12:45 pm
, Break

Break with Solutions Providers

12:45 pm – 2:15 pm
, Concurrent Session

  • 12:45 pm – 1:30 pm
    • Government Health Programs Policy, Operations, and Emerging Trends

      CMS’ Proposals on D-SNP Integration: Policy Implications

      Speakers
      Details

      The CMS 2023 Medicare Advantage-Part D proposed regulations include a host of new proposals that would impact dual eligible special needs plans (D-SNPs). In this session, a panel of experts will review the key proposals and discuss their implications for people with Medicare and Medicaid, D-SNP organizations, and states, as well as the outlook for advancing integration of Medicare and Medicaid.

    • Health Equity, SDOH, and Community Health

      Addressing SDOH through Value-Driven Eye Health Programs and Member Outreach

      Presented by Versant Health
      Speakers
      Details

      This session will provide an overview of how social determinants of health (SDOH) affects members’ health day-to-day, particularly when it comes to vision and how that may impact their quality of life. Learn how your health plan can leverage value-driven eye health management, member engagement, and outreach programs to align with HEDIS measures while driving quality, member outcomes and cost savings

    • Care Management, Delivery Transformation and Value

      Prioritizing Mental Health in the Marketplace: A Formula for Success

      Presented by Teladoc Health – An AHIP Select Member
      Speakers
      Details

      The ACA increased access to mental health services, but 1 in 5 adults still live with mental illness. This session will explore one health plan’s journey to meet member mental health needs from the ACA’s passage to the current public health emergency. Learn how they’ve set priorities, why and how they’ve leaned on partners, and what’s set them on a path of industry-leading plan offerings and member experiences. Gain practical insight to help meet the mental health needs of your members.

    • Technology, Business Solutions and Product Innovations

      Elevating Strategy with Psychographic Segmentation and Advanced Analytics

      Presented by IBM Watson Health
      Speakers
      Details

      This session will showcase how health plans can combine advanced analytic models with cutting-edge segmentation methodology, including a rich set of health care-specific consumer lifestyles, attitudes and behaviors to help design effective targeting and communication strategies. Speakers will share real-life examples from health plans that aim to provide the right message to the right person at the right time and prioritizing patients through targeted advanced analytics.

  • 1:30 pm – 2:15 pm
    • Government Health Programs Policy, Operations, and Emerging Trends

      MA Advance Rate Notice: Implications for 2023 and Beyond

      Speakers
      Details

      In this session, speakers with deep expertise in Medicare Advantage (MA) will review key elements of the 2023 Advance Notice for MA and Part D, and share insights on the impact and implications for health insurance providers.

    • Health Equity, SDOH, and Community Health

      Advancing Health Equity and Social Needs for the Medicare Population

      Speakers
      Details

      This session will highlight how health plans bring disparate sources of data together into visualized data dashboards that inform actions to advance health equity. Speakers will describe how they use population health analytics to identify health disparities, target vulnerable areas or populations, and use that information to more effectively address social determinants of health and ensure equitable access to care.

    • Technology, Business Solutions and Product Innovations

      The Benefits of Activity: Physical, Mental, and Social

      Speakers
      Details

      While the health benefits of physical activity are well documented, we are now in a time of focus on the true impact of mental and social activity. CMS, payors, and public and private organizations have taken a keen interest in programs that engage seniors through mental enrichment and social connectivity. Learn how a leading fitness program for older adults has joined forces with a senior learning platform to improve overall health, and how these solutions can also impact cognitive function.

2:15 pm – 2:45 pm
, Break

Break with Solutions Providers

2:45 pm – 3:30 pm
, Concurrent Session

    • Government Health Programs Policy, Operations, and Emerging Trends

      Meeting MA Members Needs through Expanded Supplemental Benefits

      Speakers
      Details

      Speakers will discuss the current state and trajectory of supplemental benefit offerings to improve care and address the needs of Medicare Advantage enrollees.

    • Employer-Sponsored Health Coverage, Marketplace Policy, and Emerging Trends

      What Does the Future of the Marketplace Look Like?

      Speakers
      Details

      The ACA’s health insurance marketplaces saw record-breaking enrollment over the last year, due in large part to enhanced subsidies under the American Rescue Plan Act. Other policies like the new special enrollment period for low-income Americans and Medicaid redeterminations at the end of the public health emergency could result in an additional influx of new enrollees. Panelists will discuss what these changes could mean for the future of the marketplaces.

    • Health Equity, SDOH, and Community Health

      Innovations in Dental Coverage to Address Health Care Disparities and Access

      Speakers
      Details

      It is well recognized that oral health and overall systemic health are linked. Speakers in this session will discuss expanding dental coverage, and how providers can work together to overcome barriers to accessing quality oral health care.

    • Care Management, Delivery Transformation and Value

      Engaging Patients to Optimize Use of Preventive Care

      Speakers
      Details

      The COVID-19 pandemic has discouraged many people from getting preventive care; screenings for cancer and sexually transmitted infections, for example, and routine vaccination rates are down significantly during the pandemic. However, even prior to the current situation, preventive service utilization rates were low, with fewer than half of adults up to date on their recommended preventive care. This session explores how health insurance providers are engaging their members and the provider community to encourage increased uptake of valuable preventive services and the innovative approaches they are taking to do so.

3:30 pm – 4:00 pm
, Keynote Session

4:00 pm – 4:15 pm
, Break

Stretch Break

4:15 pm – 5:00 pm
, Keynote Session

9:00 am - 3:00 pm Mar 17 • 2022

9:00 am – 3:00 pm
, Break

Registration and Help Desk Open

10:15 am – 11:00 am
, Keynote Session

11:00 am – 11:15 am
, Break

Stretch Break

11:15 am – 12:00 pm
, Keynote Session

  • ,

    Assessing Clinical and Policy Challenges with New Treatments for Alzheimer’s Disease

    ,

    CMS’ recent proposed National Coverage Determination for monoclonal antibodies approved by the FDA under accelerated approval has brought to the forefront a complex set of issues, including the need for finding innovative treatments for this devasting disease, assessing evidence of clinical benefits and adverse effects, and how to promote safety, equitable access and affordability. Panelists in this session will offer perspectives on these critically important issues.

12:00 pm – 1:00 pm
, Break

Break

1:00 pm – 2:45 pm
, Keynote Session

2:45 pm – 2:45 pm
, Break

Adjournment