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AHIP 2023 Medicare, Medicaid, Duals & Commercial Markets Forum

Dates:
Mar 14 - 16, 2023
Location:
Washington, DC

AHIP 2023 Medicare, Medicaid, Duals & Commercial Markets Forum focuses on the most pressing policy priorities, emerging issues and regulatory updates for Medicare, Medicaid, Duals, and the commercial market.

Agenda Filters

Sessions

7:00 am - 6:30 pm Mar 14 • 2023

7:00 am – 5:30 pm
, Registration Desk Open

Terrace Foyer
Registration and Information Desk Open

7:30 am – 6:30 pm
, Exhibit Hall Open

Columbia

7:30 am – 8:45 am
, Continental Breakfast

Columbia
Continental Breakfast in the Exhibit Hall with Solutions Providers

8:45 am – 10:10 am
, Welcome and Opening Sessions

10:10 am – 10:30 am
, Break

Columbia
Coffee Break in the Exhibit Hall with Solutions Providers

10:30 am – 11:00 am
, General Session

11:10 am – 11:55 am
, Concurrent Sessions

  • SERIES 1: CONCURRENT SESSIONS

    • Policy Directions in Long-Term Services and Supports

      Location
      Georgetown
      Speakers
      Details

      This session will explore trends in Medicaid Long Term Services and Supports (LTSS), including hot topics in Home and Community-Based Services and managed LTSS.  

    • Improving Data Standards to Advance Health Equity

      Location
      International Ballroom East
      Speakers
      Details

      This session will highlight health insurance provider, government, and other health care stakeholder efforts to improve sociodemographic data standards, collection, and interoperable exchange. Speakers will discuss challenges, present lessons learned, and consider what needs to be in place from a policy and infrastructural perspective to maximize data collection efforts for health equity.

    • Health & Policy: Creating Actionable Engagement in the Regulatory Environment

      Presented by The Vitality Group
      Location
      Lincoln-Monroe
      Speakers
      Details

      Employers and health plans using integrated platforms to improve health and wellness must operate under evolving regulations. Whether outdated privacy rules, wellness program incentive caps, or restrictions on gamification or communications, engaging consumers requires navigating challenging regulatory environments. Learn how to successfully navigate regulations to ensure privacy protections while creating programs that offer meaningful and equitable engagement with proven outcomes.

    • Address Social and Behavioral Determinants to Improve Outcomes & Retention

      Presented by Wider Circle
      Location
      Jefferson
      Speakers
      Details

      Social and behavioral determinants of health (SBDOH) contribute to significant variation in health care access and outcomes. The complexities of the health care ecosystem may not always support solutions to address these underlying determinants. Learn approaches to incorporate SBDOH into a holistic, scalable system that can improve access for hard-to-reach and underserved members. This session will share how interventions can reduce isolation, improve retention and address health equity.

11:55 am – 1:05 pm
, Lunch & Learns

  • Lunch will begin at 11:55 am. Speaking Sessions will begin promptly at 12:20 pm.

    • Sustainability and Scalability: Turning Tech Innovation on its Head

      Presented by Accenture – An AHIP Select Sponsor
      Location
      International Ballroom East
      Speakers
      Details

      Challenges of ambitious design and establishing appropriate data infrastructure have impeded progress towards launching and scaling health programs that focus on social needs. Learn what it takes to successfully build capacity and connect communities with key resources to address social drivers of health. Gain insights from early lessons from state Medicaid programs and their managed care partners on how leveraging tools from care management playbooks can help ensure success.

    • The Big Shift: Prepare for the End of the PHE with Virtual Primary Care

      Presented by Teladoc Health – An AHIP Select Member
      Location
      Lincoln-Monroe
      Speakers
      Details

      The end of the Public Health Emergency will lead to an historic membership shift due to Medicaid redeterminations and accelerated growth of the MA and Marketplace lines of business. Gleaning insights from over 50M telehealth visits, learn how value-based virtual primary care can make a real world impact and how virtual care can provide high-quality, preventive services to reduce avoidable costs. Explore key trends and strategies to innovate with value-based virtual primary care.

    • Improving Star Ratings Through Better Cardiometabolic Management

      Presented by Vida Health
      Location
      Georgetown
      Speakers
      Details

      With increasing membership and economic pressure, Medicare Advantage plan leaders need to identify strategies to boost Star Ratings and attract new members. This session will explore how the combination of human-led care, prescribing, and technology can deliver scalable outcomes Medicare Advantage plans can expect. Join us to learn how measurable improvements in cardiometabolic management can improve Star Ratings and member engagement.

    • Managing Chronic Disease Risk Effectively: Strategies and Lessons Learned

      Presented by Diathrive Health
      Location
      Jefferson
      Speakers
      Details

      Successfully managing chronic disease risk requires effective member engagement. Hear lessons learned from a health insurance provider on how to best engage patients with chronic diseases to improve outcomes and patient satisfaction and, in turn, reduce overall health care spending. Additionally, speakers will highlight opportunities to bring these chronic disease risk solutions to small and mid-markets.

1:15 pm – 1:45 pm
, General Session

  • , International Ballroom West-Center

    Future of Life Science Innovation and the Impact of the Inflation Reduction Act

    ,

    Executives will share their perspectives on the outlook for life science innovations and how the Inflation Reduction Act will bring significant changes for drug pricing and payment.

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1:45 pm – 2:30 pm
, General Session

2:30 pm – 3:30 pm
, Break

Columbia
Coffee Break in the Exhibit Hall with Solutions Providers

3:30 pm – 5:15 pm
, Concurrent Sessions

  • 3:30 pm – 4:15 pm

    SERIES 2: CONCURRENT SESSIONS

    • No Surprises Act – Implementation and Implications Two Years In

      Location
      Jefferson
      Speakers
      Details

      The No Surprises Act has already prevented over 12 million claims from reaching consumers in the form of surprise medical bills. Implementation of this sweeping new law with its complex dispute resolution has proven to be challenging. Advocates and academic leaders will discuss lessons learned in the past 2 years and what unions, employers, health insurance providers, and consumers can expect in the coming years as policymakers address the underlying issues that gave rise to surprise billing.

    • Updates on CMMI Medicare Advantage and Part D Models

      Location
      International Ballroom East
      Speaker
      Details

      This session will highlight updates on the CMS Innovation Center’s latest initiatives for improving quality of care and reducing health care costs for Medicare beneficiaries through Medicare Advantage and Part D models.

    • Leverage Rapid Whole Genome Sequencing to Improve Treatment Decisions & Outcomes

      Presented by Illumina
      Location
      Georgetown
      Speakers
      Details

      Health insurance providers and health systems are increasingly collaborating to leverage genomics and precision medicine to enhance patient experience, improve outcomes, and reduce costs. The advent of rapid whole genome sequencing (rWGS) allows timely identification of genetic disorders and alters interventions in 40% of patients. Learn about benefit coverage decisions for genetic testing for critically-ill infants and how leveraging rWGS can improve treatment decisions and reduce total cost.

    • MA Plans: Prepare for the CMS Health Equity Index with Research Insights

      Presented by Inovalon – An AHIP Select Sponsor
      Location
      Lincoln-Monroe
      Speakers
      Details

      Health equity is the first pillar of the 2022 CMS Strategic Plan. As such, the development of a Health Equity Index (HEI) is a key initiative to enhance Medicare Advantage (MA) Star Ratings. This session will explore how the HEI will be calculated and provide insights on how MA plans may perform. Gain insights to improve outcomes for enrollees with social risk factors by exploring data-driven solutions to reduce disparities.

  • 4:30 pm – 5:15 pm

    SERIES 3: CONCURRENT SESSIONS

    • State Approaches and Employer Efforts to Address Prescription Drug Affordability

      Location
      Jefferson
      Speakers
      Details

      This session will address what is keeping employers up at night regarding drug affordability and the public policies that these organizations/employers are seeing in the states that are either concerning and/or policies that can be supported. 

    • Mental Health Parity at a Crossroads: What the Future Holds

      Location
      International Ballroom East
      Speakers
      Details

      In this session, payers, regulators, and providers will discuss recent changes to the Mental Health Parity and Addiction Equity Act (MHPAEA) and where they see parity moving next.

    • Combating Hunger and Diet-Related Disease: Considerations for Health Plans

      Presented by Mom's Meals 2022 logo
      Location
      Lincoln-Monroe
      Speakers
      Details

      The federal government and other stakeholders are making strides to address hunger and engage the health care ecosystem to reduce the burden of food insecurity and diet-related disease. Learn about best practices for nutrition security programs and opportunities for health insurance providers to help support programs to combat hunger. This session explores approaches to apply research on clinical and cost impacts of medically-tailored meals programs to reduce the burden of diet-related diseases.

    • Leveraging Analytics to Optimize P4P Contracts and Improve Primary Care Access

      Presented by Gray Matter Analytics
      Location
      Georgetown
      Speakers
      Details

      Advanced data analytics can provide insights to improve primary care access and P4P partnerships. A leading health insurance provider shares lessons learned following the consolidation of three MCOs with 7,000+ providers. This session will explore how to employ analytics to integrate diverse data sets and leverage a framework to prioritize interventions for P4P contracts. Learn how to identify risk, reduce preventable admissions and utilize measures to increase access to primary care.

5:15 pm – 6:30 pm
, Reception

Columbia
Opening Night Reception in the Exhibit Hall with Solutions Providers

7:30 am - 7:00 pm Mar 15 • 2023

7:30 am – 5:00 pm
, Registration Desk Open

Terrace Foyer
Registration and Information Desk Open

7:30 am – 9:00 am
, Continental Breakfast

Concourse Foyer

8:00 am – 8:30 am
, AHIP Member Briefing*

  • , Lincoln-Monroe

    CPI Policy Priorities for 2023*

    ,

    In this session, CPI’s Deputy Administrator and Director of the Center for Program Integrity will discuss the agency’s priorities for protecting the Medicare and Medicaid programs from fraud, waste and abuse. 

    *This session is for AHIP member health insurance providers only and is closed to Press, non-members, and other registration categories. This session will not be available on-demand following the conference.
    • Learn more about Dara Corrigan
      Dara Corrigan
      ,
      Deputy Administrator and Director, Center for Program Integrity
      , Centers for Medicare and Medicaid Services (CMS)
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8:45 am – 10:00 am
, General Session

  • 8:45 am – 9:15 am, International Ballroom West-Center

    Improving Mental Health Care for All Americans

    ,

    Join us for a dialogue with the leader of SAMHSA to discuss their priorities for addressing the behavioral health care needs of individuals, communities, and service providers. The priorities include preventing overdose, preventing suicide, promoting resilience and emotional health for children and families, integrating behavioral and physical health, and strengthening the behavioral health workforce.

    • Learn more about Miriam E. Delphin-Rittmon, PhD
      Miriam E. Delphin-Rittmon, PhD
      ,
      Assistant Secretary for Mental Health and Substance Use
      , U.S. Department of Health and Human Services (HHS) and the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA)
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  • 9:15 am – 10:00 am, International Ballroom West-Center

    Transparency and Interoperability Requirements

    ,

    Policymakers from CMS and ONC share recent regulatory updates on transparency, information sharing, and interoperability. Learn about new requirements for data sharing, updates on the Trusted Exchange Framework and Common Agreement (TEFCA), and efforts to build the necessary infrastructure to support interoperability, including the USCDI+ and the National Directory for Healthcare.

    • Learn more about Alexandra Mugge, MPH
      Alexandra Mugge, MPH
      ,
      Director and Deputy Chief Health Informatics Officer, Health Informatics and Interoperability Group (HIIG)
      , Centers for Medicare & Medicaid Services (CMS)
    • Learn more about Micky Tripathi, PhD, MPP
      Micky Tripathi, PhD, MPP
      ,
      National Coordinator for Health Information Technology, Office of the National Coordinator for Health IT (ONC)
      , U.S. Department of Health and Human Services (HHS)
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10:00 am – 7:00 pm
, Exhibit Hall Open

Columbia

10:00 am – 11:00 am
, Break

Columbia
Coffee Break in the Exhibit Hall with Solutions Providers

11:00 am – 11:45 am
, Concurrent Sessions

  • SERIES 4: CONCURRENT SESSIONS

    • High Performance Networks in the Individual Market: Improving Quality + Cost

      Location
      Jefferson
      Speakers
      Details

      Health insurance issuers curate provider networks to deliver high-quality, low-cost care that meets the diverse needs of individual market enrollees. In 2023, HHS adopted new federal network adequacy time and distance standards for issuers offering plans on the Federal Exchange, and more changes may be on the way. This panel will discuss the challenges issuers have faced while implementing those requirements and suggest flexible solutions that balance patient access, quality, and costs.

    • Current Legal Issues in Medicare Advantage and Part D

      Location
      Lincoln-Monroe
      Speakers
      Details

      Legal experts will review the current landscape of legal issues affecting the policy and regulatory agenda for Medicare Advantage and Part D plans.   

    • Achieve the Triple Aim for Medicare Members by Activating Family Caregivers

      Presented by Ceresti Health
      Location
      Georgetown
      Speakers
      Details

      Frail elderly members are an underserved and difficult-to-engage population that incurs more than 50% of total medical costs. Increasingly, family caregivers are being enlisted as they are uniquely able to detect and address changes in a member’s condition. Join this session to learn how a digital caregiver program activates family caregivers by utilizing a framework that aims to improve cost, quality and member experience.

    • Advancing Health Equity through End-to-End Solutions

      Presented by Optum – An AHIP Select Sponsor
      Location
      International Ballroom East
      Speakers
      Details

      Medicaid MCOs are experiencing increased pressure given elevated contractual requirements from states and shifting market dynamics. Increased requirements to support health equity and collect data on social determinants of health have made it more imperative than ever to manage the total cost of care. Join this session to learn how to develop end-to-end solutions to meet states’ contractual and accreditation expectations and create a measurable and positive impact on health equity and SDOH.

11:45 am – 1:45 pm
, Networking Lunch

Columbia
Lunch & Dessert in the Exhibit Hall with Solutions Providers

2:00 pm – 3:45 pm
, Concurrent Sessions

  • 2:00 pm – 2:45 pm

    SERIES 5: CONCURRENT SESSIONS

    • Best Practices in Medicare Advantage: Leveraging Provider Networks to Improve Care and Equity

      Location
      Jefferson
      Speakers
      Details

      As Medicare Advantage continues to grow, partnerships with provider networks are essential to improve health outcomes and ensure equity. Learn about progressive strategies to design an ecosystem that aligns regional/local providers and community-based organizations to advance health equity and improve care delivery to vulnerable communities.

    • Maternal Health and Postpartum Coverage

      Location
      International Ballroom East
      Speakers
      Details

      Speakers will discuss the changing nature of perinatal and maternal health care, highlighting national trends in access and outcomes, post-partum Medicaid coverage, and innovative care delivery, including the use of digital tools and telehealth. Panelists will explore important policy options to improve maternal and infant health and strategies to address disparities.

    • Generational Trends and Perceptions across Medicaid & Medicare Populations

      Presented by Zipari
      Location
      Lincoln-Monroe
      Speaker
      Details

      Generational differences are becoming increasingly salient as digital tools dominate the consumer experience space. Join this session to hear insights from a recent survey of Medicaid members on their digital consumer experiences with their health plans compared with members of Medicare and commercial health plans. Learn how health insurance providers can employ market-specific insights into digital trends to directly impact key organizational outcomes.

    • Scaling Enrollee Outreach and Communications: Lessons from Other Industries

      Presented by CAQH
      Location
      Georgetown
      Speakers
      Details

      The end of the Public Health Emergency will put enormous burden on Medicaid programs and health care organizations to find, communicate, and coordinate with enrollees at scale for eligibility renewals and program changes. Join this discussion to hear perspectives and learnings about how consumer banking and other industries have developed approaches to scale massive consumer outreach efforts using target segmentation, automation, data and insights.
  • 3:00 pm – 3:45 pm

    SERIES 6: CONCURRENT SESSIONS

    • Emerging State Medicaid Trends

      Location
      International Ballroom East
      Speakers
      Details

      In this session, experts will discuss trends in Medicaid programs and priorities of state Medicaid directors and how plans are partnering with states to achieve states’ goals. 

    • Medicare Advantage Rate Notice and Regulatory Environment for 2024

      Location
      Jefferson
      Speakers
      Details

      In this session, experts will discuss key elements of the 2024 Advance Notice and Regulations for MA and Part D and share insights on the impact and implications for plans. 

    • Impacting Medical Loss Ratio: Innovative Approaches to Collaborate with PCPs

      Presented by Optum – An AHIP Select Sponsor
      Location
      Lincoln-Monroe
      Speakers
      Details

      Despite advancements in value-based care efforts, Medicare Advantage plans may face challenges in achieving their Medical Loss Ratio (MLR) goals. Join this session to discuss an innovative approach to addressing fragmentation across quality, risk and affordability initiatives. Learn how Medicare Advantage plans can foster payer/provider collaboration and partner with independent PCPs to positively impact their MLR.

    • Pain Is Personal — How Digital Care Addresses Health Inequities

      Presented by Hinge Health
      Location
      Georgetown
      Speakers
      Details

      Everyone experiences pain in unique ways. Effective pain care must recognize the whole person and adapt to individual differences, including social determinants of health that are linked to worse health outcomes across the board. How are digital care solutions addressing musculoskeletal (MSK) pain, depression, anxiety, and women’s health issues? How can employers close the health equity gap? Learn how personalized health care solutions can help people move beyond pain.

4:00 pm – 6:00 pm
, General Session

  • 4:00 pm – 4:30 pm, International Ballroom West-Center

    The Value of Medicare Advantage

    ,

    Speakers will discuss the value of public-private partnerships for the Medicare Advantage program and the growth and popularity of this vital program that serves millions of older adults and people with disabilities.

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  • 4:30 pm – 5:15 pm, International Ballroom West-Center

    Overcoming Barriers to Address Health Equity

    ,

    A panel of health care and health insurance provider leaders will explore strategies and solutions to build a culture of equity within organizations and to promote a more inclusive and equitable health care system. They will discuss policy levers that facilitate health insurance providers’ and other stakeholders’ ability to focus on health equity and how an ecosystem approach to equity can overcome challenges.

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  • 5:15 pm – 6:00 pm, International Ballroom West-Center

    CMS 2023 Priorities for Medicaid and Marketplace in a Post-Pandemic Future

    ,

    The coming year will present government health programs with challenges ranging from verifying continuing eligibility to improving health equity, promoting competition and increasing access to behavioral health services. In this general session, the directors of CCIIO and CMCS will discuss their respective agencies’ plans for tackling the major issues affecting the individual health insurance marketplaces and the Medicaid program in 2023.
    • Learn more about Ellen Montz, PhD
      Ellen Montz, PhD
      ,
      Deputy Administrator and Director, Center for Consumer Information and Insurance Oversight (CCIIO)
      , Centers for Medicare & Medicaid Services (CMS)
    • Learn more about Daniel Tsai
      Daniel Tsai
      ,
      Deputy Administrator and Director, Center for Medicaid and CHIP Services (CMCS)
      , Centers for Medicare & Medicaid Services (CMS)
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6:00 pm – 7:00 pm
, Reception

Columbia
Reception in the Exhibit Hall with Solutions Providers

8:00 am - 5:15 pm Mar 16 • 2023

8:00 am – 12:00 pm
, Registration Desk Open

Terrace Foyer
Registration and Information Desk Open

8:00 am – 9:30 am
, Continental Breakfast

Concourse Foyer

8:30 am – 10:35 am
, General Session

  • 8:30 am – 9:00 am, International Ballroom West-Center

    FDA’s Accelerated Approval Pathway for New Drug Therapies: What the Future Holds

    ,

    This session will address the challenges and promises of the accelerated approval program for drugs and biologicals.
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  • 9:00 am – 9:45 am, International Ballroom West-Center

    Driving Innovation: Updates from CMMI and Private Sector

    ,

    This session will explore how the public and private sectors are working to transform health care and move toward a system that emphasizes healthy outcomes and affordability. As the health system works toward this vision, panelists will share what is driving innovation and what is on the horizon for value-based care delivery and payment.

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  • 9:45 am – 10:05 am, International Ballroom West-Center

    CMS’ Priorities for Dual Eligibles

    ,

    In this session, the director of the CMS Medicare-Medicaid Coordination Office will discuss CMS initiatives and priorities for programs serving Medicare-Medicaid dual eligible enrollees, and the outlook for the evolution of integrated care delivery models.

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  • 10:05 am – 10:35 am, International Ballroom West-Center

    The Future of Medicare: Policy Updates and Market Innovation

    ,

    CMS’ Center for Medicare lead will share her vision for the continuing growth and evolution of the Medicare Advantage and Part D programs.

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10:35 am – 11:00 am
, Break

Concourse Foyer
Coffee Break in the Foyer

11:00 am – 11:45 am
, Concurrent Sessions

  • SERIES 7: CONCURRENT SESSIONS

    • Policy Updates and Advancing Care Coordination for Duals

      Location
      International Ballroom East
      Speakers
      Details

      In this session, staff from the CMS Medicare-Medicaid Coordination Office will review current and planned initiatives for integration of services for people who are dually eligible for Medicare and Medicaid, and the outlook for integrated care delivery models like dual eligible special needs plans (D-SNPs).

    • Implications of Hospital Consolidation, Competition, and Private Equity

      Location
      Lincoln-Monroe
      Speakers
      Details

      Decades of hospital mergers have led to highly consolidated markets which has impacted the price of hospital services, the quality of care, and the pace of innovation. Recently, hospitals have acquired physicians and entities offering ancillary services. Private equity purchases of specialty physician practices and other has led to a rapid increase in prices. This panel will examine the implications of such consolidation for health care markets and consumers.

    • Applying Policy to the Real World: Wellness Programs for Chronic Disease

      Presented by Tivity Health
      Location
      Jefferson
      Speakers
      Details

      Wellness programs can be instrumental in preventing and managing chronic disease in older adults, yet policy dynamics can prove challenging to successfully implementing these programs. A panel of stakeholders will discuss new value-based reimbursement opportunities in fitness partnerships and other innovative collaborations, including use of digital solutions for health and wellness. Join this session to identify policy gaps, explore winning models, and effective program approaches

11:45 am – 1:45 pm
, Networking Lunch

International Ballroom West-Center
Lunch & Dessert in the International Ballroom West-Center

1:45 pm – 3:30 pm
, Concurrent Sessions

  • 1:45 pm – 2:30 pm

    SERIES 8: CONCURRENT SESSIONS

    • Updates on Medicaid Redeterminations

      Location
      International Ballroom East
      Speakers
      Details

      This session will cover the nationwide impacts on enrollees and coverage (Medicaid and Marketplace); policy and administrative processes and challenges at the state level, MCO partnerships to support state efforts, including the ability to contact members and the impact of the TCPA.  

    • Evolving Supplemental Benefits in MA

      Location
      Lincoln-Monroe
      Speakers
      Details

      This session will highlight the current state and trajectory of supplemental benefit offerings to improve care and address the needs of Medicare Advantage enrollees. Speakers will also discuss the value of using supplemental benefits data to understand general use and access trends. 

  • 2:45 pm – 3:30 pm

    SERIES 9: CONCURRENT SESSIONS

    • Advancing Equity through Quality Measurement and Accreditation

      Location
      International Ballroom East
      Speakers
      Details

      COVID-19 has brought into focus the disparities in health and health care in the United States and spurred a call to urgently address health equity. Health plans are taking numerous actions to identify and address disparities and promote health equity. Quality measurement and accreditation have become key levers in addressing disparities and promoting health equity.

    • Impacts of the Inflation Reduction Act on the Medicare Part D Program

      Location
      Lincoln-Monroe
      Speakers
      Details

      Speakers will discuss the Inflation Reduction Act (IRA) implementation challenges for Part D plan sponsors. 

3:45 pm – 5:15 pm
, Closing General Sessions

  • 3:45 pm – 4:30 pm, International Ballroom West-Center

    What Is Keeping State Health Legislators and Regulators Up at Night

    ,

    In this session, speakers will talk about ways policymakers and regulators are supporting patients, employers, and public purchasers’ access to affordable health care and health insurance coverage.

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  • 4:30 pm – 5:15 pm, International Ballroom West-Center

    Midterm Impact and Policy Directions from a New Congress

    ,

    A leading political analyst will offer perspectives on the current political and legislative environment, the road to the 2024 presidential election, and the impact on the future of U.S. health care.

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5:15 pm – 5:15 pm
, Conference Wrap-Up/Adjournment