HMA Conference on Trends in Publicly Sponsored Healthcare

Innovations in Care Delivery and Value-Based Payments for Publicly Sponsored Healthcare

Federal and state regulators continue to support efforts to improve healthcare quality and lower costs through the implementation of value-based payments and new care delivery models for publicly sponsored healthcare programs. During this keynote address, a leading healthcare expert will provide an overview of existing value-based payment initiatives, address government efforts to support new care delivery models, and offer a vision for the future of Medicare and Medicaid innovation.

Speakers

Speaker to be announced.

Moderator

Jay Rosen, President, HMA, Lansing, MI

What’s Next: State Medicaid Issues and Priorities Now and in the Future

Despite the potential for significant policy shifts at the federal and state level, Medicaid programs are pushing ahead with several key priorities in the next decade. These include efforts to address financial sustainability, access to care, social determinants of health, substance use disorder, long-term services and supports, value-based care, eligibility verification systems, prescription drug costs, and dually eligible Medicare-Medicaid members. During this keynote Q&A session, state Medicaid directors will discuss key short-term and long-term priorities for state Medicaid programs, including a look at innovate initiatives designed to improve Medicaid outcomes, efficiency, and cost.

Speakers

Melisa Byrd, Senior Deputy Director/Medicaid Director, Department of Health Care Finance, District of Columbia

Beth Kidder, Deputy Secretary, Division of Medicaid, Florida Agency for Health Care Administration

Carter Kimble, Deputy Secretary of Health and Human Services, State of Oklahoma

Kate Massey, Senior Deputy Director, Medical Services Administration, Michigan Department of Health and Human Services

Stephanie Muth, Former Deputy Executive Commissioner, Medicaid & CHIP, Texas Health & Human Services

Moderator

Kathy Gifford, Principal, HMA, Indianapolis, IN

The Future of Publicly Sponsored Healthcare

Publicly sponsored healthcare programs continue to play a growing role in improving the health and wellness of Americans. That’s true despite legal and regulatory challenges, policy proposals, and political battles that could dramatically alter the nation’s healthcare policy agenda and impact the future of core programs like Medicaid and Medicare. During this session, leading healthcare executives, public policy experts, and government officials will discuss what’s next for publicly sponsored healthcare, including a look at the latest innovations, potential disruptions, the impact of COVID-19, and whether government programs represent the future of healthcare in America.

Speakers

Speakers to be announced.

Moderator

Carl Mercurio, Principal and Publisher, HMA Information Services, New York, NY

11:30 – 12:30

Key Strategies, Priorities, and Concerns for Medicaid Managed Care Plans

Managed care plans face a variety of challenges as they strive to help states improve the quality and efficiency of Medicaid programs.  Along with frequent demands for improvements in access, quality, and cost, health plans are also being asked to address social determinants of health, participate in value-based payment arrangements, navigate tightening eligibility criteria, and serve patient populations with increasingly complex healthcare needs – all while facing state budget shortfalls and an uncertain political future. More broadly, Medicaid plans are pursuing opportunities that include Medicare-Medicaid dual eligibles, individual Exchange members, foster children, substance abuse treatment, prison populations, and individuals with developmental disabilities, among others. During this keynote Q&A session, leading managed care executives will discuss the strategies, priorities, and concerns they have as they strive to meet the needs of vulnerable member populations and to serve a broadening constituency.

Speakers

Heidi Chan, Market President, AmeriHealth Caritas North Carolina

Alec Cunningham, EVP, Government Services, Aetna, a CVS Health Company

Jesse Hunter, EVP, Mergers & Acquisitions, Chief Strategy Officer, Centene Corp.

Keith Payet, CEO, UnitedHealthcare Community Plan of Tennessee

Moderator

Donna Checkett, Vice President, HMA, Chicago, IL

The Role of Housing Supports in Addressing Social Determinants of Health

Housing supports have emerged as a key strategy in addressing social determinants of health, with health plans, provider organizations, state governments, and federal regulators partnering on a wide variety of promising early initiatives. During this breakout session, speakers will outline some of the early lessons learned, including successful approaches to financing, risk-sharing, and measuring return-on-investment. Speakers will also provide insights on how supportive and recovery housing might be scaled up to serve the needs of a far broader population of homeless and housing insecure Medicaid beneficiaries.

Speakers

Elizabeth (Libby) Boyce, Director of Access, Referral, and Engagement, Housing for Health

Andy McMahon, Vice President, Health and Human Services Policy, UnitedHealthcare Community & State

Other speakers to be announced.

Moderator

John O’Connor, Managing Director, HMA Community Strategies, Los Angeles, CA

Extending Medicaid Coverage for Women’s Health: Impacts on Access, Outcomes, and Cost

Several states are seeking to extend Medicaid coverage to address women’s health issues, including increased access to family planning services, reproductive health, group prenatal care, doula services, and postpartum care. Initiatives include waivers to extend postpartum coverage beyond 60 days after delivery; programs aimed at improving birth outcomes and reducing infant mortality; and waivers addressing a broad array of women’s health services, including family planning, breast and cervical cancer screening, postpartum depression, diabetes, and other health conditions. During this breakout session, representatives of state Medicaid programs, health plans, and providers will outline some of these emerging initiatives, with a special emphasis on how they are expected to improve access to care, outcomes, and cost.

Speakers

Angie Truesdale, CEO, Centering Healthcare Institute

Lisa Hollier, MD, Chief Medical Officer, Texas Children’s Health Plan

Other speakers to be announced.

Moderator

Margaret Kirkegaard, MD, Principal, HMA, Chicago, IL

Assessing Progress in the Treatment of Addiction, Opioid Use Disorder

State regulators, federal officials, health plans, and providers continue to push forward with efforts to ensure access to effective treatment for addiction and opioid use disorder. During this breakout session, speakers will provide an overview of the current state of addiction in the United States and assess the strengths and weaknesses of ongoing efforts to address the problem. Speakers will also provide case studies and best practices for offering addiction treatment across varying locations of care, including hospitals, community-based organizations, prisons, and jails.

Speakers

Speakers to be announced.

Moderator

Corey Waller, MD, Principal, HMA, Lansing, MI

Investing in Innovative Healthcare Companies

Investment firms are deploying billions of dollars in capital in search of innovative organizations serving Medicaid, Medicare, and other publicly sponsored healthcare markets. During this breakout session, speakers from private equity backed companies in healthcare technology, care delivery, population health, member engagement, and other areas will assess emerging market opportunities, prospects for sustainable growth, and key differentiators of success at the cutting edge of healthcare innovation.

Speakers

Vytas Kiselius, CEO, Referwell

William McKinney, CEO, The MENTOR Network

Other speakers to be announced.

Moderator

Greg Nersessian, Managing Director, HMA Investment Services, New York

How the Healthy Adult Opportunity Waiver Will Impact Medicaid Expansion

The Trump Administration’s Healthy Adult Opportunity (HAO) waiver provides states with the flexibility to pursue block grant funding for Medicaid expansion populations, including expansion initiatives limited to certain geographical areas or individuals with specific medical conditions. The implications of the HAO waiver are far reaching and likely to face legal challenges. But HAOs may also provide conservative states the political cover needed to implement Medicaid expansion in one form or another.  During this breakout session, leading Medicaid policy makers, state government officials, and healthcare executives will outline the key provisions and likely impact of HAOs, including an understanding of funding mechanisms, shared saving components, eligibility and benefit levels, patient protections, and the likelihood of adoption among remaining non-expansion states.

Speakers

Carter Kimble, Deputy Secretary of Health and Human Services, State of Oklahoma

Greg Moody, Executive in Residence, John Glenn College of Public Affairs, The Ohio State University

Other speakers to be announced.

Moderator

Matt Powers, Managing Director, HMA Medicaid Market Solutions, Chicago, IL

Measuring ‘Value’ in the Delivery of Long-Term Services and Supports to Individuals with Intellectual or Developmental Disabilities

Among the challenges in meeting value-based payment incentives in healthcare is determining what exactly constitutes “value” and how to measure it. That’s especially true when evaluating the delivery of long-term services and supports to individuals with intellectual or developmental disabilities, where care is as much about assistance with daily living as it is about getting healthy. During this breakout session, members of an unofficial work group of health plans, providers, advocates, academics, and accreditation organizations will deliver some of the findings and recommendations of their recent efforts to develop a framework for identifying, measuring, and delivering value to IDD populations.

Speakers

Linda Timmons, President and CEO, Mosaic

Mary Kay Rizzolo, President and CEO, Council on Quality and Leadership

Kathy Carmody, CEO, Institute on Public Policy for People with Disabilities

Other speakers to be announced.

Moderator

Josh Rubin, Principal, HMA, New York, NY

Covering Innovator Drugs: Payment Models, Partnerships to Ensure Access for Medicaid Members

State Medicaid programs are struggling to balance member access to innovator drugs with the financial constraints facing Medicaid programs. During this breakout session, representatives of state Medicaid programs, health plans, drug manufacturers, and pharmacy benefit managers will outline some of the ways they are partnering to make innovator drugs available, including the use of value-based payment models that tie reimbursements to outcomes.

Speakers

Alan Eisenberg, VP, Global Government Relations and Public Policy, Alnylam

Harold Carter, VP, Pharma Strategy & Contracting, Express Scripts

Other speakers to be announced.

Moderator

Anne Winter, Managing Principal, HMA, Phoenix, AZ

Investing in Innovative Healthcare Companies (continued)

Investment firms are deploying billions of dollars in capital in search of innovative organizations serving Medicaid, Medicare, and other publicly sponsored healthcare markets. During this breakout session, speakers from private equity backed companies in healthcare technology, care delivery, population health, member engagement, and other areas will assess emerging market opportunities, prospects for sustainable growth, and key differentiators of success at the cutting edge of healthcare innovation.

Speakers

Speakers to be announced.

Moderator

Greg Nersessian, Managing Director, HMA Investment Services, New York

Politics and Policy: Medicaid, Medicare, and Publicly Sponsored Healthcare in the Next Decade

Much of the short-term direction of healthcare policy in the United States will depend on the results of the November 2020 election and litigation surrounding the constitutionality of the Affordable Care Act. Long term, however, a heated debate will continue over how to best ensure every American has access to affordable health-care coverage and whether a continued shift to Medicaid, Medicare, and other forms of publicly sponsored healthcare is likely. During this keynote address, a leading healthcare policy expert will discuss various election scenarios at the national, state, and local level, including a look at the likely impact on healthcare policy, financing, and politics over the short and long term.

Speaker

Drew Altman, President, CEO, Henry J. Kaiser Family Foundation

Moderator

Vern Smith, Senior Fellow, HMA, Lansing, MI

Some of the biggest innovations in publicly sponsored healthcare may end up coming from some of the most unlikely sources, including retailers and other direct-to-consumer companies offering clinical services and technologies designed to ensure patients convenient and low-cost access to care. During this panel discussion, leading retailers and direct-to-consumer organizations will discuss some of these potentially disruptive products and services, including initiatives in the areas of long-term services and supports, home care, community-based clinics, and transportation.

Speakers

David Fields, President, Dean Health Plan

Liz Baker-Ray, Director, Health and Wellness, Walmart

Other speakers to be announced.

Moderator

Jean Glossa, MD, Managing Principal for Clinical Services, HMA, Washington, DC

10:30 – 11:30 am

Telehealth emerged as a key strategy for expanding access to care in response to COVID-19, and it’s use is likely to continue to grow even after the pandemic subsides.  During this session, government regulators, payers, and providers will discuss what’s next for telehealth, including some of the important lessons learned during the COVID-19 pandemic.  Speakers will also outline the key elements of implementing and sustaining a telehealth strategy, including the role of technology, clinical implications, billing considerations, and how regulatory changes can play a key role in fostering broader utilization of remote care delivery.

Speakers

Nora Belcher, Executive Director, Texas eHealth Alliance

Other speakers to be announced.

Moderator

David Bergman, Principal, HMA, New York, NY

A variety of new and extended dual eligible demonstration opportunities afford states, health plans, and providers the flexibility to test innovative models for improving the care of Medicare-Medicaid beneficiaries. During this session, state officials and healthcare industry executives will assess the impact of emerging opportunities, including an early take on whether these new and extended models are positively impacting outcomes. States, health plans, and advocates will also discuss new Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) integration requirements, how Medicaid managed long-term services and supports programs tie into dual integration, and whether additional flexibilities are needed to address the more challenging issues that arise when attempting to integrate care for Medicare-Medicaid beneficiaries.

Speakers

Christine Aguiar Lynch, VP for Medicare and MLTSS Policy, Association for Community Affiliated Health Plans

Other speakers to be announced.

Moderator

Sarah Barth, Principal, HMA, New York, NY