event

Open to all who would like to run or walk on a scenic route through downtown Washington, D.C.

Sponsored by ACAP Preferred Vendor Cognizant.

John Lovelace, Chair of ACAP and President of UPMC for You, and Meg Murray, CEO of ACAP, will discuss the contributions of Medicaid managed care to Medicaid.

Dr. J. Mario Molina, formerly the CEO of Molina HealthCare, has spent his career focused on Medicaid managed care and health care for low-income Americans. He will share his perspectives on the impact of the American Health Care Act on Medicaid and the health insurance Marketplace, the new flexibility states are seeking for Medicaid through waivers, and the future of the Medicaid managed care industry.

Moderator: John Lovelace, President, UPMC for You

Nationwide, millions of individuals and families are impacted by substance use disorder (SUD). SUD impacts all walks of life, including individuals enrolled in Medicaid. Nearly 12 percent of adults in Medicaid and 6 percent of adolescents live with SUD. According to CMS, alcohol and substance use diagnoses are two of the top ten reasons for Medicaid hospital readmissions. From patient identification and engagement, to ensuring access and providing integrated care coordination, health plans have been critical players in the concerted effort to address this growing issue.

In this session, Meg Murray will discuss with John Lovelace and Virginia Premier Health Plan CEO Linda Hines about specific actions plans are taking as highlighted in a newly released ACAP report.

Sponsored by ACAP Preferred Vendor Cognizant.

Margot Sanger-Katz, health care reporter for The New York Times, will moderate a discussion with health plan CEOs on the current state of health care, politics, and the intersection of the two.

• John Lovelace, President, UPMC for You
• Chris Palmieri, CEO, Commonwealth Care Alliance
• Peter Marino, CEO, Neighborhood Health Plan of Rhode Island

Sponsored by ACAP Preferred Vendor Cognizant.

This award honors a community-based organization or individual whose work clearly goes beyond the norm and whose services are recognized as best practices which stand as a model for replication in the safety net environment. The aim is to reward unique ways of thinking and innovative ways of performing underlined by data depicting success.

Presented by: Mark Rakowski, Vice President, Children’s Community Health Plan

The American Health Care Act (AHCA) passed the House of Representatives. But health care reform conversations are far from over. The Senate’s more deliberative approach to the AHCA heralds an opportunity for plans and others to offer constructive ideas to improve the health care delivery system. Rodney Whitlock of ML Strategies and the American Enterprise Institute’s Jim Capretta will review what the next steps are for the bill, the implications of per capita allotments on Medicaid and the plans that serve Medicaid enrollees, how the Administration is using regulatory and executive action to implement health care reform, and how plans can best position themselves in future health care reform discussions.

Sponsored by ACAP Preferred Vendor Cognizant.

ACAP-member plans and other Medicaid MCOs have played a critical role in the development of care coordination programs for children with special health care needs and their families. Amid rigorous discussion in Washington regarding how these children and their families can best negotiate a complex health care environment, ACAP worked with researchers at NORC to produce a report called Innovative Approaches in Care Coordination and Care Delivery for Children with Special Health Care Needs among Safety Net Health Plans. During this session, the paper’s lead author and ACAP-member plans will highlight a range of innovative models of coverage and care coordination used for children with special health care needs, as well as efforts to improve outcomes, access to health care services, and other needed supports.

• Mary Dale Peterson, CEO, Driscoll Health Plan
• H. Bradley Weaver, Executive Vice President and Chief Operating Officer, Health Services for Children with Special Needs

Moderated by Cheryl Austein Casnoff, Senior Fellow, NORC

The experience of dual-eligible beneficiaries in D-SNPs continues to be an area of focus for Congress. Mark Miller, Ph.D., MedPAC’s Executive Director, will discuss the Commission’s work on dual eligible beneficiaries in Medicare Advantage and D-SNPs. Dr. Miller will also discuss the Commission’s work on Medicare premium support on how care delivery for duals could change under a premium support system.

Moderated by Hany Abdelaal, President, VNSNY CHOICE Health Plans

Sponsored by ACAP Preferred Vendor CVS Health

Open to all who would like to run or walk on a scenic route through downtown Washington, D.C.

Sponsored by ACAP Preferred Vendor Community Care Behavioral Health.

Meg Murray, CEO of ACAP, will welcome attendees to the second day of the ACAP CEO Summit and provide a recap of yesterday’s sessions.

The Marketplaces have been fraught with change and instability since their inception, but particularly over the past year, with numerous issuers dropping out altogether and others threatening to do so. Yet other issuers—including ACAP plans—have opted to enter the Marketplaces, and some have been quite successful. In this session, we will hear from plans in the Marketplaces and what the impact of the current political climate and instability means for their role moving forward.

• Mark Rakowski, Vice President, Children’s Community Health Plan
• Karen Love, Executive Vice President and COO, Community Health Choice
• Susan Coakley, President, BMC HealthNet Plan (invited)

Moderated by Christopher Koller, President, Milbank Memorial Fund

Sponsored by ACAP Preferred Vendor MedImpact.

Since the November election, all eyes have been on consumer-focused coverage as a reform that could save federal dollars and increase patients’ involvement in their own care decisions.

Indiana, home to HIP 2.0, which employs health savings accounts (HSAs) for the first time for very low-income Medicaid enrollees, serves as a test site for this experiment. Indiana HIP Director Natalie Angel will describe the promises and challenges of HIP 2.0, paying special attention to the impact it has on enrollee behavior. Justin Giovannelli of Georgetown University’s Health Policy Institute, will add his perspective on the utility of HSAs to lower premiums and increase consumer involvement in the individual health insurance Marketplaces as well.

Moderated by Jim Parker, CEO, MDwise

Prescription drug spending continues to be a key driver of the increase in national Medicaid spending. To date, ensuring a value proposition in drug purchasing has been a lofty but elusive goal. In this session, we will first hear from Susan Stuard, Project Director of the State Medicaid Alternative Reimbursement and Purchasing Test for High-cost Drugs (SMART-D). The goal of the Smart-D program is to strengthen the ability of state Medicaid programs to utilize alternative purchasing models (APMs) for high-cost drugs that address cost concerns while protecting patient access to safe, effective drugs. Dr. Andrea Gelzer (invited) will then present on AmeriHealth Caritas’ efforts to implement a value-purchasing program that specifically addresses the role of pharmaceuticals.