AHIP’s National Conferences on Medicare, Medicaid & Duals

  • October 23 – 27, 2016
  • Washington, D.C.
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Washington, D.C.

From payment rates and value-based payment models to expansion and major new regulations — stay on top of the latest trends and operational need-to-knows at AHIP’s National Conferences on Medicare, Medicaid & Duals in Washington, D.C.

What’s on the horizon?

The Medicare and Medicaid programs now insure more than one-third of Americans and it’s more vital than ever before to focus on moving forward and adapting to meet new demands. Get in-depth perspectives and analysis from policymakers, health plan leaders, scholars, thought leaders, and industry stakeholders on:

  • The Agency’s view of both the Medicare and Medicaid programs for 2017 and beyond, and future priorities for MA and Part D.
  • What comes next for Medicare/Medicaid Dual-eligible integration.
  • Innovative program designs, value-based approaches, and effective collaborations for improving beneficiary health and well-being.
  • Ways that MA plans are effecting positive change in the Medicare program, and in turn, how Medicare is helping transform the health care system.
  • Harmonizing the new Medicaid Managed Care Rule standards with efficient business operations.
  • How Medicare Advantage (MA) plans are improving the lives of low-income beneficiaries in the inner city.
  • Tactical guidance on encounter data, provider directories, RADV audits, FDR oversight, and denials, appeals and grievances, and more.
  • Providing coordinated access to quality, person-centered care.
  • Preparing for possible implications of the 2016 election on public programs.

Read more about the issues.

Join us this October as we showcase the initiatives that demonstrate tremendous promise on improving access, streamlining long-term services and containing costs so you can strategically plan for next year and beyond.

Early Registration Ends: September 14
Cancellations: September 21

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

Three Targeted Events — One Convenient Location

Whether you choose one, two or three of these programs, you’ll learn firsthand what’s working now and what’s next. The agendas are filled with leading speakers you’ve come to expect from AHIP, including top health plan execs, industry thought leaders, and policy makers.

National Conference on Medicare

  • CMS’ Andy Slavitt will discuss the agency’s priorities for the Medicare Program in 2017 and beyond.
  • Jim Eppel from UCare will address the opportunities and challenges for Medicare Advantage Health Plans.                      
  • The Role of Medicare in the future of delivery system reform, featuring CMS’ Patrick Conway, MD, MSc.

National Conference on Duals

  • Melanie Bella will discuss what comes next as we move toward Duals integration.
  • Learn more about Medicare-Medicaid plan demonstrations from CMS’s Federal Coordinated Health Care Office, including Tim Engelhardt, Lindsay Barnette, Sharon Donovan, Vanessa Duran, and Marla Rothouse.
  • A panel of state leaders will examine prevalent and alternative program models for serving dual eligibles and their long term viability.

National Conference on Medicaid

  • Virginia Governor Terry McAuliffe will deliver the Closing Keynote Address: “Medicaid Policy Priorities in the States: A Governor’s Perspective”
  • CMS’ Victoria Wachino, MS will discuss the agency’s ongoing priorities for the Medicaid program and its growing role within the reformed health care system.
  • James Golden, PhD  from CMS will discuss the underlying themes of the final Medicaid managed care regulations.
  • John Baackes from L.A. Care Health Plan will discuss how Medicaid Plans are improving beneficiary health and well-being.

Beyond the General Session Stage…

Breakfast and concurrent sessions compliment the general sessions at the Conference on Medicare and Conference on Medicaid.

Throughout the week, whether you attend one or more conferences, you’ll also enjoy learning about the latest products and services in our display area.

DOWNLOAD THE CONFERENCE AGENDAS BELOW

Medicare Conference Medicaid Conference Duals Conference
MMC_316_89_MCMCD2016_200x100_Medicare MMC_316_89_MCMCD2016_200x100_Medicaid MMC_316_89_MCMCD2016_200x100_Duals
January 01
October 23
3:00 pm
5:00 pm

Registration and Information Desk Open

October 24
6:45 am
5:45 pm

Registration and Information Desk Open

8:00 am
8:45 am

The Future of Medicare: Understanding the Next Wave of Enrollees

Breakfast Briefing

Powered by Deloitte LLP
As Baby Boomers increasingly join the ranks of Medicare eligibles, Medicare Advantage (MA) plans will need to know how to attract and retain this population, as well as what might be some of the cost and affordability implications of this next wave of enrollees. With an older population already on Medicare for several years and the younger half of the generation still more than ten years out, the differences in characteristics could potentially be significant; including use of online services, shopping habits, and other key characteristics. Understanding their decision making processes is critical to the business of MA plans and enrollee buy-in. Attendees will learn how future beneficiaries differ from current ones and whether their preferences, habits, and decision making processes differ. Speakers will share findings from their primary research on consumer attitudes, preferences and priorities that shed light on these strategic questions.

Claire Boozer Cruse

Lead Market Insights, Deloitte Center for Health Solutions

Deloitte Services LP

View Speaker Biography

Leslie Read

Principal

Deloitte Consulting LLP

View Speaker Biography

8:00 am
8:45 am

The State of Value-Based Reimbursement in 2016

Breakfast Briefing

Powered by McKesson Health Solutions
Value-based insurance design (V-BID) and reimbursement are often cited as potential solutions to questions of cost. Value-based proposals continue to garner interest and bipartisan support from multi-stakeholder groups. During this session, information will be newly released and highlight technologies providers and payers are employing on their journey to value-based reimbursement. Learn how connecting payer systems can help accelerate the value realized from these new, innovative models.

Andrei Gonzales, MD

Director, VBR Initiatives

McKesson Health Solutions

View Speaker Biography

8:00 am
8:45 am

Transforming While Performing in a Rapidly Evolving Industry

Breakfast Briefing

Powered by Cognizant Technology Solutions
Transformative market forces, coupled with rapid advances in digital technologies, are placing consumers at the center of an increasingly virtualized, personalized and delocalized healthcare system. Government health plans are looking for new ways to drive down costs and maintain compliance while shifting from volume to value and creating a personalized experience for their members. Addressing these challenges will require broad new capabilities, from improving administrative efficiencies, through building business models based on quality of outcomes, and implementing digitized processes that address consumer demands for product customization and more control over their care decisions. How will your organization embrace change and succeed in our rapidly evolving healthcare landscape when faced with so many competing priorities? Join us for a discussion of strategies that can help impact your organization’s success today and tomorrow.

Becky Erbe

Vice President, Government Solutions

Cognizant

View Speaker Biography

Diana Sonbay-Benli

Vice President, Government Solutions Product Management

Cognizant

View Speaker Biography

8:00 am
8:45 am

Network Adequacy Requirements in Medicare and Medicaid: What You Need to Know

Breakfast Briefing

Powered by Berkeley Research Group, LLC
Health plans are creating new and more complex provider networks in an effort to increase quality and reduce costs. These new networks are receiving increased scrutiny by regulators at both the federal and state level. In addition to the adequacy of the network itself, regulators and consumers are increasingly focused on provider directory accuracy given the complexity of new provider networks and the out-of-pocket costs associated with out-of-network services. Recent regulatory developments underscore the importance of this issue as well as the operational challenges health plans face in meeting these requirements. This session will provide an overview of the efforts to define adequacy and accessibility, including a discussion of recent developments in federal Medicare and Medicaid requirements.

Jeremy Earl

Partner

McDermott Will & Emery

View Speaker Biography

Brian E. Hoyt

Managing Director

BRG

View Speaker Biography

8:00 am
8:45 am

Changing Payer-Provider Relationship – Are You Prepared?

Breakfast Briefing

Powered by Payspan, Inc.
This session will provide a snapshot of key changes taking place with new ACO alternative reimbursement models and how they will impact payer-to-provider relationships for reimbursement. These new dynamics will affect payers as providers struggle with performance base reimbursement and new governance requirements. The traditional relationship between payers and providers will change significantly in the coming years. Are you ready to handle these challenges while at the same time providing superior service to your members and meeting consumer expectations? Join this session to take a look ahead and discuss how you can apply solutions now.

Bill Nordmark

Chief Growth Officer

Payspan, Inc.

View Speaker Biography

8:00 am
8:45 am

Embedding Flexibility in Solutions to help Transform Payer Organizations

Breakfast Briefing

Powered by ikaSystems
This session will provide perspectives on current and forward-thinking solutions that help (and will help) payers transform their business so it can effectively compete and thrive in era of accelerated changes. Attendees will learn about real-world challenges related to driving engagement, regulatory compliance, and reducing administrative costs. Attendees will also learn why innovative flexible technology solutions are a must to address these payer challenges.

Girish Pathria

Vice President, Product Management and Marketing

ikaSystems

View Speaker Biography

8:00 am
8:45 am

Improving Star Ratings Utilizing Lead Indicators for Operational Metrics

Breakfast Briefing

Powered by Dell Services
Have you ever wondered what your health plan could do to improve CAHPS and/or HOS measures that are part of the Medicare Advantage Star Ratings? How can a health plan influence responses to the questions on these surveys? This session will explore how to use operational metrics as lead indicators to provide insight to Stars Ratings measures that are based on survey data, as well as using supplemental data sources (e.g. social media) to assist in identifying opportunities for improvement.

Deana Rhoades

Automation Practice Lead, Health Plan Solutions

NTT DATA Services

View Speaker Biography

Karen Way

Analytics Practice Lead

Dell Services

View Speaker Biography

8:00 am
8:45 am

Understanding How Medicare Age-ins Navigate Enrollment

Breakfast Briefing

Powered by eHealth, Inc.
This session will highlight the results of a recent qualitative in-home study with 30 current Medicare enrollees, as well as quantitative research with 2,000 current and future Medicare enrollees. You will learn how consumers navigate health insurance options, enrollment, and make health care decisions. The speakers will also discuss how health plans can help Medicare beneficiaries make more informed choices when shopping online.

Lorrianne Nault

Senior Director, User Experience Design

eHealth, Inc.

View Speaker Biography

Nate Purpura

Vice President, Communications

eHealth, Inc.

View Speaker Biography

Jennifer Wheat

Senior Manager, Customer Care

eHealth, Inc.

View Speaker Biography

9:00 am
9:45 am

Priorities and Future Directions for Medicare Advantage and Part D: View from CMS

Welcome and Opening Keynote

The speaker will describe CMS’s vision for the continuing growth and evolution of the Medicare Advantage and Part D programs.

Sean Cavanaugh

Consultant; Former Deputy Administrator and Director, Center for Medicare

Centers for Medicare and Medicaid Services (CMS)

View Speaker Biography

9:45 am
10:15 am

How Medicare Advantage Plans Improve the Lives of Low Income Beneficiaries

General Session

Pat Wang

Chief Executive Officer

Healthfirst

View Speaker Biography

10:15 am
10:35 am

Break with Table Tops

Sponsored by Relias Learning

10:40 am
11:25 am

CMS Provider Directory Monitoring Initiative

Concurrent Session: Compliance

This session will highlight CMS’ monitoring efforts related to Medicare Advantage provider directories.  In addition, best practices for health plans working to improve provider directory accuracy will be shared.

Christine M. Reinhard, ESQ, MBA,

Health Insurance Specialist, Division of Surveillance, Compliance and Marketing, Medicare Drug and Health Plan Contract Group

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Jeremy Willard

Health Insurance Specialist, Division of Surveillance, Compliance and Marketing

Medicare Drug and Health Plan Contract Group

View Speaker Biography

10:40 am
11:25 pm

Ongoing Development of the Encounter Data System

Concurrent Session: Operations

Speakers will share insights into the current challenges of and potential futures uses for Medicare Advantage encounter data.

Eric Cahow

Vice President, Medicare Revenue Management

Anthem, Inc.

View Speaker Biography

Mark E. Miller, PhD

Executive Director

MedPAC

View Speaker Biography

10:40 am
11:25 am

Personalization: The Secret to Driving Engagement and Improving Health Outcomes

Concurrent Session: Technologies & Business Solutions

Powered by Welltok
The secret to fully understanding and engaging your senior members – both within and outside of the healthcare system – lies in taking a systematic approach to engagement centered around personalized member experiences. By using a combination of consumer data, applied analytics, incentive design, and multi-channel communications, you can improve the beneficiary experience and improve Stars performance – whether it’s member satisfaction and retention or diabetes care and gaps closure. This session will reveal new insights on seniors, including their increasing use of technology to improve their health and what it means for your engagement initiatives. Speakers will also explore how to leverage data, CMS-compliant incentives and enterprise-level technologies to create a truly personalized and rewarding experience for your Medicare members, that’s also scalable. Your seniors are ready, are you?

Christopher Coloian

Chief Solutions Officer

Welltok

View Speaker Biography

10:40 am
11:25 am

Medicare Secondary Payer Law: What You Need to Know

Technologies & Business Solutions: Concurrent Session

Powered by MSP Recovery

11:30 am
12:15 pm

MA/Part D Denials, Appeals & Grievances: Best Practices and Common Findings

Concurrent Session: Compliance

Speakers will discuss recent CMS audit findings related to denials, appeals and grievances and provide insight on practical tools and best practices that MA organizations and Part D plan sponsors can implement to improve performance.

Beckie Peyton

Division of Appeals Policy, Medicare Enrollment and Appeals Group

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Jennifer M. Smith

Director, Division of Analysis, Policy & Strategy, Medicare Part C & D Oversight and Enforcement Group

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

11:30 am
12:15 pm

Insights to Improve the MA Value-Based Insurance Design Model

Concurrent Session: Operations

Speakers will discuss the Medicare Advantage Value-Based Insurance Design (MA-VBID) model test that starts on January 1, 2017 and model improvements to promote quality of care and reduce health care costs for Medicare Advantage beneficiaries.

Adam Finkelstein

Health Insurance Specialist, VBID Lead, Seamless Care Models Group, Center for Medicare and Medicaid Innovation (CMMI)

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Helene Weinraub

Vice President, Medicare

UPMC Health Plan

View Speaker Biography

11:30 am
12:15 pm

Using Analytics to Identify and Strategically Manage Patient Opioid Abuse

Concurrent Session: Care Management

Powered by Verscend
Opioid abuse continues to be a chronic health care issue, impacting every community across the country. Health plans managing Medicare and Medicaid populations face ongoing challenges in successfully addressing members with opioid abuse problems, and will benefit from proactive identification and intervention before potential risk turns into full-blown addiction, or worse. This session will explore the use of data analytics to identify potential opioid abuse patterns, including the use of predictive modeling and benchmarking. The session will also provide practical tactics to use data to develop and deploy clinical support to patients at-risk to curb potential long-term abuse.

James Colbert, MD

Senior Medical Director, Population Health

Verscend

View Speaker Biography

David Rearick, DO, MBA, CPE

Chief Medical Officer, Marsh & McLennan Agency

Mid-Atlantic

View Speaker Biography

11:30 am
12:15 pm

Members Coping with an Advanced Illness: Meeting Their Needs Through Collaboration and Communication

Concurrent Session: Care Management

Powered by Vital Decisions
In this interactive session, the speakers will discuss the role that collaboration among providers, health plans and other stakeholders plays in supporting members who are coping with advanced illnesses and approaching end of life. Hear about the strategies one health plan employed to support and meet the special needs of their SNP members. By attending this session, participants will develop an understanding of the needs of a SNP population as they cope with advanced illness and approach EOL. They will also consider through the experiences of the speakers, the role that collaboration and communications take on in their organization. Lastly, participants will understand the benefits to the member when the plan or vendor work together to support members.

Connie Ducaine, PhD, LPC, LCADC, ACS, BCPC, NCC

Director of Clinical Account Management

Vital Decisions

View Speaker Biography

Mary Mailloux, MD

Medical Director, Medicare Dual-Eligible Special Needs Plan (D-SNP)

Coventry Health Care of Florida

View Speaker Biography

12:15 pm
1:15 pm

How the Medicare Advantage Program Enhances Consumer Choice

General Luncheon Session

Mark B. Ganz

President & CEO

Cambia Health Solutions

View Speaker Biography

1:25 pm
2:10 pm

Medicare Risk Adjustment Data Validation Audits: What You Need to Know

Concurrent Session: Compliance

Speakers will discuss recent developments in CMS’s RADV program including the ongoing MAC contracting efforts, the fee-for-service adjuster, and best practices to ensure more effective data submission processes.

Thomas E. Hutchinson

Strategic Advisor

EBG Advisors, Inc.

View Speaker Biography

1:25 pm
2:10 pm

Strategies to Better Understand and Address Health Care Disparities

Concurrent Session: Care Management

Speakers will discuss recent CMS data detailing the health care experiences and quality of care received by diverse Medicare Advantage populations. Strategies that plans can implement to reduce health disparities will also be shared.

Madeleine A. Shea, PhD

Deputy Director, Office of Minority Health

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Ghita Worcester

Senior Vice President, Public Affairs and Marketing

UCare

View Speaker Biography

1:25 pm
2:10 pm

Using Segmentation and Analytics to Optimize Plan Performance and Increase the Star Rating

Concurrent Session: Technologies & Business Solutions

Powered by Novu
If you are seeking to understand the inner workings of how analytics matched with omni-channel technology can improve your plans’ ability to meet beneficiary needs and increase your Star rating, then this session is designed for you. Join us to learn about the process, tools and technologies required to build a successful reward and incentive program for your health plan.

Tom Wicka

CEO and Co-Founder

Novu

View Speaker Biography

1:25 pm
2:10 pm

Are You Ready for a CMS Audit? Perspectives on What You Need to Know

Concurrent Session: Operations

Powered by Cody Consulting Group, Inc.
This session will provide lessons learned from a Medicare Advantage plan recently subject to a CMS audit. Attendees will hear about one plan’s experience with the audit process and best practices for demonstrating compliance with CMS rules. The speaker will offer insight on steps plans can take prior to the start of the process and advice on how to best use technology solutions and other resources to address issues likely to arise during these audits.

Mike Turrell

CEO

Ultimate Health Plans

View Speaker Biography

2:10 pm
2:30 pm

Dessert Break with Table Tops

2:30 pm
3:20 pm

Plan-Provider Collaborations to Promote the Right Care at the Right Time

General Session: Delivery of Care Models

Leaders will discuss innovative programs that take best advantage of health plan and provider capabilities to address the needs of Medicare beneficiaries.

Eric Haas, MD

Senior Medical Director, Medicare Cost & Performance Solutions

Florida Blue

View Speaker Biography

Augusta L. Kairys

Senior Vice President, Market Development, Health Plans

Medecision

View Speaker Biography

Glen R. Stream, MD, MBI

President and Chair

Family Medicine for America's Health

View Speaker Biography

Ankit Patel

Vice President

Clover Health

View Speaker Biography

3:20 pm
3:40 pm

Why Medicare Advantage is Important: How Health Plans are Shaping the Medicare Program

General Session

Marilyn Tavenner

President and Chief Executive Officer

America's Health Insurance Plans (AHIP)

View Speaker Biography

3:40 pm
4:00 pm

Break with Table Tops

Sponsored by Relias Learning

4:00 pm
4:45 pm

The Spillover Effect: How MA is Influencing the Fee-for-Service Program

General Session

This session will highlight new research demonstrating the effects Medicare Advantage plans have on improving care and reducing costs throughout the Medicare program.

Jose F. Figueroa, MD, MPH

Instructor of Medicine

Harvard Medical School

View Speaker Biography

Austin Frakt, PhD

Health Economist

Boston VA Healthcare System

View Speaker Biography

4:45 pm
5:45 pm

Implications of the 2016 Election for Public Programs

General Session

John E. McDonough

Professor, Department of Health Policy & Management

Harvard T. H. Chan School of Public Health

View Speaker Biography

Avik Roy

President

Foundation for Research on Equal Opportunity (FREOPP)

View Speaker Biography

5:45 pm
7:15 pm

Networking Reception with Table Tops

October 25
7:15 am
5:45 pm

Registration and Information Desk Open

8:00 am
8:45 am

Care Models That Work: Moving from Complex to Collaboration

Breakfast Briefing

Powered by Optum
What care models are delivering the best quality of care and most value for Medicare and Medicaid populations? Our industry continues to focus on the challenge of escalating medical spend while resources are limited to engage and deliver the spectrum of care required to manage populations at risk. This forces a new collaboration across payers, providers and consumers—with significant financial incentives to reduce costs and improve clinical and quality outcomes. In this session, we will explore care models that derive value by integrating care programs and delivering a person-centric approach.

Melissa Lindholm, MBA, Six Sigma Certification

Senior Director, Specialty Services, Oncology

Optum

View Speaker Biography

Michael W. Rosen, MD

Senior National Medical Director

Optum

View Speaker Biography

8:00 am
8:45 am

An Innovative Approach to Supporting Patients with the Greatest Needs

Breakfast Briefing

Powered by CVS Health
Patients with multiple chronic conditions require significantly more care and have higher costs than patients with a single chronic condition. This session will explore an innovative approach that delivers personalized pharmacy care for these patients. You will learn how a dedicated pharmacy care team can help support coordination with health plan resources and provide patients with unique pharmacy service.

Keith Reynolds

Vice President, Enterprise Health Plan

CVS Health

View Speaker Biography

8:00 am
8:45 am

How Can We Be “Insights Poor” in an Era of Data “Richness”?

Breakfast Briefing

Powered by LexisNexis® Health Care
Though HHS has drawn considerable attention to the release of CMS data over the past several years, the promise of big data has yet to be realized across the Medicare and Medicaid programs. Access to data alone does not guarantee improvement in the areas of greatest need. It’s where big data, small data and analytics intersect that true intelligence can be achieved and leveraged to make decisions that lead to cost reductions, improved health outcomes and compliance. Join this session to explore the promise of data intelligence when socioeconomic information, public records data and analytics collide with your health programs traditional data sources.

Josh Schoeller

Vice President, Client Engagement

LexisNexis® Health Care

View Speaker Biography

8:00 am
8:45 am

To SNP or Not to SNP

Breakfast Briefing

Powered by Change Healthcare
This session will present the regulatory and operational challenges faced by Medicaid and Medicare plans entering the MMP and DSNP markets. We will address audit requirements, operational and service impacts, analytics and reporting, impacts on community based care, claim filing, reporting and clinical staff.

Shelley Stevenson

Director, Government Programs Practice

Change Healthcare

View Speaker Biography

8:00 am
8:45 am

Modernize your MA Risk Adjustment Program with a 360 Degree Approach

Breakfast Briefing

Powered by Health Fidelity
Through the real-world experience of a provider-sponsored health plan, this session will demonstrate how a comprehensive risk adjustment program that fits multiple lines of business while achieving operational economies is a necessity in today’s value-based care landscape. Attendees will discover how to best leverage retrospective risk adjustment approaches in partnership with point of care efforts, explore best practices for implementing new technology, and review analytics for measuring risk adjustment transformation.

Kimberly L. Geidel, BS, MPM

Director of Government Revenue

UPMC Health Plan

View Speaker Biography

Adele L. Towers, MD, MPH FACP

Senior Clinical Advisor

UPMC Enterprises

View Speaker Biography

8:00 am
8:45 am

Understanding the Dynamics of Socio-Economic Status and Star Ratings: How to Overcome Barriers to Accurately Measure Medicare Advantage Plan Performance

Breakfast Briefing

Powered by Inovalon
There is growing awareness in the healthcare industry that the socio-economic status (SES) of a Medicare Advantage health plan’s members can have a big impact on its quality ratings. With quality ratings increasingly linked to reimbursement and member retention, understanding the impact of SES factors on CMS Star Ratings is key. This session will provide an update on current research related to which SES factors most affect quality ratings for specific measures and provide perspective on the current CMS proposals to address SES in Star Ratings. Speakers will explore how research findings can help shape your strategies to effectively engage disadvantaged populations and target those members at greatest risk to improve overall quality and performance scores.

Christie Teigland, PhD

Vice President, Advanced Analytics

Avalere

View Speaker Biography

8:00 am
8:45 am

Maximizing your MTM Programs to Drive Improved Health Outcomes

Breakfast Briefing

Powered by Express Scripts
The ever-changing Medicare landscape is requiring plans to adapt their Medication Therapy Management (MTM) programs by employing new strategies, innovative initiatives, and different uses of technology to be able to provide the best in class, holistic care your members need. Session attendees will learn how to strategically up their MTM game through care coordination amongst providers, members, nurse care coordinators and pharmacies to maximize health outcomes. We will also demonstrate how plan sponsors could be using MTM programs to tackle challenging performance measures and major healthcare issues like the opioid epidemic.

Kevin Boesen, PharmD

Chief Executive Officer

SinfoníaRx

View Speaker Biography

Snezana Mahon, PharmD

Vice President, Product Development, Customer and Physician Solutions

Express Scripts

View Speaker Biography

8:00 am
8:45 am

A Unique Approach to Managing Post-Acute Care

Breakfast Briefing

Powered by naviHealth
This session will explore one health plan’s unique approach to managing post-acute care (PAC). Attendees will learn how this approach has resulted in improved patient care, and significant cost savings.

Ken Botsford, MD

Chief Medical Officer

naviHealth

View Speaker Biography

Daniel Gell, RN, BSN, MS, MOD

Director of Utilization Management and Care Management

Security Health Plan

View Speaker Biography

9:00 am
9:35 am

Challenges and Opportunities for Medicare Advantage Health Plans

General Session

Jim Eppel

President and Chief Executive Officer

UCare

View Speaker Biography

9:35 am
9:55 am

Break with Table Tops

Sponsored by Relias Learning

9:55 am
10:25 am

Future of Delivery System Reform

General Session

This session will highlight new demonstrations and ongoing efforts to further transition the Medicare program from volume to value-based payments, including MACRA, MA-VBID, and the Part D enhanced MTM models.

Patrick Conway, MD, MSc

CMS Deputy Administrator for Innovation and Quality, Director, Center for Medicare and Medicaid Innovation (CMMI)

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

10:25 am
11:10 am

Strategies for Strengthening Your FDR Oversight Program

Concurrent Session: Compliance

In this session, MA organizations and Part D plan sponsors will learn about strategies to utilize to ensure effective oversight of first tier, downstream and related entities (FDRs).

Lynne Newson

Medicare Compliance Director

Blue Cross Blue Shield of Massachusetts

View Speaker Biography

10:25 am
11:10 am

Plan Strategies for Managing Rising Drug Costs

Concurrent Session: Operations

This session will highlight ongoing MA and Part D plan efforts to ensure access to breakthrough medications while promoting affordability for beneficiaries and taxpayers.

Sarah Marche

Vice President of Pharmacy Services

Highmark, Inc.

View Speaker Biography

Mark Owen

President, Government Programs

Health Care Service Corporation (HCSC)

View Speaker Biography

10:25 am
11:10 am

RAPS to EDS Transition: The Necessary Partnership between Providers, Groups, and Health Plans

Concurrent Session: Operations

Powered by Episource, LLC
In this new risk adjustment world where EDS (Encounter Data System) is quickly replacing RAPS (Risk Adjustment Processing System), it is integral that health plans, providers and other stakeholders work together to address the vast array of new challenges. Under EDS, CMS has significantly increased the complexity of the data necessary for submission for risk adjustment and payment purposes. This session will help health plans, providers and groups navigate this complexity by providing strategies on how to collaborate more effectively with each other. Specifically, the discussion will focus on how to understand and resolve rejected submissions, how to drive value from the MAO-004 reports (i.e. EDS version of accepted diagnosis codes for risk adjustment), and identify additional compliance and related RADV audit risks of potential concern for the industry. Attendees will learn how to prepare for this new EDS world, and what they need to be doing today in order to be successful tomorrow.

David Meyer

Vice President

SCAN Health Plan

View Speaker Biography

Tim Spaeth

Senior Vice President, Payer Solutions

Episource

View Speaker Biography

10:25 am
11:10 am

The MACRA Rule and its Technology Implications for Payers with Medicare Lines of Business

Concurrent Session: Technologies & Business Solutions

Powered by HealthEdge
This session will provide an overview of key imperatives facing health plans with regards to the impending Medicare Access and CHIP Reauthorization Act (MACRA) rule. Attendees will learn about important preparations necessary for health plans with Medicare Lines of Business. This session will explore how technology will play a critical role enabling the agility essential for health plans to quickly and easily adapt to the value-based reimbursements and new provider contracts that MACRA requires. The speakers will share the implications that technology has for effectively dealing with the new dynamics that MACRA is bringing first to Medicare, and also to Medicare Advantage and Medicaid plans.

Andrew Davis

Vice President and General Manager, Medicare Segment

Medica

View Speaker Biography

Harry Merkin

Vice President, Marketing

HealthEdge

View Speaker Biography

11:15 am
12:00 pm

Improving Care for Medicare Beneficiaries with Chronic Conditions: Views from the Hill

General Session

Jordan Bartolomeo

Health Legislative Assistant

Senator Johnny Isakson (R-GA)

View Speaker Biography

Matt Kazan

Senior Health Policy Advisor, Senate Committee on Finance

Democratic Staff

View Speaker Biography

Jen Kuskowski

Senior Policy Advisor, Senate Committee on Finance

Republican

View Speaker Biography

12:00 pm
12:30 pm

The Medicare Program in 2017 and Beyond: The View from CMS

Closing Session

The speaker will discuss CMS’s policy priorities for positioning the Medicare Advantage and Part D programs to best serve the nation’s seniors and individuals with disabilities as the Medicare population rapidly expands over the coming decades.

Andrew Slavitt

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

1:45 pm
5:45 pm

National Conference on Duals

October 27
October 25
1:45 pm
5:45 pm

National Conference on Duals

1:45 pm
2:15 pm

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

Welcome and Opening Keynote

The speaker will discuss the state of dual eligible integration and CMS’ vision for the future of integration initiatives for Medicare-Medicaid beneficiaries.

Tim Engelhardt

Director, Federal Coordinated Health Care Office

Centers for Medicare and Medicaid Services (CMS)

View Speaker Biography

2:15 pm
3:00 pm

Medicare-Medicaid Plan Experiences and Transitions

General Session

The panel will discuss key experiences and lessons learned from planning and implementing Medicare-Medicaid Plan demonstrations in ten states.

Lindsay Barnette

Director, Models, Demonstrations and Analysis Group, Federal Coordinated Health Care Office

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Sharon Donovan

Director, Program Alignment Group, Federal Coordinated Health Care Office

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Vanessa Duran

Deputy Director, Program Alignment Group, Federal Coordinated Health Care Office

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

Marla Rothouse

Senior Advisor, Federal Coordinated Health Care Office

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

3:00 pm
3:15 pm

Break

3:15 pm
4:15 pm

Delivering on the Promise of Integration: How Do Health Plans Best Serve Duals?

General Session

Dual eligibles present health plans and policy makers with a wide range of care and service needs. Representatives from four health plans with long histories of serving dual eligibles will discuss how they have tailored their care models to serve this diverse population.

Kit Gorton, MD, MHSA

President

Tufts Health Public Plans Inc.

View Speaker Biography

Michael Monson

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

Centene Corporation

View Speaker Biography

Bill Roth

President

SCAN Health Plan

View Speaker Biography

Thomas Standring

Vice President, Medicare

Molina Healthcare

View Speaker Biography

4:15 pm
4:30 pm

Break

4:30 pm
5:15 pm

Future of Benefit Alignment in the States

General Session

A panel will review the prevalent and alternative program models for serving dual eligibles, explore the advantages and disadvantages of those models, and speculate on their long term viability.

Camille Dobson

Deputy Executive Director

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

View Speaker Biography

Karen Kimsey

Deputy Director, Complex Care and Services

Virginia Department of Medical Assistance Services

View Speaker Biography

Gretchen Ulbee

Manager, Special Needs Purchasing

Minnesota Department of Human Services

View Speaker Biography

5:15 pm
5:45 pm

Moving Towards Duals Integration. What Comes Next?

Closing Session

The speaker will comment on the future of integrated models for serving dual eligibles and the administrative, regulatory and legislative changes needed to support and promote those models.

Melanie Bella

Consultant and Former Director, Federal Coordinated Health Care Office

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

October 27
October 26
7:00 am
5:30 pm

Registration and Information Desk Open

8:00 am
8:45 am

Innovative Programs Proven to Engage and Empower Complex, High-Utilizing Members and Improve Their Well-Being

Breakfast Briefing

Powered by Matrix Medical Network
Engaging and retaining hard-to-reach members with complex or chronic health conditions is challenging work. In this session we’ll discuss and share the results of several innovative chronic care programs. You will learn how these programs help improve access to quality care, boost member participation in healthy behavior and improve health outcomes.

Troy Garland, MBA, BA, RN

Vice President Clinical Services, Health Choice Arizona

Health Choice Generations, Health Choice Essential

View Speaker Biography

Heidi Wold, MSN, ARNP, ANP-BC

Vice President, Chronic Care, Matrix Care Direct

Matrix Medical Network

View Speaker Biography

8:00 am
8:45 am

Delivering Meaningful Solutions for Individuals with Serious Mental Illness

Breakfast Briefing

Powered by Beacon Health Options
This session will highlight opportunities for health plans to improve both cost and quality outcomes for individuals with serious mental illness. Patients with serious mental illness face unique challenges, including a high frequency of co-morbid medical conditions and complex social needs. Remaining largely disconnected from the system of care, this population frequently relies on emergency departments or acute inpatient facilities for treatment. Attendees will learn about a recently launched pilot program that utilizes peer support to target the unique needs of individuals with serious and persistent mental illness. The speakers will also examine how addressing non-medical extensions of care can improve individual health outcomes while reducing health care costs.

Jeremy Hastings

Senior Vice President, Network Strategy

Beacon Health Options

View Speaker Biography

Jill Lack, MS, LMHC

Director of Behavioral Health

Neighborhood Health Plan

View Speaker Biography

8:00 am
8:45 am

Assessing Plan Efforts to Increase Effectiveness in Medicaid Managed Care

Breakfast Briefing

Powered by Xerox
In this session you will learn how your plan can assess its current service and infrastructure investments to maximize its effectiveness and/or alter your strategy in the growing Medicaid Managed Care environment. You’ll learn how to compare and select programs to improve care delivery outcomes, create a business roadmap to get more out of your initiatives, benchmark industry best practices and reduce existing costs. These skills will enable your plan to successfully address complex challenges such as provider reimbursement and value-based payment, care coordination and delivery, clinical analytics and predictive modeling, social determinants of health, contractual and regulatory compliance, population health and financial stability. After this session, you will be better equipped to assess options critical for success under the Medicaid Managed Care Final Rule.

Steve Reynolds

Vice President, Market Management, Government Healthcare Solutions

Xerox

View Speaker Biography

8:00 am
8:45 am

Terms of Engagement: Reinforcing Payer-Provider Collaboration with Equally Beneficial Analytics

Breakfast Briefing

Powered by Pulse8
With provider groups assuming progressively more risk and with the proliferation of risk adjustment and quality metrics across all three lines of government business, market forces necessitate increased data sharing among payers and providers. To avoid sinking under all these data demands, risk-bearing entities need to leverage advanced analytics that will coordinate their gap closure efforts to simultaneously address both risk adjustment and quality initiatives. To reduce provider abrasion and alert fatigue, payers also need to collaborate with their network providers on efficient data collection methods. This session will explore how plans can leverage alternative data gathering and intervention modalities (such as EMR Integration and telehealth), and better integrate gap closure initiatives to more effectively nurture payer-provider collaboration. The speakers will also share the provider engagement and collaboration strategies that are essential to improve quality and fulfill mutually beneficial goals.

Scott Stratton

Chief Data Scientist and Vice President, Product Analytics

Pulse8

View Speaker Biography

8:00 am
8:45 am

Using Integrated Health Intelligence Technology to Improve Participant Outcomes & Lower Costs

Breakfast Briefing

Powered by Finity, Inc.
This session will provide the results of two Medicaid incentive programs powered by a health intelligence platform. Attendees will learn how to use health intelligence technology to improve participant outcomes and achieve lower costs. The speakers will also share program results to date, incentive and engagement plan design strategies, and closed-loop tracking plan design methodologies.

Alexandra MacDonald

Senior Vice President, Population Health Management

Finity

View Speaker Biography

Matt Onstott, PhD

Vice President, Government Solutions

Finity

View Speaker Biography

8:00 am
8:45 am

The Value of Hospice Care Among Dual Eligibles and Long-Term Nursing Home Residents

Breakfast Briefing

Powered by VITAS Healthcare
As health plans work to improve care coordination, outcomes and satisfaction among the vulnerable dual eligible population, many have engaged in large-scale, transformative changes and taken on increased financial risk. With growing enrollment, health plans continue to confront challenges in serving their dual eligible members and identifying the most appropriate interventions for those with the greatest needs. For members at end of life, hospice may be an appropriate option but members and even providers may not understand the benefits hospice care can provide. Session participants will learn how effective use of hospice can improve care coordination, manage symptoms, and mitigate risk, all while helping members to remain at home or in community settings at the end of life.

Mary Busowski, MD, FACP

Associate Medical Director

VITAS Healthcare

View Speaker Biography

Ron Greeno, MD, FCCP, MHM

Senior Advisor, Medical Affairs

Team Health

View Speaker Biography

Shellie Williams, MD

Assistant Professor of Medicine

University of Chicago

View Speaker Biography

8:00 am
8:45 am

Managing the Frail Elderly: An Integrated Model of In-Home Risk Adjustment and Care Management

Breakfast Briefing

Powered by ComplexCare Solutions, Inc.
This session will outline an integrated and effective approach to risk adjustment and care management that incorporates in-home assessment, engagement and in-home monitoring— first by more accurately stratifying members to identify those most impactable by clinical and nonclinical services, then by managing care according to various intensities of engagement. Attendees will learn how this coordinated, face-to-face approach of risk adjustment and care management can result in improved health, outcomes and quality of life for members and reduced medical costs for health plans.

Anthony Kotin, MD

Chief Medical Officer

ComplexCare Solutions, Inc.

View Speaker Biography

Debra S. Richman

Chief Strategy and Business Development Officer

ComplexCare Solutions, Inc.

View Speaker Biography

8:00 am
8:45 am

Innovations in PBM Delivery: A Collaborative Approach to Reduce Overall Pharmacy Costs, Drug-Impacted Medical Costs, and Specialty Spend

Powered by RxAdvance Corporation

Susan Hayes, AHFI, CPNT

Principal

Pharmacy Outcome Specialists

View Speaker Biography

9:00 am
9:35 am

The Medicaid Program in 2017 and Beyond: The View from CMS

Welcome and Keynote

The speaker will discuss the agency’s priorities for the program and its growing role within the reformed health care system.

Victoria Wachino

CMS Deputy Administrator and Director of the Center for Medicaid and CHIP Services (CMCS)

Centers for Medicare & Medicaid Services (CMS)

View Speaker Biography

9:35 am
10:05 am

Enhancing Medicaid for Future Generations: A Plan’s Perspective

General Session

Paul A. Tufano

Chairman and CEO

AmeriHealth Caritas

View Speaker Biography

10:05 am
10:25 am

Break with Table Tops

Sponsored by Relias Learning

10:25 am
10:55 am

Medicaid Managed Care Rule: Implications for Health Plans

The speaker will discuss the first update to the Medicaid Managed Care Rule in over a decade and the effect it will have on health plan operations, care delivery, and partnerships with states and the federal government.

Cindy Mann

Partner, Manatt Health

Manatt, Phelps and Phillips, LLP

View Speaker Biography

11:00 am
11:45 am

Concurrent Sessions

11:00 am
11:45 am

Leveraging Telemonitoring to Reduce Hospital Readmissions and Cost of Care for Heart Failure Patients

Concurrent Session: Technologies & Business Solutions

Powered by AMC Health
Patients with heart failure face a progressively deteriorating course of disease, with exacerbations and the accompanying debilitating symptoms that require urgent medical attention and often lead to frequent hospitalizations and emergency department visits. Patient self-monitoring of signs and symptoms offers a means to detect early signals of deteriorating conditions and the opportunity to intervene before urgent/emergent care and hospitalization is necessary. Learn how the addition of telemonitoring can further extend a case manager’s ability to monitor individuals with heart failure, improving patient’s clinical outcomes and cost of care. You will hear a living case study of one health plan’s journey.

Andrea Fenner-Koepp, MS

Director of Care Coordination and Integration

Geisinger Health Plan

View Speaker Biography

Jonathan Leviss, MD, FACP

Chief Medical Officer

AMC Health

View Speaker Biography

11:00 am
11:45 am

Voice of the Customer: How States and Health Plans Can Work Together

Concurrent Session: Operations

The speakers will provide insights into state planning for moving new populations and waivers into Medicaid managed care, how states structure their procurement processes, engage with stakeholders to shape the Medicaid environment, and key values states look for in working with health plans.

Calder Lynch

Director, Division of Medicaid and Long-Term Care

Nebraska Department of Health and Human Services

View Speaker Biography

Pam Perry

Regional Vice President, State Affairs and Government Relations

Anthem

View Speaker Biography

11:00 am
11:45 am

Improving Care Transitions: A Case Study from the Virginia MMP Dual Eligible Demonstration

Concurrent Session: Care Management

This session will explore how three area agencies on aging organized to contract with health plans for the Virginia MMP demonstration, and key takeaways for health plans interested in contracting with community based organizations.

William S. Massey

Chief Executive Officer

Peninsula Agency on Aging

View Speaker Biography

Kathy Vesley

President and CEO

Bay Aging

View Speaker Biography

Farah Burch, BSN, RN, CCM

Manager of Case Management

Virginia Premier Health Plan

View Speaker Biography

11:00 am
11:45 am

Practical Examples of Value-Based Care Collaboration

Concurrent Session: Technologies & Business Solutions

Powered by GE Healthcare
In this session, we’ll explore multiple examples of how payer-provider collaboration can be fostered through the exchange of clinical, financial, and administrative data. This exchange can be leveraged to automate the communication of gaps in care, as well as HCC Risk Adjustment data and other clinical data needed for quality metrics.

Shiv Gopalkrishnan

General Manager, Enterprise Financial Management

GE Healthcare

View Speaker Biography

11:50 am
12:35 pm

The Spectrum of Behavioral and Physical Health Integration

Concurrent Session: Policy

The speakers will examine how integrated physical and behavioral health work from the standpoint of plan members. What do members like and dislike about integrated arrangements, and what factors should Medicaid providers and health plans consider to improve integrated programs?

Karen E. Michael RN, MSN, MBA, CHIE

Vice President, Corporate Medical Management

AmeriHealth Caritas Family of Companies

View Speaker Biography

Jeff O’Neil

CEO

Greater Cincinnati Behavioral Health Services

View Speaker Biography

Jonas Thom, MA, PCC

Vice President, Behavioral Health

CareSource

View Speaker Biography

11:50 am
12:35 pm

Magnificent Seven: Innovations in Managed LTSS

Concurrent Session: Care Management

This session will highlight noteworthy LTSS and HCBS innovations
developed and implemented by AHIP Medicaid plans, in areas ranging from care
management to home and community-based services.

Michelle Bentzien-Purrington

Vice President MLTSS

Molina Healthcare of California

View Speaker Biography

Anthony Evans, RN

Senior Vice President, Integrated Care and Home Health Services

CareSource

View Speaker Biography

Sharon Alexander

President, LTSS Solutions

AmeriHealth Caritas

View Speaker Biography

Drew Gulick

Manager, Product Development, Complex Care

Centene Corp.

View Speaker Biography

Mary T. McSorley

Staff Vice President, Medicaid Product Development

Anthem

View Speaker Biography

Bea Thibedeau, DNP, RN

Director of Clinical Management and Long-Term Care Services

Tufts Health Public Plans Inc.

View Speaker Biography

Dana Mott-Bronson

Executive Director, Health Policy, Government Programs

Health Care Service Corporation

View Speaker Biography

11:50 am
12:35 pm

Best Practices in Welcoming, Onboarding and Retention

Concurrent Session: Operations

Powered by Eliza Corporation
The Affordable Care Act has flooded the insurance market with new consumers in both Medicaid and Marketplace plans. While it’s wonderful that so many people finally have access to affordable healthcare, many health plans are struggling with a population that has little-to-no experience with insurance. Effective welcome and onboarding strategies are needed to educate new members on their benefits and how to use and keep their coverage. Learn how to reduce churn and improve retention through innovative, timely, multichannel outreaches starting upon enrollment and throughout the year.

Jennifer Forster

Director, Medicaid Strategy

Eliza Corporation

View Speaker Biography

Ellen Harrison

Senior Vice President, Market Strategy and Consulting

Eliza, an HMS Company

View Speaker Biography

11:50 am
12:35 pm

Outcomes of an Integrated Remote Monitoring Pilot: Improving Cost, Quality and Member Experience

Concurrent Session: Technologies & Business Solutions

Powered by Medtronic and Geneia @Home
A key challenge for health plans is increasing utilization of health care services among members with chronic disease. Care teams must identify appropriate interventions that help prevent unnecessary emergency department and hospital utilization, a common occurrence among chronically ill patients. Remote patient monitoring has shown efficacy in the literature to improve health outcomes and reduce utilization and cost among chronically ill patients. An optimal program design would incorporate a robust case management program and in-home clinical support, along with remote patient monitoring technology. This session will focus on the results of a non-randomized pilot program that was effective in reducing utilization and improving outcomes among heart failure patients. The study resulted in slowed disease progression in the pilot group, as measured by retrospective risk scores; reduced hospital admissions; improved patient experience; and substantial per-participant, per-year cost savings. Attendees will learn about best practices for integrating remote monitoring into a case management program and how to distinguish attributes that contribute to patient engagement. They will hear perspectives from the remote monitoring technology provider and the sponsor of the pilot program on how developing and implementing a remote patient monitoring program can reduce cost, improve outcomes and lead to a better member experience.

Pat Ingerick

Director

Geneia Institute

View Speaker Biography

Dietrich Ruehlmann, PhD, MBA

Senior Global Product Manager

Medtronic

View Speaker Biography

Karen A. Shehade, CHIE, MBA, MHP, PA-C

Global Medical Affairs, Health Care Economics, Policy, Reimbursement and Payer Solutions

Medtronic

View Speaker Biography

12:35 pm
1:35 pm

Three Key Years

General Luncheon Session

George Halvorson

Chair & CEO

Institute for InterGroup Understanding

View Speaker Biography

1:45 pm
2:30 pm

New Medicaid Regulations for Quality Measurement

Concurrent Session: Technologies & Business Solutions

Powered by DST
Recent Medicaid managed care regulations have established new requirements for state Medicaid programs and Medicaid Health Plans. For example, CMS will develop a quality ratings strategy for implementation to create more consistent nationwide measures across states. This session will provide attendees with an overview of CMS’ plans for quality ratings and how these regulations will help align these quality measures at a national level.

Amy Salls

Director, Population Health Strategy

DST Health Solutions

View Speaker Biography

Rayvelle A. Stallings, MD

Vice President, Government Programs

DST Health

View Speaker Biography

1:45 pm
2:30 pm

Value-Based Approaches Used by Plans to Rein in Drug Costs

Concurrent Session: Operations

This session will focus on innovative methods Medicaid health plans are using to address the emerging challenges posed by rising drugs costs. Speakers will discuss value-based pharmacy management, the need for health plan pharmacy leadership, and best practices for working with PBMs.

Karen S. Amstutz, MD, MBA, FAAP

Chief Medical Officer

Magellan Health

View Speaker Biography

Cynthia J. Pigg, RPh, MHA, FAMCP

Chief Pharmacy Officer

Gateway Health

View Speaker Biography

1:45 pm
2:30 pm

Emerging Trends in Medicaid Reform

Concurrent Session: Policy

What new features are states building into their Medicaid program designs, especially for expansion populations? This session will examine emerging program designs in Medicaid, such as premiums and copayments linked to savings accounts and wellness incentives, as well as the operational obstacles and opportunities they present for health plans.

Brian Coyne

Doctoral Candidate, Law and Policy

Northeastern University

View Speaker Biography

John McCarthy

Director

Ohio Department of Medicaid

View Speaker Biography

Joseph W. Thompson, MD, MPH

Director, Arkansas Center for Health Improvement and Professor, University of Arkansas for Medical Sciences

View Speaker Biography

1:45 pm
2:30 pm

Innovation in a Digital Era: Using Data to Pivot to ‘the New’

Concurrent Session: Technologies & Business Solutions

Powered by Accenture
Disruptive forces are accelerating innovation in the Medicaid space. Forward-looking public and private sector stakeholders are leading the way, leveraging government funding to develop novel care delivery methods and models that accelerate financial, clinical, and operational outcomes in the digital age. This session will explore the unique challenges and inherent opportunities of data and analytics-driven reform, highlighting relevant case studies. Join us to gain insight into pragmatic actions that enable tangible outcomes in a dynamic Medicaid environment.

Drew C. Boston

Senior Manager

Accenture Strategy

View Speaker Biography

Michael Kovach

Consultant, Health Strategy

Accenture

View Speaker Biography

John G. Lovelace

President, UPMC for You and President, Government Programs and Individual Advantage

UPMC Health Plan

View Speaker Biography

2:30 pm
2:50 pm

Dessert Break with Table Tops

Sponsored by Relias Learning

2:50 pm
3:20 pm

The Role of Medicaid Health Plans in Improving Beneficiary Health and Well-Being

General Session

The speaker will discuss how managed care plans partner with states in serving Medicaid enrollees, the different kinds of people served by Medicaid and Medicaid health plans through specialized waiver programs, and the role of Medicaid in promoting and supporting social and economic development of people with low incomes.

John Baackes

Chief Executive Officer

L.A. Care Health Plan

View Speaker Biography

3:20 pm
4:10 pm

Operationalizing in a Dynamic and Expanding Regulatory Environment

General Session

This session will focus on the implications, opportunities and challenges arising from the dramatic increase in regulations for Medicaid managed care programs. Speakers will share strategies that harmonize these new standards with efficient business operations and assist governmental payers with broader health system transformation goals.

John G. Lovelace

President, UPMC for You and President, Government Programs and Individual Advantage

UPMC Health Plan

View Speaker Biography

John Kaelin

Senior Advisor

Centene Corporation

View Speaker Biography

Susan Montgomery

Vice President, Medicaid and Regulatory Affairs

MVP Health Care

View Speaker Biography

4:10 pm
5:30 pm

Implementing the Medicaid Managed Care Rule: View from the States

General Session

This session will highlight state perspectives on the new Medicaid managed care regulations, including implications on beneficiaries, Medicaid health plans, and state budgets.

Preston W. Cody

Division Director, Division of Medicaid Program Operations and Integrity

Washington State Health Care Authority

View Speaker Biography

Calder Lynch

Director, Division of Medicaid and Long-Term Care

Nebraska Department of Health and Human Services

View Speaker Biography

John McCarthy

Director

Ohio Department of Medicaid

View Speaker Biography

Matt Salo

Executive Director

National Association of Medicaid Directors (NAMD)

View Speaker Biography

Jen Steele

Medicaid Director

Louisiana Department of Health & Hospitals

View Speaker Biography

5:30 pm
7:00 pm

Networking Reception with Table Tops

October 27
7:15 am
12:30 pm

Registration and Information Desk Open

8:00 am
8:45 am

Managing Opioid Utilization in Your Medicaid Benefit

Breakfast Briefing

Powered by Express Scripts
Opioid utilization is a topic that is center stage in the national spotlight, but has long been a focus of Medicaid plans. In this session, attendees will hear some of the latest observations about opioid utilization in the Medicaid population and learn best practices to help manage this increasingly concerning class of drugs. We will also share tools health plans can use to analyze their trend and make changes before problems start.

Brian Mischel, RPh, MBA

Director, Medicaid Innovation

Express Scripts

View Speaker Biography

Krista Ward, MBA

Senior Director, Medicaid

Express Scripts

View Speaker Biography

8:00 am
8:45 am

Realizing the Potential of PAC Partnership Models

Breakfast Briefing

Powered by CareCentrix
Post-acute care (PAC) can account for approximately forty percent of a
Medicare Advantage plan’s cost for a ninety-day episode of care. However, an
integrated PAC solution has the potential to reduce total per episode costs by
as much as twenty-five percent. Today, a number of systemic issues impede
health plan efforts to reduce post-acute care costs, improve quality and
simplify the administration of these services. But that is about to change with
the introduction of new health plan and PAC partnership models built on value
based payments approaches. This session will address the challenges Medicare
Advantage health plans face in managing PAC delivery and costs, the value
improvement opportunity presented by an integrated PAC partnership model,
and the critical features of a health plan/PAC partnership solution.

Gary Jacobs

Executive Vice President, Strategic Relationships

CareCentrix

View Speaker Biography

8:00 am
8:45 am

Innovative Health Management Strategies to Support Complex Care Needs and Improve Access to Care

Breakfast Briefing

Powered by Health Dialog Services Corporation
This session will feature successful health management strategies for individuals with complex care needs, high costs, and care access challenges.
Attendees will learn how to mix traditional disease management programs with innovative patient-centered care models to successfully and cost
effectively support the unique needs of these patients. Additionally, the session will highlight the latest innovations driving more connected care for Medicaid
members, including in-person community resources and digital technologies that have the potential to slow disease progression and better engage patients
in their care.

Divya Errabelli

Vice President, Analytics

Health Dialog

View Speaker Biography

8:00 am
8:45 am

Why Population Health Management Needs Behavioral Health

Breakfast Briefing

Powered by ODH, Inc.
Population Health Management provides a systemic approach for identifying, understanding and managing the high leverage drivers of the health of a population, subgroups of the population and individuals in communities. This session will explore the role of behavioral health in the overall health of population health management. Learn how a new multifunctional enterprise system for the transformation of population health management can advance innovative patient care management and provider network management.

8:00 am
8:45 am

Creating Synergies for Better Cost Control and Care Efficiency

Breakfast Briefing

Powered by SDLC Partners, LP
No one value- or member-focused strategy, alone, can achieve the levels of improved outcomes, cost control, and care efficiencies payers are striving for today. This session will look at how one plan has implemented a go-forward strategy to realize their goals through the synergy of three initiatives — automating and streamlining the enrollment experience, collaborating with providers through bundled payments and managing cost of care through prioritized outreach. By breaking out each initiative, the speakers will demonstrate how, together, these tactics can help plans drive down the cost of care while improving outcomes and engaging their most impactful members.

Nikhil Mendhi

Vice President & Practice Leader, Provider Management

HM Health Solutions

View Speaker Biography

Alycia Sepe, RN, BSN

Vice President, Practice Leader, Clinical and Government Programs

HM Health Solutions

View Speaker Biography

8:00 am
8:45 am

The Time for Collaboration is Now

Sponsored Breakfast Briefing

Powered by GE Healthcare
The journey to value-based care requires new shared capabilities between providers and payers. Most importantly, they need a platform for collaboration and coordination. After years of evolution, the technology and regulatory enablers are in place. This session will discuss how collaboration can form the foundation for our journey to value-based care.

Jon Zimmerman

General Manager

GE Healthcare IT

View Speaker Biography

8:00 am
8:45 am

Leveraging a Structured Approach to Improving Medicaid Population Health

Breakfast Briefing

Powered by ZeOmega
Medicaid enrollees are often both more medically complex and harder to engage than other insured populations. This session will explore a structured approach to advancing the health of the Medicaid population in turbulent times. The speaker will discuss how to harness the power of information to provide priorities for action for this challenging population. Tools and resources necessary to drive operational efficiency, care quality and patient engagement will be discussed, as well as Medicaid specific strategies for their application.

Elizabeth A. Barnett, BSN, JD

Vice President of Government Solutions and Innovation

ZeOmega

View Speaker Biography

9:00 am
9:15 am

The Important Role Medicaid Health Plans Play in Asthma Prevention

General Session

Janet McCabe,

Acting Assistant Administrator, Office of Air and Radiation

United States Environmental Protection Agency (EPA)

View Speaker Biography

9:15 am
9:50 am

Medicaid Policy Priorities for 2017: View from the Hill

General Session

Josh Trent

Deputy Chief Counsel, Health Subcommittee

House Energy and Commerce Committee

View Speaker Biography

9:50 am
10:05 am

How Health Plans Are Helping to Strengthen the Medicaid Program

Marilyn Tavenner

President and Chief Executive Officer

America's Health Insurance Plans (AHIP)

View Speaker Biography

10:05 am
10:35 am

The Medicaid Managed Care Landscape: A Plan’s Perspective

General Session

The speaker will discuss the opportunities and challenges for health plans in the context of increasing state acceptance of Medicaid managed care, new managed care regulations, and a dynamic political landscape.

Michael F. Neidorff

Chairman, President and CEO

Centene Corporation

View Speaker Biography

10:35 am
10:50 am

Break

Sponsored by Relias Learning

10:50 am
11:30 am

Drilling Down on Social Determinants of Health

General Session

Explore how social determinants of health factors such as housing, employment, geography, food access/security, social interaction, and quality of life impact ability of Medicaid members to access and realize benefits of health care. How can plans and other stakeholders evaluate impacts on performance using aging and disability measures, such as those in the national core indicator set?

Merrill Friedman

Senior Director, Disability Policy Engagement

Anthem, Inc.

View Speaker Biography

Sharon Lewis

Principal

Health Management Associates

View Speaker Biography

11:30 am
12:00 pm

New Medicaid Managed Care Rule: A View from the Agency

General Session

The speaker will discuss the underlying themes behind the new rule and his ongoing priorities for the Medicaid managed care program.

James Golden, PhD

Centers for Medicare and Medicaid Services (CMS)

View Speaker Biography

12:00 pm
12:30 pm

Medicaid Policy Priorities in the States: A Governor’s Perspective

Closing Session

Terence R. McAuliffe

Governor

Commonwealth of Virginia

View Speaker Biography

12:30 pm
12:30 pm

National Conference on Medicaid Adjourns

Will we see you in D.C.?

Hotel and Travel Information

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

*Important Message: Potential Fraud Alert*

Please be aware that AHIP is NOT working with any outside companies to provide housing details for our 2016 National Conferences on Medicare, Medicaid and Duals.

AHIP will communicate primarily through email regarding the National conferences on Medicare, Medicaid and Duals hotel reservations. AHIP never requests credit card numbers or housing reservations over the phone. We currently use the hotel’s Passkey room reservation portal for hotel reservations. AHIP has not endorsed any private companies other than the J. W. Marriott Washington, DC (the hotel where our event is being held) to act on our behalf. AHIP cannot be responsible for any hotel reservations made through any company other than through AHIP’s Passkey secure link or with the hotel directly.

If you have made hotel reservations and provided a credit card number to any company (that has initiated contact with you on behalf of AHIP other than of the J.W. Marriott Washington, DC), please call your credit card company immediately and request that they investigate the charge.

If you have any questions or need further assistance, please contact conferences@ahip.org.

The contracted group rate at the J.W. Marriott Washington, DC is SOLD OUT.  Please check with Marriott reservations at 800.393.2503 directly for availability.

If you are in need of a room for the National Conferences on Medicare, Medicaid and Duals we have found the following hotels may have availability.  Please check with these hotels directly for current availability and rates.

The Willard Intercontinental
1401 Pennsylvania Avenue, NW
Washington, DC
202.628.9100
http://washington.intercontinental.com/

Grand Hyatt Washington
1000 H Street, NW
Washington, DC
202.582.1234
https://washingtondc.grand.hyatt.com/en/hotel/home.html

Capital Hilton
1001 16th Street, NW
Washington, DC
202.393.1000
http://www3.hilton.com/en/hotels/district-of-columbia/capital-hilton-DCASHHH/index.html

Sofitel Washington DC
Lafayette Square
806 15th Street, NW
Washington, DC
http://www.sofitel-washington-dc.com/en

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

This cut-off is a guideline and not a guarantee of availability.

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Accenture – An AHIP Select Sponsor Logo
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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.

Amgen – An AHIP Select Sponsor Logo
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Amgen is committed to unlocking the potential of biology for patients

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.

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DentaQuest is a dental enterprise and one of the largest dental benefit administrators in the nation.

GE Healthcare – An AHIP Select Sponsor Logo
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GE Healthcare provides transformational medical technologies and services

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ikaSystems delivers cloud/SaaS-based business automation and process solutions

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Driven by data, Inovalon identifies gaps in care, quality, data integrity, and financial performance

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

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Optum combines technology, data and expertise to power modern health care.

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PaySpan® is a trusted source of innovative healthcare reimbursement solutions.

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Quest Diagnostics empowers people to take action to improve health outcomes.

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RxAdvance is a national full-service pharmacy benefit manager

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Welltok, Inc. is fundamentally transforming the way population health managers partner with consumers

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