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Agenda at a Glance

Agenda at a Glance

Monday, May 20, 2013: Pre-Conference Summits
Full Day
Medicaid Managed Care 101
The Medicaid managed care landscape is extremely complex and it can be difficult to understand for those that
are new to the space. This summit provides an overview of all of the key elements of Medicaid managed care.
8:00 Registration and Morning Coffee
9:00 Chairman's Opening Remarks
Clay Farris, Managing Editor, Mostly Medicaid
9:15 Differentiate Medicaid from other Forms of Healthcare
Philip Bonaparte, MD, Vice President of Clinical Affairs,
Chief Medical Officer
, Horizon NJ Health
10:00 Distinguish Managed Care from Fee for Service Models
Lisa Hatton, LSW, QMRP, Corporate Director,
Provider Services
, Molina Healthcare
10:30 Networking Break
10:45 Make a Commitment to Higher Quality
Carol L. Stanley, MS, CPHQ, Quality Improvement Analyst, Division of Health Care Services,Virginia Department of Medical Assistance Service
11:30 Best Practices for M&A
Steven Bohner, Chief Financial Officer and Senior Vice President of Finance, AmeriHealth Mercy Family of Companies
12:15 Networking Luncheon
1:15 Understand the Typical Medicaid Managed Care Member
Ken Janda, President and CEO, Community Health Choice, Inc.
2:00 Understand the Implications of the ACA for Medicaid
Julia Paradise, Associate Director, Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation
2:45 Networking Break
3:00 Dual Eligibles: An Opportunity to Provide Better
Care for More Members

William G. Wood, MD, PhD, FAPA, Chief Medical Officer,
Behavioral Health
, Amerigroup Community Care of Tennessee
3:45 Learn How Medicaid Expansion May Look in Your State
Joe Moser, Director of Government Affairs and Interim CEO, Medicaid Health Plans of America (MHPA)
4:30 Summit Concludes
Full Day
Health Insurance Exchange Intensive
Now that the 2012 elections are a distant memory, health insurance exchanges are a reality and the timelines are extremely tight. This intensive provides you with insight into all of the most important elements of exchanges.
8:00 Registration and Morning Coffee
9:00 State of the States: An Update on Health
Insurance Exchanges across the Country

Andrew Berenato, Director, Office of Exchanges,
AmeriHealth Mercy
9:45 Compare and Contrast Different Exchange Models
John Kaelin, Senior Vice President, Health Reform,
UnitedHealth Group
10:30 Networking Break
10:45 Maryland's Approach to Building a Successful State-Based Exchange
Tequila Terry, Director, Plan & Partner Management, Maryland Health Benefit Exchange
11:30 Prepare Now to Hit the Ground Running when
Exchanges Go Live

John Lovelace, President, UPMC for You, President of Government Programs and Individual Advantage Products, UPMC Health Plan
12:15 Networking Luncheon
1:15 Building Products to Compete for Small Businesses and Individuals On and Off Exchanges
Robert Thompson, Vice President of Community Health Engagement, Excellus BlueCross BlueShield
2:00 Massachusetts Alternative to the BHP
Michael Norton, Senior Manager of External Affairs and Carrier Relations, The Health Connector
2:45 Networking Break
3:00 Pharmacy within the Exchanges
Teresa DeLuca, MD, MBA, Chief Medical Officer Magellan Pharmacy Solutions
3:45 Build an Exchange for Long-Term Sustainability
4:30 Summit Concludes
Half Day
Medicaid Managed Care for Pharmaceutical Executives
As more states move to managed care, inclusion on managed care formularies is becoming more and more important to pharmaceutical companies. This half-day summit is a must-attend event for any pharmaceutical executive looking to see the interworkings of a Medicaid health plan. Health plans share how they build their formularies and how their processes must change in the upcoming years due to healthcare reform and states shifting to a single formulary.
8:00 Registration and Morning Coffee
9:00 Overview of the Managed Care Landscape for Pharma
Philip Hanus, PharmD, Director of Pharmacy,
Molina Healthcare of Ohio
9:45 CalOptima's Formulary Development Process
Kristin Gericke, PharmD, Director, Clinical Pharmacy Management, CalOptima
10:30 Networking Break
10:45 Implications of a Statewide Formulary and a
State-by-State Breakdown of Specialty Pharma

Cindy Pigg, Senior Vice President of Pharmacy,
Magellan Medicaid Administration
12:15 Networking Luncheon, Summit Concludes
Half Day
Clinical & Financial Benefits of Predictive Modeling
Predictive modeling is becoming common as we continue to see the benefits. This half-day summit explores uses for predictive modeling to assess and decrease risk when providing care to Medicaid recipients.
12:15 Clinical & Financial Benefits of Predictive
Modeling Registration
1:15 Benefits of Advanced Analytics on Fraud, Waste,
and Abuse Mitigation

Mary Beach, AHFI, CFE, Associate Vice President,
Corporate Investigations
, Amerigroup Corporation
Anne Donovan, Vice President, Cost Recovery and Premium Risk, Amerigroup Corporation
Randy Carnevale, PhD, MPH, Director, Clinical Analytics, Amerigroup Corporation
2:45 Networking Break
3:00 Strategic Compilation of Large Data Sets to
Identify Risk and Drive Proactive Care Models

Leslie Naamon, Chief Operating Officer, Peach State Health Plan, Centene Corporation
Robyn Lorys, Senior Director, Clinical Outcomes, Peach State
Health Plan, Centene Corporation
3:45 Use of Predictive Modeling to Increase Outcomes
for Pregnant Women and Their Children

Mary Mason, Chief Medical Officer, Centene Corporation
4:30 Summit Concludes
Tuesday, May 21, 2013: Main Conference Day One
7:30 Registration and Morning Coffee
8:30 Chairman's Opening Remarks
Vernon Smith, PhD, Managing Principal, Health
Management Associates
8:45 KeynoteUpdate on the Political Landscape of
Healthcare in the U.S.

Michael Steele, Former Chair, Republican National Committee; Political Analyst, MSNBC
9:30 KeynoteTrends in Medicaid Managed Care
Barbara Coulter Edwards, Director of the Disabled and Elderly Health Programs Group in the Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services (CMS)
10:00 Networking Break
10:30 KeynoteOpting In for Medicaid Expansion
Michael Koetting, Deputy-Director for Planning & Reform Implementation, Department of Healthcare & Family Services
11:00 STATE SPOTLIGHT: Vermont's Single Payer System
Robin Lunge, Director of Health Care Reform,
State of Vermont
, Agency of Administration
11:15 States Shifting from Fee for Service to Managed Care
Lawrence Kissner, Commissioner, Cabinet for Health and Family Services, Department for Medicaid Services, Kentucky
Susan Mosier, MD, Director of Medicaid Services, State of Kansas
Robert Wychulis, Chief Executive Officer, Community Care,
Amerigroup New York
12:00 Networking Luncheon with State-Led Roundtables
1:00 Health Plan Roundtable: Alternative Payment Models
Moderator:
Meg Murray, Chief Executive Officer,
Association for Community Affiliated Plans (ACAP)
Panelists:
Christina Severin, Chief Executive Officer,
Network Health
David Evans, RN MBA, Program Director, GHP Family,
Geisinger Health Plan
1:45 KeynoteCMS Center for Medicare and Medicaid Innovation Update
Richard Gilfillan, M.D., Director, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services (CMS)
2:15 STATE SPOTLIGHT: Texas' Long-Term Care Expansion
Gary Jessee, Deputy Director for Program Operations, Medicaid/ CHIP Division, Texas Health and Human Services Commission
2:30 Networking Break
  ADMINISTRATIVE & FINANCIAL
CONSIDERATIONS
ENROLLMENT, ENGAGEMENT &
RETENTION
COMPLEX CARE MANAGEMENT
3:00 KeynoteInvolve Members in the
Evaluation Process

Ken Pariseau, Manager of Government Affairs,
Neighborhood Health Plan of Rhode Island
Jacqueline Dowdy, Member Advocate, Neighborhood Health Plan of Rhode Island
Integrate Traditional and Non-
Traditional Member Engagement
Tools for an Integrated Engagement
Strategy

Matthew Collins, Senior Medical Director for Medical Affairs, Fallon Community
Health Plan
KeynoteMultidisciplinary and Geographic Team Approach to Case Management for the Seriously Mentally Ill
Joe Garten, PhD, Director of Behavioral Health-
Medicaid,
WellPoint
3:45 Understand (and Overcome!) State
Financial Constraints

Christian Jensrud, Vice President,
Business Development
, Amerigroup
KeynoteFish Where the Fish Are:
Member Engagement
Outside of the Office

Lynn Bradford, Ph.D., HSPP, Director of Behavioral Health, MDwise, Inc.
KeynoteAchieve the Triple Aim through Coordinated MTM Programming
Eric Berman, DO, MS, Regional Chief Medical Officer, Northern Division, AmeriHealth Mercy
Diane H. Jankowski, RN, BSN, CCM, Regional Director of Clinical Services, Northern Division Managed Care, AmeriHealth Mercy
4:30 Does the Medical Home Model Drive
Quality and Efficiency?

Paul Rothman, President,
Prestige Health Choice
KeynoteUnmanaged to Managed Care in Three Months: How Kentucky became the Focus of Healthcare in 2012
Russell Harper, Director of Government Relations, Coventry Cares of Kentucky
KeynoteAddress Health Disparities and Culturally and Linguistically Appropriate Services
Carol Smolij, BSN, RN, CPHQ,
Vice President, Clinical & Regulatory Operations, Health Partners of Philadelphia
5:15 Challenges in Achieving
Comprehensive and Continuity
through Expansion and Exchanges

Deborah Florio, Administrator, Rhode Island
Executive Office of Health and Human Services

Richard Jacobsen, PhD, Project Manager, Xerox State Healthcare/Rhode Island Executive Office of Health and Human Services
Working Within the Guardrails: Creating Marketing Campaigns that Can Be Reconfigured Across State Lines
Harry Castleman, Senior Director of Marketing and Communications, BMC HealthNet Plan
Expand Telehealth Technology to
Deliver Medicaid Access Solutions

Michael Martineau, Senior Product Development Consultant, Telehealth Department, Anthem Blue Cross
6:00 Wine and Cheese Networking Reception
Wednesday, May 22, 2013: Main Conference Day Two
7:45 Breakfast Presentation: Medicaid Per Capita Caps
Stephanie Carlton, RN, MBA, Health Policy Advisor, U.S. Senate Finance Committee
7:30 Registration and Morning Coffee
8:30 Chairwoman's Opening Remarks
Kathy Kuhmerker, Vice President, Medicaid Policy, Association for Community Affiliated Plans (ACAP)
8:45 State Medicaid Directors' Panel: Implementation of the ACA
Moderator:
Brian Osberg, Program Director, Best Practices Center, Health Division, National Governors Association
Panelists:
Linda Elam, PhD, MPH, Deputy Director – Medicaid, Department of Health Care Finance, Government of the District of Columbia
Julie B. Weinberg, Director, Medical Assistance Division, New Mexico Human Services Department
Julian J. Harris, MD, MBA, MSc., Medicaid Director, Executive Office of Health & Human Services Commonwealth of Massachusetts
9:30 KeynoteHigh-Quality Care Delivery for Medicaid: CMS' Approach
Stephen Cha, Chief Medical Officer, Centers for Medicare & Medicaid Services (CMS)
Camille Dobson, Senior Policy Advisor, Centers for Medicare & Medicaid Services (CMS)
10:00 Networking Break
  ADMINISTRATIVE & FINANCIAL
CONSIDERATIONS
ENROLLMENT, ENGAGEMENT &
RETENTION
COMPLEX CARE MANAGEMENT
10:30 Understanding Pharmacy Spend and Managing Costs
Tim Emert, Director of PharmaHealth Analytics, US Script
KeynoteEncourage Children to
Make Healthier Decisions
when Selecting Foods and
Changing How Children
Think About Exercise

Jan Smith Reed, Director, Community Outreach,
Molina of Ohio
KeynoteLifestyle Adherence
through Integrated Care
Management

Frances Martini, BSN, MBA, Director of Government Clinical Programs, BlueCare, the Medicaid Plan of Blue Cross Blue Shield of Tennessee
11:00 Discuss Different Managed
Care Models

Susan M. Coakley, Chief Legal Officer, Boston Medical Center HealthNet Plan
Meryl Friedman Price, President, Health Policy Matters
Engage Community Partners to Connect with Dual Eligible Populations
Charlisa Watson, Vice President,
Community Development
, UnitedHealth Care
Advanced Analytics and Innovation:
Improving Care for Members with
Chronic Conditions

Karen M. Dale, RN, MSN, Executive Vice
President Healthcare Management
,
DC Chartered Health Plan
11:30 Medicaid Managed Care for People with Disabilities: Policy and Implementation Considerations
Ari Ne'eman, Entitlements Chair, National Council on Disability (NCD)
Community Outreach to Increase
Physical Activity in Elementary-Aged
Children

Jamie Bruce, MBA, CHC, Chief Development
and Marketing Officer, MDwise
KeynoteHealth Homes: Best
Practice Solutions for
Effective, Cost-Saving
Integrated Care Models or
Just Another Layer of Bureaucracy?

Margaret (Peggy) Leonard, MS, RN-BC, FNP, Sr. Vice President for Clinical Services, Hudson Health Plan
12:00 Networking Luncheon with State-Led Roundtables
1:00 Engage People with Disabilities, Self-Advocates and Stakeholders to Ensure Managed Care is Done Right
Moderator:
Merrill Friedman, Vice President, Advocacy, Amerigroup
Panelists:
Mark Perriello, President and CEO, American Association of People with Disabilities (AAPD)
Bruce Darling, CEO, Center for Disability Rights New York
1:45 STATE SPOTLIGHT: North Carolina
Carving in Behavioral Health

Patrick Piggott, MSW, LCSW, DCSW, Chief, Behavioral
Health Review Section
, North Carolina Division of Health &
Human Services
2:00 Best Practices for Long-Term Services and Supports
Wendy A. Morriarty, RN, MPH, State President, 'Ohana Health Plan
2:45 Close of the 21st Annual Medicaid Managed Care Congress— See You Next Year!


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