National Conferences on Medicare, Medicaid & Duals

  • September 24 – 28, 2017
  • Washington, D.C.
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about

Washington, D.C.

Americans are living longer, healthier lives.

Since their enactment more than 50 years ago, the Medicare and Medicaid programs have made great strides in delivering health care to our nation’s most vulnerable – the aging, the poor, the disabled. We can look to these programs’ innovations in payment reform, benefit design, and community-based care as models for reshaping the way we deliver quality health care.

During AHIP’s National Conferences on Medicare, Medicaid & Duals, you’ll uncover the myriad ways health plans are reducing barriers to care, delivering high-quality services, and lowering costs, including:

  • Developing partnerships and community-based collaborations,
  • Testing innovations at the state level,
  • Utilizing technology for more efficient care delivery,
  • Expanding value-based provider relationships,
  • Lowering costs through Alternative Payment Models (APMs),
  • Addressing the unique social factors impacting the health of vulnerable populations, and
  • Balancing affordability and innovation for prescription drugs.

From ensuring value and improving outcomes for beneficiaries to policy and regulatory changes, you’ll hear the latest updates for today, as well as priorities for the future. Register today!

Three Targeted Events – One Convenient Location

AHIP’s National Conferences on Medicare, Medicaid & Duals includes three distinct events:

  • Medicare: Sept. 24-26
  • Duals: Sept. 26
  • Medicaid: Sept. 27-28

Stay on top of the latest trends and operational need-to-knows. Register today for one, two, or all three events.

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There’s a reason health care professionals budget their time and travel dollars to attend these conferences year after year, and why they recommend them to their colleagues. See what your peers have to say about attending.

Early Registration Ends: August 23
Cancellations: August 30

The Expert Speakers, Timely Topics, and Networking Opportunities You Need

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Hear from policymakers and thought leaders. Gain insight from innovators and stakeholders.

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Peer-to-peer learning and take-aways that have positive impact.

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Connect

Network with experts, peers, and partners. Discover your solutions.

agenda
  • Overview
  • Medicare Conference
  • Duals Conference
  • Medicaid Conference
about

Looking at Public Programs as Models for Reshaping the Way We Deliver Quality Health Care

National Conference on Medicare, Sept. 24-26 National Conference on Duals, Sept. 26 National Conference on Medicaid, Sept. 27-28

 

There’s a reason health care professionals budget their time and travel dollars to attend these conferences year after year, and why they recommend them to their colleagues. See what your peers have to say about attending.

 

January 01
September 24
3:00 pm
5:00 pm

Registration and Information Desk Open

September 25
6:45 am
5:35 pm

Registration and Information Desk Open

8:00 am
8:45 am

Breakfast Briefings

8:00 am
8:45 am

Leveraging Ambulatory ICU Delivery to Improve Outcomes and Reduce Costs of Care for Patients with Complex Needs

Breakfast Briefing

Powered by AbsoluteCARE, Inc.
The current primary care system cannot provide the care needed for the highest-need, highest-cost patient population that account for 30-40% of all paid claims. This session will explore a unique delivery model that addresses social determinants of health, addiction and behavioral health issues, and leads to improved outcomes for patients with complex needs. Learn how the Ambulatory ICU Delivery Model can drive down unnecessary utilization while addressing value based purchasing and improved quality for the high-acuity, chronically ill population.

Alan Cohn

Chief Executive Officer

AbsoluteCARE, Inc.

View Speaker Biography

Gregory P. Foti, MD

Executive Vice President

AbsoluteCARE, Inc.

View Speaker Biography

8:00 am
8:45 am

5 Key Strategies to Streamline the Pre-Authorization Process

Breakfast Briefing

Powered by HealthTrio, LLC
This session will focus on five best practice strategies that optimize authorization workflow and improve health outcomes. Attendees will learn how new regulations are impacting authorizations and how to prepare for these changes. This session will also present these key strategies within real life case studies, highlighting where health plans have implemented these strategies and experienced major turning points in their authorization programs.

Megan Meyer, RHIA, CSM

Senior Product Manager

HealthTrio, LLC

View Speaker Biography

8:00 am
8:45 am

MACRA MIPS & APMS: Are You Ready for the New Era of Physician Payment?

Breakfast Briefing

Powered by Inovalon
With the first year under MACRA’s mandatory Quality Payment Program (QPP) nearing completion, and 2017 performance data submission deadlines just around the corner, providers across the care continuum remain at varying levels of readiness for this new era of physician payment. This session will provide a snapshot of Year 1 of MACRA implementation and look ahead to what’s to come in Year 2 and beyond. Attendees will learn how data-driven analytics can support quality reporting requirements under the QPP by offering actionable insights into expected performance and improvement opportunities, as well as helping identify and evaluate impact of improving performance on key measures to inform goals.

Fred Bentley

Vice President, Center for Payment and Delivery Innovation

Avalere

View Speaker Biography

Angel Oddo

Senior Vice President, Quality Products & Solutions

Inovalon

View Speaker Biography

8:00 am
8:45 am

Leveraging Clinical Collaboration to Enhance Post-Acute Care and Improve Outcomes

Concurrent Session: Technologies & Business Solutions

Powered by Optum
The first 30 to 60 days following a member’s discharge from an acute care setting represents a critical time period that can result in a costly avoidable readmission. This session will examine the growing need for a comprehensive post-acute care strategy. Speakers will share a real-world case study that details key success factors that resulted in a reduction in readmission rates, stronger length of stay management, and improved diagnostic coding and gap closure. Learn how these strategies can lead to significant clinical results.

Diane Flynn

National Vice President of Strategy, Complex Care Management

Optum Care

View Speaker Biography

9:00 am
9:45 am

The Future of Medicare and Critical Role of Medicare Advantage

Welcome and Opening Session

In this session, you will learn about HHS’ priorities and strategies for strengthening the Medicare Advantage and Part D programs.

9:45 am
10:15 am

Transforming the Health Care Delivery System and What It Means for Medicare Beneficiaries

General Session

In this session, a leading Medicare Advantage plan CEO will discuss Medicare’s future and health plans’ continuing role to affect positive change in the program, as well as innovations in serving Medicare members.

Bruce D. Broussard

President and Chief Executive Officer

Humana

View Speaker Biography

10:15 am
10:30 am

Break

10:30 am
11:20 am

MACRA and Other Value-Based Arrangements

Concurrent Session: Operations

The speakers will discuss the ongoing transition from volume-based to alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA), as well as current successes and opportunities for expansion of value-based contracting and other arrangements in Medicare Advantage.

Griffin Myers, MD

Co-Founder and Chief Medical Officer

Oak Street Health

View Speaker Biography

Gregory Woods

Director, Division of Alternative Payment Model Infrastructure, Policy and Programs Group, Center for Medicare and Medicaid Innovation (CMMI)

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

10:30 am
11:20 am

Medicare Diabetes Prevention Program

Concurrent Session: Care Management

This session will highlight the Medicare Diabetes Prevention Program expanded model and Medicare Advantage plan efforts to develop programs for eligible beneficiaries.

Maile M. Jedlinsky

Director

Kaiser Permanente Care Management Institute

View Speaker Biography

10:30 am
11:20 am

Navigating Uncertainty in Medicare Advantage

Concurrent Session: Technologies & Business Solutions

Powered by Visiant
Medicare Advantage continues to garner attention from health plan leaders and the market due to the size and anticipated growth in the segment. However, the definition of success varies by market and the levers to achieve outcomes require constant attention and upgrades based on regulatory changes from CMS and market conditions. It requires health plans to be setup in a dynamic way that enables flexibility. This session will explore some of the key frameworks and approaches that have enabled strong Medicare Advantage plans to not only deal with the uncertainty but also drive their culture and DNA around their operating model to help them stay nimble and lean.

Shankar Madhavan

Vice President of Strategic Planning and Product Management

Visiant

View Speaker Biography

11:30 am
12:20 pm

MA and Part D Coverage Determinations: Best Practices

Concurrent Session: Compliance

Speakers will discuss MA and Part D coverage determination requirements, including CMS guidance on what constitutes reasonable outreach to providers and prescribers. This session will also highlight best practices that plans can implement to meet program requirements.

Myra Plumey

Compliance Officer

MMM Healthcare, Inc.

View Speaker Biography

11:30 am
12:20 pm

Patient-Centered Approaches Being Tested Under the MA-Value Based Insurance Design Model

Concurrent Session: Care Management

This session will highlight value-based plan benefit designs being tested that encourage Medicare Advantage beneficiaries to use high-value clinical services.

Helene Weinraub

Vice President, Medicare

UPMC Health Plan

View Speaker Biography

Stephen Jenkins

Medicare Advantage Value-Based Insurance Design Model Lead, Center for Medicare & Medicaid Innovation (CMMI)

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

11:30 am
12:20 pm

The 2-Step Process to Engaging Medicare Members

Concurrent Session: Technologies & Business Solutions

Powered by Welltok
The competitive landscape for health plans to keep members engaged is rapidly changing. How can health plans precisely target new members, retain current members and impact Star Ratings? This session will explore a new two-step process that has the potential to drive up to forty percent more engagement among members. Learn how combining advanced analytics with best practice multi-channel communications can provide a more tailored approach to addressing readmissions, diabetes care, medication adherence, gaps in care, member satisfaction and retention. Hear how health plans have experienced results from this powerful combination.

Phil Fiero

Senior Vice President, Analytics Services

Welltok

View Speaker Biography

12:20 pm
1:35 pm

General Luncheon Session

1:45 pm
2:35 pm

Keeping Provider Directories Up to Date: Advancing Solutions for Data Accuracy and Collaboration with Providers

Concurrent Session: Compliance

Speakers will discuss best practices for improving provider directory accuracy, including provider engagement strategies.

Gale Arden

Vice President, Complex Care

Centene Corporation

View Speaker Biography

Kenneth Wrzos

Senior Director, Operational Excellence

EmblemHealth

View Speaker Biography

1:45 pm
2:35 pm

Implementing Innovative Care through Part D Enhanced Medication Therapy Management Programs

Concurrent Session: Care Management

Speakers will discuss the Part D Enhanced Medication Therapy Management (MTM) model tests and innovative strategies to optimize medication use and improve care coordination for Medicare beneficiaries.

Nicholas Minter

Division of Financial Risk, Seamless Care Models Group, Center for Medicare and Medicaid Innovation (CMMI)

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Michael Taday, PharmD, MBA

Director, Pharmacy Professional Practice and Clinical Operations

Humana

View Speaker Biography

1:45 pm
2:35 pm

Managing Medicare Advantage Costs through Better Post-Acute Care

Concurrent Session: Technologies & Business Solutions

Powered by CareCentrix
Most health plans have a keen insight on curbing costs for hospitalizations and emergency department use. Far fewer have the knowledge needed to tame the costs associated with post-acute care, such as reducing dependence on Skilled Nursing Facilities (SNFs), limiting the variability in home care quality and rates, and making sure members have what they need to be self-sufficient as they heal at home. Learn why guiding care to the home is the single best way for health plans to bend the cost curve.

Michael Cantor, MD

Chief Medical Officer

CareCentrix

View Speaker Biography

1:45 pm
2:35 pm

Payment Integrity: How Contemporary Technology and Design Creates Meaningful Change in the Health Care Industry

Concurrent Session: Technologies & Business Solutions

Powered by Burgess
This session explores the current state of disconnectedness in the American healthcare system, and how a combination of technology, design and strategic business partnerships can reduce costly errors, distress, and shift the focus to collaboration and business intelligence. Attendees will learn what payment integrity entails and how it pertains to their organization and the health care system as a whole. The speakers will demonstrate the pivotal strengths of a unified platform, and how the future of health care can be streamlined and simplified for payers and providers.

Greg Burgess

President and Head of Product

Burgess

View Speaker Biography

Jared Lorinsky

Chief Experience Officer

Burgess

View Speaker Biography

2:40 pm
3:30 pm

Cure for High Cost Drugs: Where Do We Go from Here on Drug Pricing?

General Session

In this session, drug policy experts from diverse range of industries will provide their perspectives and predictions regarding drug policy legislation and drug industry trends.

Richard A. Deem

Senior Vice President, Advocacy

American Medical Association (AMA)

View Speaker Biography

3:30 pm
3:45 pm

Break

3:45 pm
4:45 pm

Managing the Medicare Advantage and Part D Programs: Views from the Front Lines

General Session

This session will provide insight from a range of perspectives into both the high-level and day-to-day challenges, possibilities and rewards of administering the Medicare program from former senior officials who recently served at CMS.

Jonathan D. Blum, MPP

Executive Vice President, Medical Affairs, CareFirst BlueCross BlueShield; Former Principal Deputy Administrator and Director, Center for Medicare, Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Sean Cavanaugh

Consultant; Former Deputy Administrator and Director, Center for Medicare

Centers for Medicare and Medicaid Services (CMS)

View Speaker Biography

Leslie V. Norwalk, Esq.

Strategic Counsel to Epstein Becker Green; Former Acting Administrator, Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

4:45 pm
5:35 pm

Implementing Innovative Value-Based Models in Medicare and Medicare Advantage

General Session

This session will explore the opportunity for increasing efficiency and improving patient outcomes through innovative approaches to structuring health benefits, such as value-based insurance design, as well as practical applications in the Medicare program now and in the future.

Michael E. Chernew, PhD

Leonard D. Schaeffer Professor of Health Care Policy and Director, Healthcare Markets and Regulation Lab

Harvard Medical School

View Speaker Biography

Adam M. Finkelstein

Counsel

Manatt, Phelps & Phillips, LLP

View Speaker Biography

5:35 pm
7:00 pm

Networking Reception

September 26
7:15 am
6:15 pm

Registration and Information Desk Open

8:00 am
8:45 am

Breakfast Briefings

8:00 am
8:45 am

Putting the Brakes on the Opioid Epidemic in Medicare

Breakfast Briefing

Powered by Express Scripts
Drug overdose is the leading cause of accidental deaths in the U.S. ‒ more than 20,000 people fatally overdosed on opioids in 2015 and nearly two million are addicted. Research shows the Medicare population has among the highest and fastest-growing rates of diagnosed opioid use disorder, currently at more than six of every 1,000 beneficiaries. This session will explore solutions to help curb the costs, combat the opioid epidemic and keep Medicare members healthier.

Snezana Mahon, PharmD

Vice President, Product Development, Customer and Physician Solutions

Express Scripts

View Speaker Biography

8:00 am
8:45 am

Medicare Network Adequacy – Is Your Organization Ready?

Breakfast Briefing

Powered by Deloitte
The Centers for Medicare and Medicaid Services (CMS) has recently sharpened its focus on Medicare Advantage (MA) network adequacy and the accuracy and completeness of MA organizations’ provider directories. CMS is now reviewing one-third of all organizations’ directories each year and initial findings from the first round of reviews shows there is room for improvement. CMS also now requires an MA plan to submit information on its contract’s entire network as part of its service area expansion application. CMS is in the process of developing and piloting a new audit module to evaluate network adequacy. CMS’ increased oversight, coupled with its more frequent reviews of network adequacy, underscores the importance of having complete and accurate information about the providers in your network and a robust provider data management processes. This session will explore CMS’ requirements regarding provider directory accuracy and completeness and results of recent audits. Speakers will discuss Medicare Advantage network adequacy requirements and the importance of complete and accurate health service delivery tables. Learn about the role of provider data management in supporting compliance efforts and leading industry practices.

Lucia Giudice

Managing Director, Government Programs Practice Leader

Deloitte Consulting, LLP

View Speaker Biography

Danielle Moon

Senior Advisor, Government Programs

Deloitte Consulting, LLP

View Speaker Biography

Bobby Vaitla

Senior Manager, Health Plans

Deloitte Consulting, LLP

View Speaker Biography

8:00 am
8:45 am

HCC Suspecting: What’s the Value and How Do You Harness it to Drive Success?

Breakfast Briefing

Powered by Episource
Payers need to better understand their member population. Analytics tools work well to achieve this, but analytics tied to workflows work even better. This session will explore the power of workflows, why program analytics are often ignored but extremely important, and how to find the hidden value of Hierarchical Condition Categories (HCC) suspecting.

8:00 am
8:45 am

Leveraging Mobile Technology to Maximize Member Engagement in Care Management and Quality Improvement Initiatives

Breakfast Briefing

Powered by Wellframe
With smartphone ownership more than doubling in the past five years in the U.S., mobile-enabled health technology represents an enormous opportunity to leverage existing clinical resources to engage members in their health and health care in fundamentally new ways. After deciding to focus on ways to expand the reach of its integrated approach to care management and quality improvement, one large regional health plan introduced a new mobile technology platform to augment its existing telephonic-based outreach to both commercial and Medicare members. In this session, the speakers will highlight the challenges that the organization faced to implementing this tech-enabled, mobile-centric approach to care and the key learnings to drive adoption among both members and staff to engage more members, more frequently and to facilitate improved member health outcomes.

Carrie Whitcher, MHA

Vice President, Health Care Improvement

Excellus Health Plan

View Speaker Biography

8:00 am
8:45 am

Changing Regulations, Payment Models and Member Expectations – How to Prepare for What’s Next

Breakfast Briefing

Powered by HealthEdge
Change and the resulting uncertainty were in the air prior to the 2016 election. Now there are even more questions regarding political and regulatory outcomes, particularly for the future of Medicare and Medicaid. What can health plans with government sponsored programs do to be ready for whatever comes next? Value-based reimbursement will continue to be a driving force in both Medicare and Medicaid, according to industry experts. Many studies prove that increased engagement with members leads to improved outcomes and decreased medical costs. This session will focus on the agility needed to rapidly respond to changing regulations, payment models and member expectations today and tomorrow.

Harry Merkin

Vice President, Marketing

HealthEdge

View Speaker Biography

8:00 am
8:45 am

Taking Control and Improving Care: Empowering Your Diabetic Members

Breakfast Briefing

Powered by Matrix Medical Network
According to the Centers for Disease Control and Prevention, more than 29 million people in the United States have diabetes and one in four people with the disease doesn’t know he or she has it. This session will discuss how an in-person intervention can identify diabetics not previously diagnosed, improve care for people with diabetes, help close gaps in care, and empower members to better manage the disease. Attendees will learn how these personal, one-on-one visits and appropriate follow-up can identify risks early and reduce dangerous and costly complications, including the results of one ongoing diabetic intervention program.

Scott Howell, DO, MPH & TM, CPE

Senior Executive

Heritage Provider Network

View Speaker Biography

Marcia Naveh, MD, FACP, CMD

Co-Founder & Chief Medical Affairs Officer

Matrix Medical Network

View Speaker Biography

8:45 am
9:45 am

The Medicare Program in 2018 and Beyond: Views from the Hill

General Session

The speakers will discuss the political environment and possible future changes and improvements to the Medicare program.

9:45 am
10:00 am

Break

10:00 am
10:50 am

The Future of Risk Adjustment and the Risk Model

Concurrent Session: Operations

Speakers will discuss the strengths and weaknesses of the current CMS-Hierarchical Condition Category (HCC) risk model that CMS uses to adjust payments to Medicare Advantage plans to account for disease severity.  The session will address potential opportunities for improving the model as well as alternatives that could be considered in the future.

Sean Creighton

Vice President, Policy

Avalere Health

View Speaker Biography

David Meyer

Vice President

SCAN Health Plan

View Speaker Biography

Bil Westerfield

President

Magpie Health Analytics, Inc.

View Speaker Biography

10:00 am
10:50 am

Advanced Illness Management: Empowering Patients and Their Families

Concurrent Session: Care Management

Terri Maxwell, PhD, APRN

Chief Clinical Officer

Turn-Key Health, LLC

View Speaker Biography

Angelo Volandes, MD, MPH

President, ACP Decisions; Faculty, Harvard Medical School and Massachusetts General Hospital

View Speaker Biography

10:00 am
10:50 am

Now is The Time for a Health Care Moonshot

Concurrent Session: Technologies & business Solutions

Powered by RX Advance
We are living in an era of significant innovation and technological advancement, where companies such as Uber in transportation and Airbnb in hospitality have transformed their respective industries with innovative business models and technologies. The health care industry should also incorporate innovation to drive progress. PBMs are uniquely positioned to influence this innovation and are ripe for disruption. This session will address why now is the time for a PBM moonshot.

John Sculley

Chief Marketing Officer and Chairman, RxAdvance; Former CEO, Apple and PepsiCo

View Speaker Biography

10:00 am
10:50 am

Megatrends in the Medicare Market: Dispelling the Myths, Increasing Engagement & Driving Results

Concurrent Session: Technologies & Business Solutions

Powered by Connecture, Inc.
With only days until the next annual election period, carriers and brokers are working hard behind the scenes to ensure an easy and seamless enrollment process for their customers. But, as the regulatory environment continues to shift and the impact of healthcare consumerism deepens, what’s the best way to separate fact from fiction when it comes to Medicare beneficiaries and how they like to shop for coverage? This session will explore key data findings and megatrends of the Medicare market, and what to expect in 2018 and beyond. The speaker will discuss specific ways to build actionable retention and engagement strategies for Medicare beneficiaries. Learn how plans, providers and brokers are prioritizing the consumer experience in their go-forward initiatives to better engage and retain members.

Jeff Surges

President & CEO

Connecture, Inc.

View Speaker Biography

10:50 am
11:00 am

Break

11:00 am
11:50 am

Adjusting for Socioeconomic Status in Medicare Quality Ratings

General Session

This session will highlight foundational research, measure development activities and policy proposals to address disparities in health outcomes observed in Medicare quality ratings due to socioeconomic status.

Helen Burstin, MD, MPH, FACP

Chief Scientific Officer

National Quality Forum (NQF)

View Speaker Biography

Joyce Chan, MBA

Vice President, Population Health Strategy

Healthfirst

View Speaker Biography

Young Joo, MS

Vice President, Clinical Operations

CareMore Health System

View Speaker Biography

John M. O’Brien

Deputy Assistant Secretary for Health Policy, U.S. Department of Health and Human Services (HHS)

Office of the Assistant Secretary for Planning and Evaluation (ASPE)

View Speaker Biography

11:50 am
12:20 pm

Priorities and Future Directions for Transforming Medicare Advantage and Part D

Closing Session
12:20 pm
12:20 pm

National Conference on Medicare Adjourns

1:30 pm
1:30 pm

National Conference on Duals Begins

Separate registration required
September 28
September 26
7:15 am
6:15 pm

Registration and Information Desk Open

12:30 pm
12:30 pm

National Conference on Medicare Adjourns

1:30 pm
2:00 pm

Serving Dual Eligible Beneficiaries: Where We Are and Where We Are Going

Welcome and Opening Keynote

The director of CMS’ lead office for dual eligible programs will recap the agency’s perspective on the current state of dual eligible programs, and provide an update on future policy directions and initiatives under consideration.

Tim Engelhardt

Director, Federal Coordinated Health Care Office

Centers for Medicare and Medicaid Services (CMS)

View Speaker Biography

2:00 pm
2:15 pm

Break

2:15 pm
3:15 pm

Where States Are Heading for Integration

General Session

This panel of experts with unique experience in state Medicaid programs, Medicaid health plans and federal policy will discuss strategies states are considering as they work to improve health outcomes and coordination of services for their dually-eligible enrollees.

Toby Douglas

Commissioner, MACPAC; Senior Vice President, Medicaid Solutions

Centene Corporation

View Speaker Biography

Elizabeth Goodman

Chief of Long Term Services and Supports, MassHealth & Executive Office of Elder Affairs

Commonwealth of Massachusetts

View Speaker Biography

Gary Jessee

Managing Director, Sellers Dorsey; Former Deputy Executive Commissioner for Medical and Social Services, Texas Health & Human Services Commission

View Speaker Biography

3:15 pm
4:15 pm

Policy Opportunities for Innovation and Integration

General Session

Speakers from four health plans will review opportunities to promote innovation and expand integration of dual eligible programs. Such opportunities might involve new policies, or targeted refinements in Medicare Advantage, Medicare Part D, and Medicaid policy at the federal and/or state level.

Julie Faulhaber, CHIE

Vice President, Enterprise Medicaid

Health Care Service Corporation (HCSC)

View Speaker Biography

Eve Gelb, MPH

Senior Vice President, Healthcare Services

SCAN Health Plan

View Speaker Biography

Michael Monson

Senior Vice President, Long Term Services & Supports and Dual Eligibles

Centene Corporation

View Speaker Biography

Lynn Nonnemaker, PhD

Director of Medicare Policy

Cigna Corporation

View Speaker Biography

4:15 pm
4:30 pm

Break

4:30 pm
5:15 pm

Future of Duals Delivery Models

General Session

Panel participants will discuss the respective merits and limitations of Medicare-Medicaid-Plans (MMPs), Dual Eligible Special Needs Plans (D-SNPs) and Programs of All-Inclusive Care for the Elderly (PACE) as delivery models for realizing integration of Medicare and Medicaid for dual eligibles.

Maureen Hewitt

President and Chief Executive Officer

InnovAge

View Speaker Biography

Lisa A. Rubino

Senior Vice President, Medicare

Molina Healthcare, Inc.

View Speaker Biography

Mollie Mennell

Staff Vice President, Operations, Duals Demonstration

Anthem, Inc.

View Speaker Biography

5:15 pm
6:15 pm

Reimagining a Unified Program for Dual Eligibles

Closing Session

Two nationally-respected experts will examine characteristics of an ideal unified program structure for dual eligibles, exploring issues such as state vs. federal level administration, implications for beneficiary experience, impacts on operations, and potential financial and administrative synergies.

John Baackes

Chief Executive Officer

L.A. Care Health Plan

View Speaker Biography

Melanie Bella

Consultant and Former Director, Federal Coordinated Health Care Office

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

6:15 pm
6:15 pm

National Conference on Duals Adjourns

September 28
September 27
7:15 am
5:45 pm

Registration and Information Desk Open

8:00 am
8:45 am

Breakfast Briefings

9:00 am
9:35 am

Welcome and Opening Session

9:35 am
10:05 am

Preserving Medicaid for Future Generations

General Session

The speaker will provide a health plan perspective on the prospects for Medicaid, challenges and opportunities on the horizon, and the role of managed care plans in providing stability and long-term viability for the Medicaid program.

Bernard J. Tyson

Chairman and Chief Executive Officer

Kaiser Permanente

View Speaker Biography

10:05 am
10:30 am

The Importance of Medicaid

General Session

Marilyn Tavenner

President and Chief Executive Officer

America's Health Insurance Plans (AHIP)

View Speaker Biography

10:30 am
10:50 am

Break

10:50 am
11:40 am

Medicaid Waivers: From Personal Responsibility to New Flexibility

Concurrent Session: Policy

This session will review recent trends in Medicaid waiver design and examine challenges to implementation, such as financial and health literacy, and engaging with enrollees to help them understand complex program requirements.

Lindsey Browning

Program Director

National Association of Medicaid Directors (NAMD)

View Speaker Biography

Hemi Tewarson

Director, Health Division

National Governors Association Center for Best Practices

View Speaker Biography

10:50 am
11:40 am

Opioids: Balancing Policy, Privacy and Pain Relief

Concurrent Session: Care Management

This session will explore current efforts to focus on patients’ needs while trying to find the balance between effective pain control, addiction treatment and controlled prescribing.

Andrea D. Gelzer, MD, MS, FACP

Senior Vice President and Corporate Chief Medical Officer

AmeriHealth Caritas

View Speaker Biography

Cynthia Reilly, MS, BS Pharm

Director, Substance Use Prevention and Treatment Initiative

The Pew Charitable Trusts

View Speaker Biography

10:50 am
11:40 am

Mastering Complexity of Provider Data: Prioritizing Health over Health Care

Concurrent Session: Technologies & Business Solutions

Powered by DST Health
Ongoing legislation and regulations are changing the healthcare market drastically for government-sponsored payers and healthcare professionals. More and more, the industry is seeking quality and efficiency data to drive payment and measure effectiveness. Accurate and timely provider data is a must to prioritize health over healthcare, including care delivery metrics, population health management, prescribing habits and provider demographics to optimize adequate networks and provider directories. A holistic approach, including both medical and pharmacy reporting requirements, is designed to assess the economic environment in an effort to drive these populations toward value-based care. Federal as well as state regulations are intended to ensure provider quality and serve as the basis for measurable insights into provider practices. This session will explore how the convergence of medical and pharmacy data can be innovative in payment transformation and improve patient access to health care value. Learn about the direction reform is taking and gain perspective on the data you are capturing with tips to position for strategic data usage in a rapidly changing environment.

Adele Allison

Director of Provider Innovation Strategies

DST Health Solutions

View Speaker Biography

Rayvelle A. Stallings, MD

Vice President, Government Programs

DST Health

View Speaker Biography

11:50 am
12:40 pm

Plan Innovations Impacting Social Determinants of Health

Concurrent Session: Policy

A panel of managed care experts describe their organizations’ innovative programs to address major factors influencing health and health outcomes – housing, food and employment – and discuss linkages with care management and health services.

Julie H. Stoss

Vice President, Government Relations

Kaiser Permanente

View Speaker Biography

Dan LaVallee, MS

Director of Government Programs

UPMC Health Plan

View Speaker Biography

Karin VanZant

Vice President/Executive Director, Life Services

CareSource

View Speaker Biography

11:50 am
12:40 pm

A Managed Care Roadmap for Success in Serving Foster Care and Adoption

Concurrent Session: Operations

Merrill Friedman

Senior Director, Disability Policy Engagement

Anthem, Inc.

View Speaker Biography

Gary Jessee

Managing Director, Sellers Dorsey; Former Deputy Executive Commissioner for Medical and Social Services, Texas Health & Human Services Commission

View Speaker Biography

Earlie Rockette, RNP, MN, LSSB

Regional Vice President, Special Populations

Anthem, Inc.

View Speaker Biography

Mark A. Washington

President, Child Welfare Division

Alton Healthcare

View Speaker Biography

11:50 am
12:40 pm

Key Considerations for Health Plans for an Effective Approach to Genetic Testing

Concurrent Session: Technologies & Business Solutions

Powered by Quest Diagnostics
This session will focus on key considerations for health plans for effective genetic testing. Speakers will explore trends in genetic testing and the impact for health plans, and highlight considerations related to the clinical utility of genetic testing. Attendees will learn about strategies for appropriate test selection and interpretation, and misconceptions related to proprietary genetic tests.

L. Patrick James, MD,

Chief Clinical Officer, Health Plans and Policy

Quest Diagnostics

View Speaker Biography

Felicitas Lacbawan, MD

Executive Medical Director, Advanced Diagnostics

Quest Diagnostics

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Andi Ybarra, CGC

Genetic Counselor

Quest Diagnostics

View Speaker Biography

12:45 pm
1:45 pm

Medicaid Back to the Future

General Luncheon Session

Matt Salo

Executive Director

National Association of Medicaid Directors (NAMD)

View Speaker Biography

1:50 pm
2:40 pm

Home is Where the Heart Is: Current Issues in HCBS

Concurrent Session: Policy

Panel participants will discuss key trends and dimensions of home and community based services, including integration of care and service coordination, direct care work force issues, evidence based practices and the evolution and status of key CMS regulations.

Kathleen A. Cameron, MPH

Senior Director, Center for Healthy Aging

National Council on Aging

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Laura Chaise

Vice President, Long Term Services and Supports

Centene Corporation

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Camille Dobson

Deputy Executive Director

The National Association of States United for Aging and Disabilities (NASUAD)

View Speaker Biography

Ari Ne’eman

Chief Executive Officer

MySupport.com

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1:50 pm
2:40 pm

Program and Policy Implications of Precision Medicine and Gene Therapy

Concurrent Session: Care Management

Maria Lopes, MD, MS

Chief Medical Officer

Magellan Rx Management

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Steven D. Pearson, MD, MSc

Founder and President

Institute for Clinical and Economic Review (ICER)

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1:50 pm
2:40 pm

Why Health Plans Must Re-Invent Their Approach to Medicaid Now

Concurrent Session: Technologies & Business Solutions

Powered by SKYGEN USA
This session will explore the disruptive effect technology innovations have had on once rock-solid companies and how lessons learned apply to health plans today. The speaker will explore how and why technology-enabled solutions are the only pathway for payers to scale their Medicaid business, whether it be medical, dental, or vision. The speaker will also introduce a new technology strategy that promises to re-invent the way health care benefits are delivered to optimize efficiency. Learn how uncertainties in Medicaid create additional urgency to enhance the practice of managing the spend on benefits through analysis and technology that ranks and rewards good providers with advantages such as higher reimbursement rates, while uncovering instances of fraud, waste, and abuse more effectively, enabling health plans to deliver more and better care to more members.

Craig Kasten

Chairman of the Board and Co-Founder

SKYGEN USA

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1:50 pm
2:40 pm

Member Engagement Designed to Enhance Satisfaction and Loyalty

Concurrent Session: Technologies & Business Solutions

Powered by NovuHealth
This session will explore how an intelligently designed engagement program, based on consumer loyalty practices, can deliver short-term benefits of quality and over the longer-term increases satisfaction, retention and a reduction in cost. Learn how to streamline the process of providing the right message, incentive and channel to the right member.

Jordan Mauer

Executive Vice President, Marketing and Member Engagement

NovuHealth

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2:40 pm
3:00 pm

Dessert Break

3:00 pm
3:45 pm

Medicaid Moving Forward: Key Perspectives from the Hill

General Session

Two senior health advisors to the House of Representatives Energy and Commerce Committee will present contrasting perspectives on prospects for Medicaid reform legislation and the forecast for new directions in federal Medicaid policy.

Rachel C. Pryor

Health Policy Advisor,

House Energy and Commerce Committee

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Josh Trent

Deputy Chief Counsel, Health Subcommittee

House Energy and Commerce Committee

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3:45 pm
4:45 pm

Medicaid Moving Forward: Implications for States and Health Plans

General Session

This session will highlight state perspectives on the outlook for Medicaid, including implications for beneficiaries, Medicaid health plans, and state budgets.

Thomas Betlach

Director, State of Arizona

Arizona Health Care Cost Containment System

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Michael G. Heifetz

Medicaid Director

Wisconsin Department of Health Services

View Speaker Biography

Shannon M. McMahon, MPA

Former Deputy Secretary, Health Care Financing

Maryland Department of Health and Mental Hygiene

View Speaker Biography

Matt Salo

Executive Director

National Association of Medicaid Directors (NAMD)

View Speaker Biography

Daniel Tsai

Assistant Secretary for MassHealth

Commonwealth of Massachusetts, Department of Health and Human Services, Office of Medicaid (MA)

View Speaker Biography

4:45 pm
5:45 pm

Medicaid Prescription Drugs: What You Need to Know

General Session

This panel discussion will examine the unique structure of the Medicaid prescription drug program and Medicaid drug coverage, review utilization patterns and cost trends, and explore recent policy innovations for improving effectiveness and reducing costs.

Joel Menges

Chief Executive Officer

The Menges Group

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Trish Riley

Executive Director

National Academy for State Health Policy (NASHP)

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5:45 pm
7:00 pm

Networking Reception

September 28
7:30 am
12:30 pm

Registration and Information Desk Open

8:00 am
8:45 am

Breakfast Briefings

8:45 am
9:15 am

Medicaid Policy Priorities: View from CMS

General Session
9:15 am
10:00 am

The Politics of Medicaid

General Session

Seasoned health affairs observers will comment on the political environment surrounding Medicaid, and the interactions of Medicaid policy and politics with the larger political environment, “repeal and replace” and entitlement reform.

Lanhee J. Chen, Ph.D.

David and Diane Steffy Research Fellow, Hoover Institution

Stanford University

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Topher Spiro

Vice President, Health Policy; Senior Fellow, Economic Policy, Center for American Progress

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10:00 am
10:15 am

Break

10:15 am
11:00 am

Medicaid Reform: Where Do We Go from Here?

General Session

Sara Rosenbaum, JD

Harold and Jane Hirsh Professor of Health Law and Policy

George Washington University

View Speaker Biography

11:00 am
11:50 am

Innovative Community Approaches in Asthma Management

Concurrent Session: Care Management

Health plans, providers, and community organizations are working together to improve the health of Medicaid beneficiaries who suffer from asthma and other respiratory conditions. Program leaders will share insights on identifying members for intervention; engaging with providers, care teams, and members to improve member health; and leveraging partnerships to augment program capabilities and maximize success.

Cheryl R. Shafer, MD

Chief Medical Officer

Molina Healthcare South Carolina

View Speaker Biography

11:00 am
11:50 am

The Humanization of Health Care: Addressing Social Determinants of Health to Improve Behavior Change

Concurrent Session: Technologies & Business Solutions

Powered by Envolve
Understanding the barriers to accessing care is essential to developing effective care models for vulnerable populations. By addressing these barriers early for pregnant mothers and children with programs that educate and eliminate obstacles to care, we can promote healthy choices mitigating future chronic health conditions including childhood obesity and diabetes. This session will explore behavior-based health care interventions and the impact these initiatives have in building long-term healthy behaviors.

Debra Haire-Joshu, PhD, MS, MSEd

Joyce Wood Professor, Brown School; Director, Center for Diabetes Translation Research; Director, Center for Obesity Prevention and Policy Research; Faculty Director, Envolve Center for Health Behavior Change

View Speaker Biography

Mary V. Mason, MD, MBA, FACP

Senior Vice President, Chief Medical Officer

Envolve

View Speaker Biography

11:50 am
12:30 pm

Medicaid Policy Priorities in the States

Closing Session
12:30 pm
12:30 pm

National Conference on Medicaid Adjourns

Closing Session

Will we see you in D.C.?

Fall is a fabulous time to be in D.C.

JW Marriott
1331 Pennsylvania Ave, NW, Washington, DC 20004

Not too hot, not too cold. And always a comfortable setting to plan for your organization’s coming year in public programs. Conveniently located, AHIP’s National Conferences on Medicare, Medicaid & Duals is a great place to get down to business. So sign up for the conference and receive special hotel rates!

As an added bonus, nearby you’ll find plenty of walkable green spaces, D.C.-only attractions like the White House, Smithsonian Museums and the National Mall, and great restaurants for when you need to take a short break from it all.

Important Hotel Information

We’ve negotiated special room rates to help stretch even the most limited travel budgets. Make your hotel reservations today!

The group rate is available until Friday, August 25, 2017 or when the room block has sold out (whichever comes first). This cut-off is a guideline and not a guarantee of availability.

Make your reservation today online using the conference Passkey link https://aws.passkey.com/e/49104294 or by calling 800.393.2503, if you are calling outside the US/Canada call 202.393-2000 and reference AHIP or the conference name.

Deposit and Cancellation

All room reservations must be accompanied by a first and last night’s deposit guaranteed with a major credit card. This deposit may be charged to the guest credit card any time after booking.

If a reservation is cancelled on or before Friday, August 11, 2017 the deposit will be refunded. If a reservation is canceled from twenty-one (21) days to fourteen (14) days prior to arrival the individual will forfeit the deposit of the first and last night’s stay. If a reservation is canceled on or after thirteen (13) days prior to arrival, the individual will be charged the entire length of stay.

Travel Information

This hotel does not provide shuttle service.

Area Airports

Ronald Reagan Washington National Airport (DCA)
Distance from Hotel: 5 miles
Drive Time: 20 minutes

Washington, DC/Dulles (IAD)
Distance from Hotel: 26 miles
Drive Time: 45 minutes

Baltimore/Washington International Thurgood Marshall Airport (BWI)
Distance from Hotel: 31 miles
Drive Time: Approximately 1 hour

Rooms at this rate are being held for arrival on Sunday, September 24, 2017 and departure on Thursday, September 28, 2017.

A 14.5% sales tax will be added to the group rate. Space is limited. Reservations are made on a first-come, first-served basis and the contracted rate is available to AHIP conference attendees only.

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SELECT LEVEL

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Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations.

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Burgess helps leading American health insurers and ACOs set a new standard in payment accountability.

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CareCentrix drives savings, improved outcomes, and patient satisfaction

Change Healthcare – An AHIP Select Sponsor Logo
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Change Healthcare is inspiring a better healthcare system. Working alongside our customers and partners, we leverage our software and analytics

Inovalon – An AHIP Select Sponsor Logo
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Driven by data, Inovalon identifies gaps in care, quality, data integrity, and financial performance

NTT DATA – An AHIP Select Sponsor Logo
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NTT DATA is an end-to-end service provider of IT and business solutions for healthcare.

Optum – An AHIP Select Sponsor Logo
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Optum combines technology, data and expertise to power modern health care.

RxAdvance – An AHIP Select Sponsor Logo
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RxAdvance is a national full-service pharmacy benefit manager

Visiant – An AHIP Select Sponsor Logo
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ikaSystems delivers cloud/SaaS-based business automation and process solutions

Welltok, Inc. – An AHIP Select Sponsor Logo
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Welltok, Inc. is fundamentally transforming the way population health managers partner with consumers

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