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Informa
May 20
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Showing of Streams
Showing of Streams
9:00am - 10:00am 60 mins
Plenary Sessions
The Current Managed Care Landscape Nationwide
  • Alexander Shekhdar - Vice President, Federal and State Policy, Medicaid Health Plans of America (MHPA)
  • Ari Gottlieb - Principal, A2 Strategy Group
10:00am - 10:30am 30 mins
Plenary Sessions
Managed Care Case study
10:30am - 11:15am 45 mins
Plenary Sessions
Networking Break
11:15am - 12:00pm 45 mins
Info
Plenary Sessions
Payer and Provider Transformation: a Deep Dive into Innovative and Evidence-Based Frameworks incorporating the Patient Voice
  • Christine McSherry - Executive Director, Co-Founder, Jett Foundation
  • Jenn McNary - Advocacy and Outreach Director, Beauhawks

Invited: Michael Lee, CMO, HPHC

12:00pm - 12:45pm 45 mins
Plenary Sessions
The Transformation of Medicaid: a Perspective Through the Years
12:45pm - 1:30pm 45 mins
Plenary Sessions
Best Practices for Fraud, Waste & Abuse in Medicaid Managed Care
  • Richard Munson - Vice President, Investigations, UnitedHealthcare
  • Louis Saccoccio - CEO, National Health Care Anti-Fraud Association
  • Gary Cantrell - Deputy Inspector General, Office of Investigations, Department of Health and Human Services
  • Kelly Bennett - Office of Medicaid Program Integrity, Division of Health Quality Assurance, Agency for Health Care Administration
1:30pm - 2:30pm 60 mins
Plenary Sessions
Lunch
2:30pm - 3:15pm 45 mins
Specialty Populations and Programs
Managed care programs and Vendor Response/Considerations
  • Meryl Price - President, Health Policy Matters
2:30pm - 3:15pm 45 mins
Info
Innovation & Technology in Managed Care
Person-Centered Digital Family Engagement in Foster Care Services
  • Rini Gahir - Co-founder and CBDO, Mozzaz Corporation

Every year, over 20,000 youth age out of foster care, entering adulthood without the support most teens receive from family and friends. At one of the most critical junctures of their lives, the support systems these youth have come to rely on abruptly disappear, leaving them unprepared to adapt to the demands of daily life. Youth aging out of the foster care system are extremely vulnerable, often facing futures of homelessness, incarceration and poverty with enormous societal costs over their lifetimes. Youth Villages, based in Memphis TN, is a leader in the field of children’s mental and behavioral health with programs and services across the country. In this session, learn how Youth Villages (YV) and Mozzaz have collaborated to provide a digital engagement solution that provides enhanced support for young adults before and after discharge. Young adults have access to a smartphone app that offers supportive resources, regular check-ins, instant messaging and calling capabilities with their YV care team, as well as customized schedules and alerts. Through the platform, YV can gather post discharge data to track program outcomes and intervene when required. In the therapeutic Foster Care program, prospective foster care parents are using this innovative digital health tool to help obtain certification through training and tracking resources. Using the Mozzaz platform, active TFC parents have 24/7 access to content to support and maintain our youth in their homes, including digital tools that facilitate Collaborative Problem Solving. 1. Learn about the effectiveness of incorporating digital strategies for treatment programs, outreach and follow-up services as a way to "extend" care. 2. Learn how organization change was managed from top-down to implement a new digital model into core service lines. 3. Learn through a demonstration of the solution best practices and engagement techniques used in the design and development of the solution.

3:15pm - 4:00pm 45 mins
Specialty Populations and Programs
Reaching Complex Populations for Improved Outcomes and Population Health
3:15pm - 4:00pm 45 mins
Info
Innovation & Technology in Managed Care
Partnership’s Between Managed Care and Technical Assistance Centers: A Model for Successful Behavioral Health Implementations
  • Andrew Cleek, Psy.D - Chief Program Officer, NYU McSilver Institute for Poverty Policy and Research
  • Boris Vilgorin, MPA - Health Care Strategy Officer, McSilver Institute for Poverty Policy and Research - New York University Silver School of Social Work

This presentation will describe a model of partnership between Medicaid Managed Care Plans and technical assistance centers to improve the implementation of behavioral health payment changes. New York State will be used as a model.

4:00pm - 4:45pm 45 mins
Info
Specialty Populations and Programs
An Integrated Health Care Delivery System: A Texas Children’s Health Plan Experience with Complex Children
  • Diane Scardino - Vice President, Texas Children's Health Plan

STAR Kids is a Medicaid-managed care plan for children and young adults with disabilities that was created in 2014. These children are more likely to use multiple healthcare services, encounter barriers to healthcare, larger out-of-pocket costs, and poor health outcomes with frequent hospital admissions. The Medically Dependent Children Program (MDCP) is a home and community based services program for a subset of STAR Kids determined to be the most fragile and vulnerable. With their extensive healthcare costs, children with disabilities account for one-third of the overall healthcare expenditures in the US. The purpose of this abstract is to describe our success with this complex population using an Integrated Delivery System to provide care in the most clinically appropriate, cost-effective setting. Methods The Texas Children Health Plan (TCHP), a Medicaid managed care organization in Houston, Texas, started serving members of STAR Kids in 2016. The health plan serves 16% and 20% of the STAR Kids and MDCP population in Texas, respectively. TCHP partnered with children’s hospitals, network providers, and regional community services in Texas, to ensure minimal disruption of treatment. Many of these members receive the majority of the care at TCHP’s affiliated institution, further enhancing integration. In addition, home and telephonic visits with Service Coordinators to assess needs, develop individual care plans, manage inpatient to home transitions, and connect member to services/providers were regularly scheduled. Furthermore, proactive care management by annual member reassessments and daily coordination calls for timely information and seamless handoffs was employed. A specialized team that is fully dedicated for MDCP members was also established. Retained members between 2016 and 2018 were included in this analysis. Results The TCHP serves 26,036 STAR Kids and 1,042 MDCP members. To provide adequate personal care services and private duty nursing, the TCHP invested 13% and 117% above reported historic expenses for those services, for STAR Kids and MDCP respectively. By 2018, an overall cost of care savings of 3.4% were demonstrated for STAR Kids members accompanied by 6% decrease in hospital admissions. While cost savings are yet to be seen in MDCP, better health outcomes evident by 15% drop in hospital admissions were achieved. Finally, 61% STAR Kids and 80% MDCP member retention rates since the inception of the program in 2016 were reported. Conclusion STAR Kids, and MDCP in particular, pose a significant challenge to the healthcare system due to their complex medical needs and large expenses. In only two years, our comprehensive collaborative approach demonstrated decreased hospital admissions, improved health outcomes and quality of care, and eventual decrease in cost of care. It is our belief that even the most vulnerable population can be managed with an Integrated Delivery System that is able to address patient specific needs holistically at an individual level rather than a population level. Financial Disclosure: None of the authors has a financial interest in any of the products mentioned in this article.

4:00pm - 4:45pm 45 mins
Innovation & Technology in Managed Care
Presentation Title TBD
  • Gil Addo - CEO & Co-founder, RubiconMD