Medicaid Managed Care Leadership Summit

Medicaid Managed Care Leadership Summit

For Medicaid professionals of all levels, leave equipped to maximize member engagement

and care management in an evolving Medicaid Environment

APRIL 29 - 30, 2019Chicago, IL

SUMMIT INCLUDES

Tracks Networking Opportunities

Early Bird Topics

T H E 4 T H A N N U A L

D W 3 . 1 5 . 1 9 V 5

What are the Key Factors Related to Medicaid

Managed Care?

Please join us for the 4th Annual Medicaid Managed Care Leadership Summit where you’ll hear from 20+ key perspectives on pressing topics including case studies that are integral to the day-to-day of Medicaid personnel.

Subject matter experts will delve into the Arkansas Medicaid work requirements data to discuss how the implementation process has been and what hurdles they faced in preparation for several other states to follow suit. Experts will also discuss how the mid-term elections have impacted Medicaid and its members and what challenges can be expected over the next year. This year expect to:

• Identify strategies to improve your SDoH menu to improve quality of life for your members• Analyze the most innovative technologies serving the Medicaid space• Attend a CEO level overview of Medicaid issues at the plan, State, and National levels• Develop strategies to ensure accurate data and payment to avoid improper payments• Network with Medicaid specialists from across the nation

You can’t afford to miss this event!

Learn from industry experts on how to prepare for an evolving Medicaid Market and learn the best practices to increase efficiency in operation while serving the best care to your members!

2 Medicaid Managed Care Leadership Summit Apri l 29 -30 , 2019

WHO SHOULD ATTEND?The 4th Annual Medicaid Managed Care Leadership Summit is designed for all Medicaid professionals. With speakers of the highest caliber including CEO’s, Presidents, Executive Directors and Vice Presidents, the content, knowledge, and experience will be hugely beneficial and practical.

01 Medical Directors02 Medicaid Directors03 VP/Directors Long Term Care Services04 VP/Directors Healthcare Quality05 VP/Directors Medicaid Managed Long Term

Care and Home Care Services06 VP/Directors and Administrator, Long

Term Care07 Chief Clinical Officers08 Chief Medical Officers09 Chief Operating Officers10 Chief Executive Officers11 Chief Financial Officers12 Integrated Care Directors13 Provider Network Directors

14 VP/Directors of Medicaid Policy15 VP/Directors of State Compliance Programs16 MCO Operations Directors17 Provider Relations Managers18 Policy Analysts19 VP/Directors of Care Management20 VP/Directors Enrollee and Community

Engagement21 Government & State Programs22 Mental and Behavioral Health Specialists23 VP/Directors Dual Eligible24 VP/Directors of Compliance25 Pharmacy Specialists/ PBMs26 Data Analysts

TOP REASONS TO ATTEND

01 02 03Examine the impact of the mid-term elections on states across the US

Identify best practices for MLTSS member community inclusion

Evaluate your current Provider Network Adequacy and ways to improve it

04 05 06 07Maximize your SDoH menu to benefit your member population

Identify ways to improve Medicaid encounter data reliability and meet CMS requirements

Examine which opioid addiction treatments are successful through data analytics

Develop new strategies to prepare for members’ diverse and changing needs

08 09 10Examine Medicaid changes in 2018 and predicted changes for 2019

Explore the impact of implementing Medicaid work requirements

Network with leading Medicaid professionals in the field to discuss best practices in maximizing member engagement and program efficiency

Click Here to Register 3The Standard Club | Chicago, IL

DAY ONE: MONDAY, APRIL 29TH, 2019

7:30 - 8:30 Registration and Networking Breakfast

8:30 Pre-Conference - Medicaid Leadership Think Tank

An invite only exclusive think tank allowing the opportunity for Medicaid leaders from across the country to analyze critical topics and the future of Medicaid.

9:00 Chairperson’s Welcome Remarks

Clay Farris, Senior Healthcare ExecutiveMOSTLY MEDICAID

9:10 Panel Discussion: CEO Outlook for Medicaid 2020

• An overview of Medicaid issues at the plan, State, and National levels• Examine the evolving landscape from 2018 and identify areas of growth in 2019• Identifying best practices from the CEO level that can enhance operations within your plan• The focus on Social Determinants and the return on investment

ModeratorClay Farris, Senior Healthcare ExecutiveMOSTLY MEDICAID

Panel MembersJim Milanowski, President and CEOGENESEE HEALTH PLAN

John Lovelace, President, President of Government Programs and Individual Advantage ProductsUPMC HEALTH PLAN

Thomas Duncan, MBA, Chief Executive OfficerTRUSTED HEALTH PLAN


10:20 Case Study: Implementation of Integrated Health Homes in Illinois

• Examine the process of preparing for the new Integrated Health Home (IHH) program in Illinois, which offers fully-integrated form of care coordination for all members of the Illinois Medicaid population

• Identify members’ diverse and changing needs over time for the IHH to craft a flexible care delivery approach

• Discuss potential evolution and growth areas in Medicaid in Illinois, using the IHH as an example of Illinois’ commitment to being innovative with new provider type and services to comprehensive integration of behavioral and physical health

Samantha Olds Frey, MPPA, Executive DirectorILLINOIS ASSOCIATION OF MEDICAID HEALTH PLANS

Alaina Kennedy, Associate DirectorILLINOIS ASSOCIATION OF MEDICAID HEALTH PLANS

11:10 - 11:25 Networking Break

11:25 Case Study: Arkansas- Examining Potential Outcomes of the Medicaid Work Requirements

• Examine the implementation process of work requirements in Arkansas and other states• Dissect the Data- Has the program been successful thus far?• Identify the hurdles that Arkansas has had to overcome• Discuss the status of approved and pending waivers across the states

Libby Hinton, MSPH, Senior Policy AnalystKAISER FAMILY FOUNDATION

12:25 - 1:15 Networking Luncheon


TRACK A FINANCIAL IMPACTS AND OUTCOMES

Chairperson: Clay Farris, Senior Healthcare Executive

MOSTLY MEDICAID

TRACK B MEMBER ENGAGEMENT AND COMPLIANCE

Chairperson: To Be Announced

1:15 - 2:15Payment Risks in Medicaid Managed Care

• Estimate payment risks in managed care—what’s included and what isn’t

• Assess the risks of improper payments in managed care from the standpoint of (1) states’ payments to managed care organizations, and (2) payments of managed care organizations to providers

• Strategies to ensure accurate data and payment to avoid improper payments

Carolyn Yocom, MBA, Director, Health CareU.S. GOVERNMENT ACCOUNTABILITY OFFICE

1:15 - 2:15Community Health Innovation Region Model to Address Emergency Department Utilization and the Social Determinants of Health

• Collaboration between a community backbone organization, Patient Centered Medical Home (PCMH) practices, and Medicaid Health Plans to identify high, inappropriate, and preventable Emergency Department utilizers

• Implement a community-wide strategy to address the Social Determinants of Health

• Utilize community-based social workers, nurses, and community health workers to facilitate clinical community linkages for Medicaid patients

• Utilizing health informatics tools to facilitate clinical and community service referrals between healthcare and non-healthcare entities

Jim Milanowski, President and CEOGENESEE HEALTH PLAN

2:15 - 3:00Strategies to Reduce the Financial Impact of Opioid Addiction on Medicaid

• Strategies to manage the ever-growing costs of drugs related to opioid addiction

• Medicaid Section 1115 Waivers to maximize treatment for members with opioid addiction

• Identify success of treatments through data analytics• Evaluate early intervention and educational practices

that can be used to reduce the opioid addiction crisis.• Identify how Medicaid MCO’s can impact SDoH for

opioid addicted members• Maximize engagement with incarcerated/recently

released Medicaid members

Cynthia Reilly, MS, BS Pharm, Senior Vice President ACADEMY OF MANAGED CARE PHARMACY

John Lovelace, President, President of Government Programs and Individual Advantage ProductsUPMC HEALTH PLAN

Cynthia Reilly, MS, BS Pharm, Senior Vice President ACADEMY OF MANAGED CARE PHARMACY

2:15 - 3:00Case Study- Maximizing Communication through Text Messaging and Community Health Worker In-Home Visits

• Analyze the impact of communication through text messaging

• Examine the data to show progression and improvement in member engagement

• Identify additional areas to improve levels of communication with members

Carla Zachodni, RN, MBA, CPHQ, Director Indiana Medicaid Quality Management

Anthem Indiana Medicaid



TRACK A FINANCIAL IMPACTS AND OUTCOMES

Chairperson: Clay Farris, Senior Healthcare Executive

MOSTLY MEDICAID

TRACK B MEMBER ENGAGEMENT AND COMPLIANCE

Chairperson: To Be Announced

3:15 - 4:15Moving Alternative Payment Methods (APM) and Value-Based Reimbursement (VBR) from Concept to Reality for Mental Health and Substance Use Treatment Providers

• Identify challenges in defining value in mental health and substance use treatment services

• Evaluate quality metrics on which to base a VBR• Define technology to support value-based methodology• Outline an alternative payment model that incorporates

value-based reimbursements

David Johnson MSW, ACSW, CEOFLETCHER GROUP

3:15 - 4:15Maximizing Community Engagement with Members Living in Areas with Limited Resources

• Identify unique strategies to incentivizing participation in community engagement activities for your members

• An overview of the Medicaid policies for designing community programs

• Evaluate current programs that are producing successful outcomes

Karin VanZant, Vice President/Executive Director, Life ServicesCARESOURCE

4:15 - 5:15Improving Outcomes and Reducing Costs for Medicaid Recipients through Evidence-Based Program IntegrationCase Study: Rhode Island - Re-calibrating managed care for value-based payment

• How a mature managed care program is transitioning to MCO-led accountable care organizations

• How a fresh infusion of DSHP funding for infrastructure is enticing provider engagement

• Lessons learned about designing for a balance between standardization and innovation, about the important role of change management, and about which fundamental issues need to be addressed early

Lauretta Converse, Director of Payment Reform and Financial Analytics RHODE ISLAND MEDICAID PROGRAM

4:15 - 5:15Strategies to Build a Compliant Organization and Medicaid Audit Preparedness

• How a mature managed care program is transitioning to MCO-led accountable care organizations

• How a fresh infusion of DSHP funding for infrastructure is enticing provider engagement

• Lessons learned about designing for a balance between standardization and innovation, about the important role of change management, and about which fundamental issues need to be addressed early

Lauretta Converse, Director of Payment Reform and Financial Analytics,RHODE ISLAND MEDICAID PROGRAM

5:00 Networking Cocktail Reception

DAY TWO: TUESDAY, APRIL 30TH, 2019


7:30 - 8:00 Networking Breakfast

8:00 Chairperson’s Recap of Day One


8:10 KEYNOTE: Using High-Tech to help Medicaid MCOs Achieve the Triple Aim

• Analyze the most innovative technologies serving the Medicaid space• Identify how to accelerate use of technology to help MCO’s• Evaluate new technologies on the horizon in the next 2 years

Binoy Bhansali, Vice President SANDBOX INDUSTRIES

Vikram D. Bakhru, MD/MBA, Chief Operating Officer CONSEJOSANO, INC.

9:00 Examining the Political Environment Impact on the Future of Medicaid Programs

• Explore the results of the mid-term elections• Examine opportunities for Medicaid expansion• Overcome real world obstacles and challenges for Medicaid programs

Hank Osowski, Managing PartnerSTRATEGIC HEALTH GROUP LLC


9:45 Maximizing MLTSS to Improve Inclusion, Quality and Efficiency for Your Members

• Increase quality and efficiency by promoting community inclusion• Manage care transitions to improve outcomes• Best practices to improve relationships and communication with community-based providers.

ModeratorJim McInnis, CFO & COO, CONSUMER DIRECTED SERVICES STRATEGY & BUSINESS EXECUTION

Panel MembersMerrill Friedman, Senior Director, Disability Policy EngagementANTHEM, INC.

Camille Dobson, Deputy Executive DirectorTHE NATIONAL ASSOCIATION OF STATES UNITED FOR AGING AND DISABILITIES (NASUAD)

Sharon R. Williams, CMCE, CEOWILLIAMS JAXON CONSULTING, LLCNCOA CONSULTANT


11:00 Case Study: Strategies to Improve Medicaid Encounter Data

• Key CMS requirements intended to improve data reliability • Variation in states’ practices for ensuring data reliability • Actions that could improve CMS’s understanding of state data reliability

Aaron Fulner, Senior Director, Product Marketing EDIFECS

Carolyn Yocom, Director, Health Care U.S. GOVERNMENT ACCOUNTABILITY OFFICE

12:00 - 1:00 Networking Luncheon


1:00 Improving Provider Network Adequacy

• Examine your current provider network directory standards• Adhere to the time and distance standards required by CMS• Identify areas of improvement and gaps within your network• Best practices in improving provider relations

Lisa Peters-Beumer, MPH, Aging and Disability Service Consultant, & Immediate Past ChairNATIONAL ADULT DAY SERVICES ASSOCIATION

1:45 Social Determinants of Health - Practical Uses to Improve Quality of Life for Your Members

• Utilize data to express which social needs of your members are most important• Examine your current SDoH menu and how to improve it to benefit your population• Identify success in leading states and health plans on improving quality of life and reducing costs of

hospitalization

ModeratorTed Jones, VP of Government EngagementMEDECISION

Panel MembersMerrill Friedman, Senior Director, Disability Policy EngagementANTHEM, INC.

Dan LaVallee, Director of Government ProgramsUPMC HEALTH PLAN

Jessica Grabowski, AM, LCSW, Executive DirectorCOORDINATED CARE ALLIANCE

2:45 An Overview of the CMS Re-Released Regulations for Managed Care

• Identifying how the CMS Changes will impact your current provider network including time and distance standards

• Evaluating how the regulation changes will affect current capitation rates • Preparing for change- Best practices to identify which areas are in need of change in advance • Discussion of the recent revisions to identify what CMS is striving for

3:30 Chairperson’s Closing Remarks


3:50 Conference Adjourns


VENUE DETAILSTHE STANDARD CLUB

320 South Plymouth CourtChicago, Illinois 60604

Refined, intimate and convenient, the Club’s 60 guest rooms and suites are within easy walking distance of Chicago’s major business, financial, legal and cultural destinations. Luxurious accommodations offer our members and sponsored guests the comforts of a small, private hotel with the vast array of amenities today’s business and leisure travelers expect.

We have a block of rooms reserved at a special rate of $190/night. This rate expires on March 29, 2019; although, we expect the block to sell out prior to this date. To receive a room at the negotiated rate book well before the expiration date. Mention the “4th Annual Medicaid Managed Care Leadership Summit ” when placing your room reservation by phone to receive the negotiated rate. We urge you to book your room early as we expect the block will sell out. Upon sell out of the block room rate and availability will be at the hotel’s discretion. Please call (312) 427-9100 to book your room.

Click Here to Register 1 1The Standard Club | Chicago, IL

CONFERENCE RATESEARLY BIRD

RATEEnds 3/8/19

STANDARD RATE

Ends 4/28/19

ONSITE RATE

Government/Community Service $ 695 $ 895 $ 1,095

Health Plan/Provider $ 1,295 $ 1,495 $ 1,695Service Provider/Consultant $ 2,095 $ 2,295 $ 2,495

GROUP DISCOUNTS ARE AVAILABLEPlease contact Haley Alberghini at 704.341.2656 or [email protected]

In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For information regarding refund, complaint and/or program cancellation

policies, please visit our website: www.risehealth.org/thefineprint.aspx

HOW TO REGISTER

CALL(704) 341-2392

REGISTER ONLINErisehealth.org/medicaidmanagedcare/

(Click to Register Online)

MAILWilmington FRA

3420 Toringdon Way, Suite 240

Charlotte, NC 28277


CONFERENCE ORGANIZER

RISE is the premier community for health care professionals who aspire to meet the extraordinary challenges posed by the emerging landscape of accountable care and government health care reform.

Recognized industry-wide as the number one source for information on risk adjustment and quality improvement within health care, RISE strives to serve the community on four fronts: networking, education, industry intelligence and career development.

Through cutting-edge conferences, online courses, in-house training, webinars as well as an association comprised of over 2,500 members, RISE provides professionals with industry insights and critical information they need to stay ahead of the curve.

RISE produces more than 30 conferences annually, focused on sophisticated topics and ample networking opportunities for thousands of executives from mid- to senior-level and C-suite. Our team of subject matter experts is often first to market with emerging topics and we pride ourselves on consistently delivering on topquality operations and logistics to produce a seamless event.

Established in 2006 as an extension of Health care Education Associates (HEA), RISE now operates as the sole health care arm offering the original capabilities of HEA as well as an expanded product line. Headquartered in Charlotte, North Carolina, RISE operates alongside its counterpart, Foundation Research Associates (FRA), which serves the finance, law enforcement, government, legal and compliance communities in a similar capacity.

LEARN MORE AT RISEHEALTH.ORG


SPONSORSHIP AND EXHIBIT OPPORTUNITIESEnhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event.

To learn more about sponsorship opportunities, please contact Michelle Elam at 704.341.2393 or [email protected]

GOLD SPONSORSLeavitt Partners

SILVER SPONSORSMedecision believes in a liberated healthcare system where people, plans and care teams engage in driving the best health outcomes in a seamless, interconnected way. The company helps its clients -- more than 85 leading US health plans and systems -- achieve this purpose by providing Aerial™, its integrated health platform with a suite of engagement and workflow applications, and professional services through its Aveus division. Learn more at medecision.com or follow them on LinkedIn.

PharmMD is a data-driven healthcare technology leader in medication adherence insights and health outcomes. Our solutions are tailored for Medicare Advantage, Managed Medicaid, commercial plans, as well as self-insured employers where we deliver to achieve value-based care initiatives of higher quality and lower cost of care. As always, we continue to put people first, one person at a time. For more information, please visit www.pharmmd.com.

BRONZE SPONSORS

OFFICIAL PUBLICATIONS AND MEDIA PARTNERS


Documents

Medicaid Managed Care Leadership Summit