Plenary Webinar
Introduction
As we hopefully begin to see the pandemic in the rearview mirror, state Medicaid agencies are investing in system enhancements and capacities as they plan for an unprecedented volume of expected redeterminations. At the same time, new and innovative data sources are providing opportunities to streamline processes and add value to analytics programs to identify trends at a population level and ensure that data is actionable for citizen-centric care coordination across programs and across the care continuum.
These opportunities and modernization initiatives mean investing in a more interoperable, efficient, and transparent technology and services infrastructure that will support the adaptability and scalability to support policy initiatives and improve citizen access and program outcomes.
Plenary Abstract: Meeting Beneficiaries Where They Are: Optimizing Access, Experience, and Outcomes!
In a post COVID world, citizens expect more transparent, accessible, and responsive services from the public sector, much of which relies on data sharing and care coordination amongst multiple entities and multiple agencies. Information sharing also promises to reduce administrative burden, and promote efficiencies across the care continuum, as state Medicaid programs become increasingly reliant on care coordination, and value-based care contracts with their MCO partners.
In a ‘rubber meets the road’ plenary session, join our state, HIE, and technology leaders to understand the technologies agency and provider partners are implementing in order to optimize access, experience, and outcomes in the now while moving the needle on longer-term strategic priorities.
Key learning topics include:
- Stakeholder coordination, to improve access, experience, and outcomes
- Integrating social needs platforms into the Medicaid enterprise
- Actionable analytics using SDoH data across the HHS enterprise
- Leveraging HHS beneficiary experience data, to optimize outcomes
Presenters:
Dr. Craig Jones, Medical Director, IHDE (Idaho Health Data Exchange), Capital Health Associates
Cynthia Green Edwards, Chief Compliance Officer, Michigan Department of Health and Human Services
Melanie Bush, Chief Operating Officer, North Carolina Medicaid
Subramanian Muniasamy, Executive Director, MD THINK
Antoinette Taranto, Chief Customer Officer, Medicaid Operations, Colorado HCPF
Proudly Sponsored by
Through the Looking Glass: Achieving health equity goals with integration, data analytics, and a better member experience
Industry Insights Webinar
As we look toward the future with innovations and partnerships that may have the potential to transform outcomes for those long underserved, the opportunities to impact experience, outcomes, and cost of care across the health care system are significant. With CMS recently releasing their “Framework for Health Equity” coupled with the experience of demonstration projects focused on health equity and social determinants of health across the country, we are at the forefront of a new phase in our goal of addressing health disparities.
We now have a lens into the data & technology that enables better physical, behavior, and social health outcomes that far surpass what many of us could have imagined.
Health equity is a fundamental cornerstone of all health initiatives and the ability to obtain, maintain and sustain progress for members will be imperative. Join in as our panel of experts discusses:
- Why the future is now and how current efforts are different from past national conversations on addressing and ending disparities
- Why addressing social determinants of health from the perspective of the person is a critical component of not only whole-person care but health equity
- What the future health equity roadmap looks like with the availability of data integration and new tools
- Recent case studies with positive outcomes that provide actionable takeaways and evidence that the future is now
Presenters:
James Lukenbill, Ph.D., Analytics Strategic Product Manager, Optum State Government Solutions
Mylynn Tufte, MBA, MSIM, RN, Practice Lead, Population Health, Optum Advisory Services
Ali Shirvani-Mahdavi, Ph.D., Vice President of Analytics Consulting, Optum
Presenters
Mylynn Tufte, MBA, MSIM, RN
Practice Lead, Population Health
Optum Advisory Services
With more than 25 years of experience in health care, Mylynn helps organizations develop and implement solutions that improve health equity and social determinants of health. A former ICU nurse, she now leads the Optum Center for Health Equity. She is also a national speaker and instructor on population health policy and leadership. As the State Health Officer for North Dakota, she led the state department of health during the initial phase of the COVID-19 pandemic.
James Lukenbill, PhD
Analytics Strategic Product Manager
Optum State Government Solutions
James has a unique combination of project management, business development, and analytics skills. He has 15 years of experience in information technology, data warehouse, and project and program management, principally with Medicaid. James holds a PhD. in quantitative methods and started his career by applying complex mathematical models to detect fraud and abuse in Medicaid.
Ali Shirvani-Mahdavi, PhD
Vice President of Analytics Consulting
Optum State Government Solutions
Ali Shirvani-Mahdavi, Ph.D., is the Vice President of Analytics Consulting at Optum with a focus on consumer analytics and member engagement and is located in Minneapolis. With over 20 years of experience in health care and analytics consulting, Ali has an extensive and diverse background in healthcare analytics, social determinants of health, quality management, and consumer behavior in the healthcare marketplace.
Prior to joining Optum, Ali was the Executive Vice President of Health and Behavioral Sciences at a leading technology company focused on using technology, big data, analytics, and behavioral sciences to drive member activity to help improve population health and quality in government-sponsored plans (MA, Medicaid, and QHP).
In addition, Ali spent over 10 years at UnitedHealthcare's Medicare Advantage business as the head of Reporting and Analytics, and Accenture, where he led a number of transformational projects in analytics and customer engagement for Best Buy, AT&T, and Stanford Hospitals and Clinics. Ali received his Ph.D. in Behavioral Economics and Masters in System Engineering from MIT.
Collaborative Learning Roundtable 1: Intersections Between PDMP and Medicaid Programs with a Focus on Section 5042 of the SUPPORT Act
Abstract: CMS will soon be requiring state Medicaid agencies to partner with their state PDMPs to report on aggregate trends related to controlled substances prescribing and demographics and percentage of providers querying the PDMP prior to prescribing controlled substances. It is a significant challenge to accurately combine and match highly sensitive Medicaid patient and provider data with the PDMP’s controlled substances data and provider search history. Not doing so properly can impact the accuracy of the metrics you report.
In this session, we discuss how Medicaid agencies can partner with State PDMPs to bridge the data gap for covered patients and providers between state PDMPs and Medicaid agencies to meet the Section 5042 reporting requirements.
As the nation’s leading provider of Whole Person Care and comprehensive substance use disorder (SUD) solutions, the results of our experience in building the infrastructure, and best practices for PDMPs, clinical workflow integrations, interstate data sharing, advanced analytics for clinical decision support, and more have enabled our PDMP partners to deliver and deploy impactful, innovative solutions to address the complex opioid problem plaguing our communities.
Presenters:
Vatsala Kapur, Senior Director of Government Affairs, Bamboo Health
Adam Nitenson, Ph.D., Health Research Project Director, RI Department of Health
Kara Slusser, Director of INSPECT, Indiana Board of Pharmacy
Haley Winans, Specialist, Michigan Automated Prescription System (MAPS)
Douglas Padgett, Manager, Michigan Automated Prescription System (MAPS)
Collaborative Learning Roundtable 2: Alternative Data Sources to Accelerate “Future of Medicaid” Decision-Making and Person-Centered Care
Abstract: Digital transformation, interoperable systems, and data-sharing initiatives have resulted in state health agencies having more data than ever before. However, gaps in a real-world context and person-centered coordination persist. As States look ahead to pandemic “unwinding”, Medicaid agencies are faced with limited or outdated information on beneficiaries, complicating the realities of administrative decisions on eligibility and care coordination.
Furthermore, recognizing the impact of the pandemic on social determinants of health and the increase in the need for behavioral health services, Medicaid agencies have a unique opportunity to rethink their data management and invest in systems that provide a person-centered approach.
Specifically, this session dove into how alternative data sources enable Medicaid agencies to understand their beneficiaries as ‘whole people’, and in turn, have updated and precise data for care coordination & benefits eligibility. In this session, we explored how a referential data Master Person Index serves as the foundation for orienting data around an individual and sharing it across programs for unified care coordination. Then, we demonstrated examples of how alternative data sources for Social Determinants of Health improve population-level analytics, including risk for housing instability or hospital readmission. Lastly, we discussed a roadmap for utilizing alternative data in the PHE unwinding process and how agencies can access updated contact information for outreach, integrate SDOH into their care continuity plans, and streamline redetermination processes.
Presenters:
Kelly Hoover-Thompson, JD, Director, Government Health, LexisNexis
Diana Zuskov, MPH, Senior Director, Government Health, LexisNexis
Ashley Newmyer, Chief Data Strategist, Nebraska Department of Health and Human Services
Jamie Bland, CEO, Cync Health
Jason Vandenburg, IS Specialist/Investigator, New Mexico Medicaid Fraud Control Unit
Nonis Spinner, Medicaid Eligibility Director at the Indiana Family and Social Services Administration
Janet Reifschneider, State of Wyoming, Department of Health, Healthcare Financing Division
Jeff Grabinski, Analytics and Recovery Section Manager, Colorado HCPF
Collaborative Learning Roundtable 3: Fireside Chat with AWS and NC DHHS: Strategies from the start of the public health emergency (PHE) to the Unwinding and beyond
Abstract: The pandemic taught us a number of lessons. To survive a crisis situation, public HHS agencies need their systems and the data to be accessible, highly available, and rapidly scalable for programmatic outcomes to be achieved. Not just in a crisis, but all the time. Across the US, State Medicaid Agencies are considering what policy, operational, and technology strategies will help return their Medicaid program to pre-Public Health Emergency (PHE) operations. The State of North Carolina Department of Health and Human Services (DHHS) response to and management of the COVID-19 pandemic provides insight into the people, process, and technology strategies for the Medicaid unwinding and beyond.
This segment explored how NC DHHS successfully implemented modern strategies that have improved service delivery for their citizens and their agencies during the pandemic. The topics included lessons learned for technology enablement, digital engagement, and data strategy at scale.
- How technology enables a transparent and responsive government. A discussion on speed, agility, and scale.
- How to adopt strategies for the effective and efficient use of data.
- Reframing how citizens experience government and enabling digital engagement
Presenters:
Kat Lawrence, Medicaid Leader, AWS
Charles Carter, Assistant Secretary of Technology Services, NC Department of Health and Human Services
