May 22–24, 2017Hyatt Regency Baltimore Inner Harbor,

Baltimore, Maryland, USA

DRIVE INNOVATION WHILE NAVIGATING POLITICAL AND REGULATORY UNCERTAINTY, VALUE-BASED CARE TRANSITIONS AND FINANCIAL RESOURCING SHORTAGES

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REGISTRATION HOURSMonday: 8am-5:30pmTuesday: 7:45am-5:15amWednesday 8am-10:30am MMCC EXHIBIT HALL HOURSMonday: 10:30am – 6:30pmTuesday: 7:45am – 6:15pmWednesday: 7:45am – 11:00am WIFINetwork: InformaPassword: MMCC17

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PRE-CONFERENCE SYMPOSIUMS - MONDAY, 22 MAY 2017FULL DAY PRE-CONFERENCE SYMPOSIUM A: MEDICAID MANAGED CARE 101

HALF DAY PRE-CONFERENCE SYMPOSIUM B ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDGH)

8:45 Chairman’s Opening RemarksClay Farris, Senior Healthcare Executive, Mostly Medicaid

8:45 Chairman’s Opening RemarksJennifer Babcock, Vice President for Medicaid Policy & Director of Strategic Operations, ACAP

9:00 An Overview of Managed Care Transitions: Look at different states currently transitioning to Managed Care for part or all their populations and how the implications of policy change and general uncertainty is affecting states transitioning to managed care models. Alexander Shekhdar, Vice President, Federal and State Policy at Medicaid Health Plans of America (MHPA)

9:00 The Business Case for SDOH Jean McGuire, Ph.D., Professor of Practice, Health Sciences Department, Northeastern University

9:30 Government Accountability Office: Update on the Managed Care LandscapeCarolyn Yocom, Director, Health Care Team, U.S Government Accountability Office (GAO)

9:30 CASE STUDY: The 80% of Care Gaps Health Plans aren't AddressingBy moving past traditional sick care and exploring ways to address insecurities in food, education, housing, child care and other basal needs, Passport works to address needs across the social spectrum. This presentation will share some best practices and early lessons learned from Passport’s programs to address high risk populations. John Burich, Chief Strategy Officer, Passport Health Plan

10:00 An Overview of Managed Care TransitionsLook at different states currently transitioning to Managed Care for part or all their populations and how the implications of policy change and general uncertainty is affecting states transitioning to managed care models. Alexander Shekhdar, Vice President, Federal and State Policy, Medicaid Health Plans of America (MHPA)

10:00 CASE STUDY: The 80% of Care Gaps Health Plans Aren't AddressingBy moving past traditional sick care and exploring ways to address insecurities in food, education, housing, child care and other basal needs, Passport works to address needs across the social spectrum. This presentation will share some best practices andearly lessons learned from Passport’s programs to address high risk populations.John Burich, Chief Strategy Officer, Passport Health Plan

10:30 Grand Opening & Networking Reception in MMCC Hall

11:00 CMS Keynote: Driving Quality Improvement for Medicaid Beneficiaries through Managed CareKaren Matsuoka, Ph.D., Chief Quality Officer Director, Division of Quality and Health Outcomes, Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services

11:35 Provider Enrollment and Screening Meets Credentialing – Where States are HeadedThe Affordable Care Act (ACA) substantially changed the requirements for screening and enrollment of Medicaid providers. Providers must be placed into categories of risk; Limited, Moderate, and High. There are new requirements for periodic background and sanction checks, facility site visits, fees, and many other tasks. Another complicating factor is the role of Medicaid Managed Care Organizations (MCOs) in this process. While MCOs typically have responsibility for provider credentialing, it is often separate from screening & enrollment, creating redundancy and confusion for stakeholders. A number of States have begun to combine the Credentialing process with Medicaid Screening & Enrollment. This presentationwill explore what states are doing and the implicationsfor Medicaid Programs, MCOs, and Providers.J.P. Crouse, Vice President, Business Development, Maximus

11:35 Problem Solving for Social Determinants of Health Challenges in Rural PopulationsKenneth Beutke, President, OSF Saint Elizabeth Medical Center

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PRE-CONFERENCE SYMPOSIUMS - MONDAY, 22 MAY 2017 (continued)

12:05 Ensuring Your Value – Building and Maintaining Excellence, Efficiency and Profitability in the Managed Care LandscapeSarah Adelman, Vice President, New Jersey Association of Health Plans

12:05 CASE STUDY: SDOH - Being Part of the SolutionThere is a significant impact that SDOH have on a person’s overall health and wellbeing. Hear how Geisinger has expanded its Population Health team to include Community Health Assistants with a primary focus on key barriers preventing access to quality health care including transportation, housing, and food insecurity. Learn about Geisinger’s demonstrated impact and key partnerships developed.Stacey Souchak - Director, Health Choices, Geisinger Health Plan

12:35 The Impact of Fraud Waste and Abuse on Managed Care Health PlansJennifer DePaul - Director, Special Investigations Unit, Anthem

12:35 CASE STUDY: Initiatives for Ensuring Affordable Housing for Vulnerable Populations in MedicaidHousing is a health issue and Health is a housing issue. Learn about social determinants of health and how health system and providers can partner with housing providers to decrease community costs of high utilizers and increase housing stability. Universityof Pittsburgh Health System (UPMC) and Community Human Services (CHS) have partnered for 6 years and work collaboratively on this issue.Jeremy Carter - Chief Housing Officer, Community Human Services

1:05 Networking Luncheon

FULL DAY PRE-CONFERENCE SYMPOSIUM A: MEDICAID MANAGED CARE 101 - CONTINUED

HALF DAY PRE-CONFERENCE SYMPOSIUM C- Medicaid Long Term Services and Supports (MTSS)

2:05 Chairperson’s Welcome BackClay Farris - Senior Healthcare Executive, Mostly Medicaid

2:05 Chairperson’s Welcome BackCamille Dobson - Deputy Executive Director, Former Senior Policy Advisor, National Association of States United for Aging and Disabilities, Centers for Medicare & Medicaid Services

2:15 CASE STUDY: Program Integrity – Effective Compliance Program to Detect and Report Fraud, Waste and Abuse• Learn about the structure of one plan's Compliance Program incorporating the 7

elements of an effective program.• Analyze a Case Study on One Plan's Fraud, Waste and Abuse detection methods

including bringing on and managing a Special Investigations Unit.• Hear Tips and Techniques from a Compliance Officer on what terms should be

included in contracts with Delegated Vendors and Providers to promote compliance and integrity.

Ryan Tyrrell Lipinski - Compliance Officer, Cook County Health and Hospitals System

2:15 Managed Long Term Care Services and Supports: Examining Payment Structures and CMS OversightSusan Barnidge, Assistant Director, U.S. Government Accountability Office (GAO)

2:45 Don’t Say The F$#*D Word & Other Tips to Strengthen Program Integrity and Compliance in a Mega Reg WorldDeonys de Cárdenas, RN, JD - Director of Compliance, Department of Compliance, Select Health of South Carolina

2:45 Managed Long-Term Services and Supports - Issues and Trends• Understanding the breadth and scope of MLTSS programs• Context of Federal authorities for such programs• Program values demanded by states• Innovations offered by health plans.Camille Dobson - Deputy Executive Director, Former Senior Policy Advisor, National Association of States United for Aging and Disabilities, Centers for Medicare & Medicaid Services

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PRE-CONFERENCE SYMPOSIUMS - MONDAY, 22 MAY 2017 (continued)

3:15 Networking Break

3:45 Problem Solving for Systems Issues in Transitioning Your Medicaid Populations to Managed CareLaura Hopkins, President, Amerigroup Kansas

3:45 CASE STUDY: Transitioning Medicaid LTSS to Managed Care: Challenges, Opportunities and Lessons LearnedKelli Todd, MPH - Program Manager, Iowa Managed Care Ombudsman Program, Iowa Department on Aging

4:15 ACA and ACHA: Which Path Forward? Hector De La Torre - Executive Director, Transamerica Center for Health Studies

4:15 Minnesota's Approach to MLTSS Compliance with the Mega-RegThe State of Minnesota's Senior Health Options program includes a comprehensive long term care benefit and is one of the country's oldest integrated programs for Medicare and Medicaid enrollees. Learn how Minnesota is approaching the new focus on home and community based service provider enrollment, network adequacy and quality outlined in the Medicaid managed care regulationsGretchen Ulbee - Manager Special Needs Purchasing, Health Care Administration, Minnesota Department of Human Services

4:45 Improving Patient Outcomes Through Medicaid Health HomeHarbor has a 5-year history of providing home health services to adults with severe persistent mental illness and children with severe emotional disturbances, helping them coordinate their physical and mental health, long term care, and social service needs. The program has had positive impact on emergency visits, general and psychiatric hospitalizations with reduction in costs and increase in client outcomes.Steve Benjamin - Senior Vice President Clinical Services, Harbor Behavioral Health

4:45 Building LTSS Partnerships: Community Organizations, Managed Care Organizations and the Ever-Changing EnvironmentErica Anderson - Senior Director, National Associationof States United for Aging and Disabilities

5:30 Cocktail Reception

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MAIN CONFERENCE DAY ONE - TUESDAY, 23 MAY 20177:45 Registration & Morning Coffee

8:15 Chairman’s Opening Remarks Vernon Smith, Ph.D., Senior Advisor, Health Management Associates

8:30 Opening Keynote: Health Reform in the Trump Health Care Agenda: Impact on Medicaid Instead of a pathway to excellent health care for poor Americans, Medicaid expansion under the Affordable Care Act continued a parallel second-class health system, with poor health outcomes and fewer doctors accepting the coverage, at a cost rising to $890 billion in 2024. My health system reform plan would transform Medicaid into a bridge program geared toward enrolling beneficiaries into affordable private insurance with the same access to doctors, specialists, and treatments as the general population. Part of current federal contributions would also seed-fund health savings accounts, creating assets and incentivizing healthy lifestyles to protect those assets. Federal funding would be contingent on meeting thresholds for enrollment into private coverage and HSAs. The Trump administration will likely reform Medicaid along these lines, first with liberal granting of waivers to states and subsequent implementation of more detailed changes. This presentation will highlight the rationale for substantial Medicaid reform and the likely pathway forward under the new administration.Scott Atlas, MD David and Joan Traitel Senior Fellow, Hoover Institution, Stanford University

9:00 POLICY KEYNOTE: What Medicaid Means to Our Most Vulnerable, and the Fight to Protect ItElizabeth G. Taylor, Executive Director, National Health Law Program

9:30 PANEL DISCUSSION: Taking Stock - Exploring the Implications of the New Administration, Change or Repeal of the ACA, and Medicaid ExpansionBecause of the timing with the transition in January, more content/text will be solidified closer to the event in May, but things to be discussed will include (as appropriate)•The new administration and its stance/policy toward the ACA, Medicaid and Healthcare•The state and future of the exchanges and the marketplace and its impact on Medicaid•What will happen to innovation?Moderator: Alexander Shekhdar, Vice President, Federal and State Policy at Medicaid Health Plans of America (MHPA)Panelists: John Kaelin, Senior Advisor, Centene Corporation

John Lovelace, President, UPMC for You; President, Government Programs and Individual Advantage Joe Moser, Medicaid Director, State of Indiana

10:15 Morning Network Break

10:45 Medicaid Cost Containment: An Easy Strategy for Uncertain TimesStephen Konsin, Vice President, Syrtis Solutions

11:15 Medicaid Beneficiaries Tell-All (About How They Want To Communicate With You)Data doesn't lie. An entertaining role reversal, this presentation will give Medicaid beneficiaries a voice on the topic of member communications by using insights derived from millions of text messages, automated phone calls and emails, that have flowed through HealthCrowd's platform. Enjoy the sprinkling of real-life analyses and case studies along the way. The session will end with a look into how member communications will continue to transform itself moving into the future. Clive Wu, Chief Technology Officer, HealthCrowd

11:45 State Medicaid Director PanelModerator: Vernon Smith, Managing Principal, Health Management AssociatesPanelists: Deb Florio, - Deputy Medicaid Director & CHIP Director, State of Rhode Island

Joe Moser, Medicaid Director, State of Indiana Claudia Schlosberg, Medicaid Director, District of Columbia Department of Health Care Finance Jami Snyder, Associate Commissioner, Medicaid/CHIP, State of Texas Mike Randol - Secretary, Kansas Department of Health and Environment

1:00 Networking Luncheon

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MAIN CONFERENCE DAY ONE - TUESDAY, 23 MAY 2017 (continued)

TRACK A: PAYMENT MODELS,INNOVATION AND CONTRACTING

TRACK B: CARE COORDINATION TRACK C: INNOVATIONS IN CLINICAL SERVICES

2:00 Value Based Provider Contracting Opportunities with Managed Care OrganizationsKathryn Curtis, Vice President of Payor Contracting, Caravan Health

Partnerships That Matter • Working together to meet the complex needs of the

individual and the community.

• Learn how behavioral health managed care organizations are staying relevant and pushing innovation in an evolving managed care landscape.

• Hear how health plans, providers and stakeholders are creating new partnerships to drive value by improving care, quality, and lowering costs.

Kiara Kuentzler, Chief Operating Officer, Foothills Behavioral Health Partners

Predictive Modeling for High Risk New EnrolleesJohn Lovelace, President, UPMC for You ; President, Government Programs and Individual Advantage

2:30 Case Study: Capitation and Regional Solutions in Behavioral and Primary Care Integration –John Doherty, BHO Rate Analyst, Payment Reform Section, Colorado Department of Health Care Policy & Financing

Ensuring Coordination of Care at the Community Level for High Cost, High Need PopulationsLinda McKinnon, President & CEO, Central Florida Behavioral Health Network

WWDD (What would Deming Do)A case study of the conversion of a clinical team to control charts

Fran Martini, RN, BSN, MBA, Director, Populationn Health Management at BCBS Tennessee

3:00 Managing the Rising Cost of Drugs in Medicaid Managed CareOptimizing your pharmacy benefit in a way that helps keep plan costs lower while providing the right access to the medications your members need is more important than ever for Medicaid plans. Join Express Scripts as we look at what’s driving these rising drug costs, and what plans can do to help mitigate the increases.Krista Ward, Senior Director, Medicaid at Express Scripts

The Importance of Conflict Free Assessments in MLTSS Environments• Why is conflict free assessment is important? --What

impact does it have on beneficiaries and providers?• How are different states interpreting the CMS Managed

Care Rule on this issue?• Discuss the most successful models for complying with

conflict-free assessment requirements. Barbara Selter, Vice President, Business Development, Health Services, MaximusNancy Shanley, VP-Consulting and Policy Analysis, MaximusSusan Mohen, CFEEC Nurse Director, Maximus

Incorporating Mental Health Care as Part of Medicaid Perinatal OB/GYN Care to Improve Maternity Outcomes and Reduce Costs

Maribeth Hollinshead, RN, MSN, Nurse Navigator-Program Director, Signature Medical Group | Strong Start for Mothers and NewbornsJennie Oberkrom, MSW, LCSW, Program Coordinator, Signature Medical Group | Strong Start for Mothers and Newborns

3:30 Afternoon Refreshments Break

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MAIN CONFERENCE DAY ONE - TUESDAY, 23 MAY 2017 (continued)

TRACK A: PAYMENT MODELS,INNOVATION AND CONTRACTING

TRACK B: CARE COORDINATION TRACK C: INNOVATIONS IN CLINICAL SERVICES

4:00 State Case Study: Update on the Rhode Island Financial Alignment Demonstration for Dual Eligibles Deb Florio, Deputy Medicaid Director & CHIP Director, Rhode Island

Rapid readmission of psychiatric patients in a managed care environment: An oversight of Field Case Management in New York CityThe FCM assessed 1320 members used a shared model approach that emphasized mutual decision method that was based on choice, options and decision talk that con-tributed to managed care provider on brief hospitalization while encouraging community-based services.

Henry Montero, Case Manager, Empire Blue Cross Blue Shield

Rapid readmission of psychiatric patients in a The panel will describe New York’s efforts to integrate substance use disorder treatment within a larger program of Medicaid redesign. Specifically, the presentation will describe policy changes and technical support focused on emerging value based payment models. The presentation will provide examples of how the reforms impact on access and care for individuals with opioid use disorders.Patricia Lincourt - Director, Practice Innovation and Care Management, New York State Office of Alcoholism and Substance Abuse ServicesIlyana Meltzer - Director, Care Management Bureau, Division of Practice Innovation and Care Management, New York State Office of Alcoholism and Substance Abuse ServicesCharles Neighbors, Ph.D., MBA - Director, Health Services Research, The National Center on Addiction and Substance AbusePatricia Lincourt - Director, Practice Innovation and Care Management, New York State Office of Alcoholism and Substance Abuse Services

4:30 Update from Massachusetts: Delivery System and Payment Reform Massachusetts will be introducing new delivery system options for members in MassHealth’s managed care system in December 2017, including new Accountable Care Organizations and newly procured Managed Care Organization (MCO) plans. Its 1115 demonstration waiver supports significant federal investment through DSRIP as the new delivery systems come online, and services for members with long-term services and supports needs and behavioral health needs will be integrated into these new delivery systems over the next several years, as providers become accountable for members’ Total Cost of Care. This session will provide an overview of its new delivery system structure, including how Massachusetts is leveraging its 1115 waiver to drive value and strategically invest in the new delivery systems.Corrinne Altman Moore, Masshealth Director of Policy, Executive Office of Health and Human ServicesJulia Harvey, MassHealth Policy Analyst, Payment Innovation, MassHealth

Panel Discussion:Community and Healthcare Collaboration• Understand the benefits of serving the needs of

the whole patient by connecting healthcare to and community

• Learn to identify opportunities in the community for partnering

• Gain strategies for creating innovative partnerships that benefit your demographic

Panel: Michelle Carrothers, Executive Director Strategic Reimbursement, OSF Healthcare System

Kiara Kuentzler, Chief Operating Officer, Foothills Behavioral Health Partners

Kathy Gorosh, MBA SVP of Strategy & Business Development AIDS Foundation of Chicago

CASE STUDY: New York’s Transition to Medicaid Managed Care for Behavioral HealthAndrew Cleek - Executive Officer, NYU McSilver Institute

Robert Myers, Ph.D., LMSW - Senior Deputy Commissioner and Director, Division of Adult Services, New York State Office of Mental Health (NYSOMH)

Patricia Lincourt - Director, Practice Innovation and Care Management, New York State Office of Alcoholism and Substance Abuse Services

5:15 Networking Wine & Cheese Reception

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MAIN CONFERENCE DAY TWO - WEDNESDAY, 24 MAY 20178:45 Chairpersons Opening Remarks

Vernon Smith, Managing Principal, Health Management Associates

9:00 Keynote address: Reducing Cost and Improving Quality in Medicaid Members: Using Technology in the Real World • Can you create a medical management system that will actually create ROI. Metrics, How to avoid the Complex Medical Management requirements of NCQA that reduce member

engagement and improving outcomes, etc.

• How to Leverage “big data” to manage individual members using field nurses with the correct information.

• Optimizing Risk scores by expanding targeted testing

• Using Telehealth to reduce readmissions

Robert London, Senior Medical Director, Wellcare

9:45 eConsults: Improving the Primary Care-Specialty Care Interface and Getting to the Quadruple AimLearning Goals:

• Describe eConsults as a necessary clinical transformation that disrupts the primary care and specialty care interface

• Articulate the case for eConsults in Medicaid environments

• Position eConsults as an important strategy for Medicaid plans to achieve the Quadruple Aim

J. Nwando Olayiwola, MD, MPH, FAAFP, Chief Clinical Transformation Officer, RubiconMD, Associate Clinical Professor, UCSF Department of Family & Community Medicine

11:00 Keynote Presentation: Medicaid Pharmaceutical Reimbursement Policy Changes and DevelopmentsJeff Myers, President and CEO, Medicaid Health Plans of America

12:00 Closing Keynote Panel Discussion:What the Future Holds: Medicaid 2017 and Beyond A trade association leadership panel discussion on the national landscape from a health plan as stakeholder perspectiveModerator: John Lovelace, President, UPMC for You, Government Programs and Individual AdvantagePanelists: Rhys Jones, Vice President, Medicaid Advocacy, America's Health Insurance Plans (invited)Margaret A. Murray, CEO, Association for Community Affiliated Plans Jeff Myers, President and CEO, Medicaid Health Plans of America Seemin Pasha, Vice President, Alliance of Community Health Plans

12:45 Close of MMCC

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THANK YOU TO OUR MEDIA PARTNERS

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SPONSORS AND EXHIBITORSENGAGE INFLUENCIAL HEALTH PLAN EXECUTIVES AND KEY PLAYERS IN THE HEALTHCARE ECOSYSTEMSponsor the event to shake hands with government officials, health plan executives, industry leaders, and other key players in the healthcare ecosystem. For sponsorship and exhibition opportunities, contact: Sarah Scarry: +1.646.220.6655 sarah.c.scarry@knect365.com

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