Achieving Organizational Alignment to Drive Equitable Maternal & Infant Health Outcomes
Thursday, September 12 • 1:45pm - 2:35pm
Speakers:
Brian Shivler, National Senior Vice President, Sales, ProgenyHealth
Chantel Neece, DNP, MBA, APRN, FNP-BC, GERO-BC, CPHQ, SSBBP, Sr. Director Maternal/Child Services & Member SDO, Sentara Health Plans
Jennifer A. Sweet, MBA, MA, Chief Executive Officer, Aetna Better Health of Florida
Health inequities cost Americans an extra $320 billion a year in avoidable health care costs. Without meaningful change, these costs are expected to triple to $1 trillion by 2040 – about $3,000 a year for every American – and the health status of those most affected will continue to decline.
Nowhere is health inequity more visible than in maternal and infant health. By virtually every measure, health outcomes for U.S. women and their babies are the worst among the richest nations in the world. The depth and breadth of the crisis requires shifts across the entire healthcare landscape – with opportunity for MCOs and other partners to play a significant leadership role.
- Join us for an in-depth discussion on building equitable maternal and infant health outcomes by focusing on:
- Raising awareness among members to utilize an important benefit
Building trust in early stages of pregnancy - Fostering ongoing and active member engagement during prenatal, potential NICU admission, and postpartum stages
- Offering members multiple interactive engagement options
- Creating easier pathways to access
- Enlisting providers to play an active role in equitable care
- Driving collaboration among health plan resources and partners, and community and non-profit entities
LEARNING OBJECTIVES:
- Examine the barriers to achieving equitable maternal and infant health.
- Understand the key components to success in driving equitable care.
- Learn specific actions MCOs can take to promote better outcomes.
Rethinking Pregnancy, Childbirth and Post-Partum Tools and Policies: A Panel Discussion
Friday, September 13 • 10:00am - 10:50am
Speakers:
Lauren Barca, MHA, RN, BSN, Principal, LB Healthcare Consulting
Françoise Culley-Trotman, Chief Executive Officer, AlohaCare
Aerste Howells, Chief Commercial Officer, Icario
Debbie Weems, FACHE, Vice President, Health Solutions, Speak Benefits, a Morse Company
Pregnancy, childbirth and the post-partum period are increasingly precarious for women in the United States. With over 1.5 million babies born into Medicaid each year, or approximately 41% of all births(1), the stakes are high. Maternal mortality has been rising, with nearly 84% of pregnancy-related deaths thought to be preventable(2). Black women, particularly, face a much higher risk of complications – with 69.9 deaths per 100,000 live births in the US in 2021(3).Chronic health conditions, such as heart disease, diabetes and depression, have become a key contributing factor. Learn ways we can drive better outcomes for both mom and baby from better leveraging common tools like the Health Risk Assessment to working on long-term policy changes like making diapers a Medicaid benefit.
1 KFF analysis of Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. Data are from the Natality Records 2016-2022, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program.
2 Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019 | CDC. (n.d.). https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
3 Maternal mortality rates in the United States, 2021. (n.d.). https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm
LEARNING OBJECTIVES:
- Learn how existing tools, like the Health Risk Assessment, can provide deeper, actional insight into how to address care gaps in this population.
- Understand how changes in Medicaid policy at a state level can create better outcomes and opportunities for new moms.
- Explore the latest in thinking about how early interventions in transportation, food and housing security and access to care can change the future for moms.
MLTSS
Successful Strategies for Demonstrating Managed Care Readiness for the IDD Population
Thursday, September 12 • 10:00am - 10:50am
Speakers:
Taylor Blake, National Director of Network Management and Long-Term Services and Supports, Elevance Health
Craig Escudé, MD, FAAFP, FAADM, President, IntellectAbility
Lorene Reagan, MS, RN, Strategic Advisor, IntellectAbility
Shawn Rector, Self-Advocate
People with intellectual and developmental disabilities (IDD) have, for many years, been carved out of Medicaid managed care, primarily because managed care plans are perceived as having insufficient experience to effectively serve the population. But this is changing as more states take advantage of the benefits available through managed care to bend the cost trend for services for people with IDD, a population that incurs higher annual healthcare costs than people without IDD yet experiences the worst health outcomes.
Join this panel to learn about successful strategies for demonstrating organizational readiness for the IDD population from the RFP process through go-live and implementation. The three panelists, comprised of a managed care executive, a physician specializing in IDD healthcare, and a former state IDD director with managed care experience, will identify pain points and provide interventions designed to promote health equity, minimize member and provider abrasion, and manage costs across all aspects of managed care operations including member services, care management, utilization management, pharmacy, network adequacy and IT.
Using real-life case studies, panelists will highlight the pitfalls associated with managed care organizational readiness for people with IDD and provide a framework for structuring an effective organizational readiness review process.
LEARNING OBJECTIVES:
- Discuss the most common (and preventable) pain points associated with managed care readiness for the IDD population.
- Describe the medical conditions most likely to result in morbidity, functional decline, hospitalization, and mortality for people with IDD.
- Develop a framework for structuring an effective internal and external organizational readiness review process for the IDD population.
How Managed Care Organizations Can Use Value-Based Contracting to Improve Quality and Address the Direct Care Workforce Crisis
Thursday, September 12 • 1:45pm - 2:35pm
Speakers:
Tomas Bednar, Senior Vice President & Counsel, Healthsperien
Mary Kaschak, CEO, National MLTSS Health Plan Association
Anna Keith, Vice President, LTSS & Community Outreach, Centene
Kris Kubnick, CSW, MPA, Product Management Director, Elevance Health
Meaningful action to address direct care workforce shortages requires partnership and collaboration between states, health plans, and providers. As more states move to managed long-term services and supports (MLTSS), managed care organizations (MCOs) are responsible for developing a network of providers that have the capacity to support the growing population of people who need LTSS.
At the same time, MCOs are advancing the use of flexible funding models such as value-based contracting (VBC), that are focused on outcomes, instead of standard fee-for-service (FFS) arrangements, that are focused on hours of delivered supports or services. Under these new models, providers are empowered and enabled to find more flexible ways to meet members’ outcomes. For direct care workers, these models better support flexibility of their workday and contribute to greater job satisfaction by connecting their role to the members’ goals.
How can MCOs use VBC to address the ongoing direct care workforce crisis? The MLTSS Association has developed a set of actionable policy proposals and innovative best practices about how states and health plans can use VBC to support innovative models and system transformation needed to address workforce challenges.
LEARNING OBJECTIVES:
- Participants will learn concrete ways that MLTSS plans are advancing VBC for LTSS.
- Participants will learn about how VBC can support direct care workers.
- Participants will learn about MLTSS Association policy recommendations related to advancing VBC in the MLTSS space and addressing the direct care workforce crisis.
Barriers, Best Practices, and Policy Recommendations on Supporting a Consumer’s Navigation of their Integrated Care Options
Friday, September 13 • 10:00am - 10:50am
Speakers:
Ann Mary Ferrie, Vice President, Strategy and Public Policy, VNS Health
Chamiere Greenaway, Senior Policy Director, Healthsperien
Mary Kaschak, CEO, National MLTSS Health Plan Association
Kate Paris, Vice President Policy & Advocacy, UnitedHealthcare Community & State
While integrated health care coverage for dually eligible consumers has advanced significantly over the past decade, the sheer magnitude and types of integrated care options available has also correspondingly increased. Dually eligible consumers, who are already often managing an interrelated set of physical, behavioral, long-term care, and social health challenges, must navigate this complicated system, often with limited support.
This session will identify the key challenges consumers face in navigating their integrated care options, review best practices states, plans, and other stakeholders are leveraging, and offer policy recommendations to solution for barriers identified. Key topics to be discussed include enhancements to State Health Insurance Assistance Programs (SHIP), changes to Medicare Plan Finder, revisiting of certain marketing requirements, development of education materials, and other methods to ensure consumers are empowered to make the choice that best suits their needs.
The discussion will be a culmination of the MLTSS Association’s multi-month research effort in which best practices, barriers, and recommendations on dually eligible consumer navigation efforts are collected and assessed.
LEARNING OBJECTIVES:
- Participants will learn about best practices and recommendations coming out of the MLTSS Association's work on dually eligible consumer navigation efforts.
- Participants will learn about the consumer navigation challenges faced by dually eligible individuals.
- Participants will learn about potential enhancements to SHIPs.
Friday, September 13 • 1:45pm - 2:35pm
Speakers:
Mary Kaschak, Chief Executive Officer, MLTSS Association
Kate Paris, Vice President, Policy & Advocacy, UnitedHealthcare Community & State
Allison Rizer, Executive Vice President, Payer Solutions, ATI
The Medicare Advantage CY 2025 Final Rule lays out significant changes to the Medicare and Medicaid integration landscape. This Medicare Advantage focused rule will require states to contemplate program changes to enhance alignment for those who are dually eligible. When applied against a complex Medicaid environment full of carve outs, service areas and differing contracts, navigating state program design impacts will be necessary for states, health plans and consumers. Join policy partners and health plans in a conversation on the impacts to managed care, LTSS programs and Medicare integration.
LEARNING OBJECTIVES:
- Understand the major provisions made by the CY 25 Medicare Advantage Final Rule.
- Discuss the current Medicare and Medicaid integration landscape.
- Discuss the final rule’s impact to managed care, LTSS programs and Medicare integration
Policy
What’s on Tap for the Lame Duck: Congressional Activity Impacting Medicaid to Close Out 2024 (off the record/closed to press)
Thursday, September 12 • 10:00am - 10:50am
Speakers:
Sean Garrity, Director, Federal Affairs, Medicaid Health Plans of America
Heather Hallman, Director of Government Relations, UPMC Health Plan
Rick Van Buren, Director of Health Policy, Cozen O’Connor Public Strategies
Shannon Attanasio, Senior Vice President, Government Relations, Policy & Advocacy (Moderator)
A “lame duck” session in Congress is the period following the November elections and before the start of a new Congress when legislative activity, untethered from political dynamics impacting policymaking earlier in the session, shifts into overdrive. And lame ducks following Presidential elections, when the balance of power for both chambers of Congress and the Administration can shift, that process takes on added urgency. During this session, take a deep dive into the legislative priorities impacting Medicaid and managed care that Congress has their eye on for the 2024 lame duck session. Learn about where MHPA is focusing our Congressional advocacy and how your plan can plug into these efforts to advance legislation that best supports the millions of Americans who rely on Medicaid for lifesaving coverage and care.
2024 CMS Regulatory Sprint: A Panel Discussion on the Medicaid Impacts of Recently Finalized Rulemaking (off the record/closed to press)
Thursday, September 12 • 11:30am - 12:20pm
Speakers:
Andrea Bennett, Senior Director, Public Policy, CVS Health
Kate Paris, Vice President Policy & Advocacy, UnitedHealthcare Community & State
Jack Rollins, Director of Federal Policy, National Association of Medicaid Directors
Nicolas Wilhelm, Director, Medicaid Health Plans of America (Moderator)
2024 was a busy year for CMS, as they finalized a high volume of landmark final rules impacting managed care and the Medicaid program. Join us for a panel discussion as we walk through key final regulations including the Managed Care Rule, the Ensuring Access to Medicaid Services Rule, and the Enrollment and Eligibility Rule, highlighting the most significant provisions likely to shape the future of the Medicaid program.
Looking Beyond: Best Practices and Lessons Learned from the Medicaid Redetermination Unwinding Period
Thursday, September 12 • 1:45pm - 2:35pm
Speakers:
Mildred Menos, Director, Product Administration - Medicaid, Horizon BCBSNJ
Cora Steinmetz, Medicaid Director, Indiana Family and Social Services Administration
John Szczech, Director, Medicaid Program Management and Strategy Execution, Kaiser Permanente
Stephen Cozzo, Vice President Government & External Affairs/Public Policy, AmeriHealth Caritas (Moderator)
Through extensive Medicaid redetermination outreach campaigns and community engagement, states and MCOs have worked through many challenges with the goal of ensuring Medicaid beneficiaries maintained coverage during the Medicaid unwinding period. This session will share challenges, lessons learned, best practices, and how states and MCOs are looking ahead beyond the unwinding.
LEARNING OBJECTIVES:
- What were the challenges faced during the unwinding period for states and MCOs.
- What lessons can be learned from the unwinding period that can be carried into the future as redetermination processes return to normal.
- What best practices have come out of the unwinding and how are states and MCOs looking to the future.
Unlocking the Potential of Technology-Driven Solutions in Medicaid: MCO Learnings and Recommendations
Friday, September 13 • 10:00am - 10:50am
Speakers:
Paruj Acharya, Policy Director, Health Data, Technology and Consumer Experience, UnitedHealthcare Community & State
Steven Johnson, Executive Director, Government Programs, HCSC (tentative)
Gabe Moreno, Vice President, Provider, Clinical and Data Capabilities, UnitedHealthcare Community & State
Nick Wilhelm, Director, Regulatory Affairs, MHPA
The COVID-19 pandemic significantly accelerated the adoption of technology and digital platforms to improve healthcare delivery and access. The usage rate of eHealth solutions used by office-based physicians reached 88% in 2021. While the pandemic brought about a shift toward a more digitized health system, it also highlighted the need for improved digital health literacy, system interoperability and flexibility to reduce coverage losses. There’s an opportunity to utilize these advancements in technology to enhance the experience and health outcomes of the Medicaid population.
In 2023, MHPA completed a survey of more than 100 Medicaid MCOs about the efforts made to support the redetermination process, including best practices and opportunities. In the same year, UnitedHealthcare Community & State, which serves nearly 7 million Medicaid members, worked to identify key challenges and opportunities where technological advancements can address gaps in access, workforce shortages and health inequities.
In this session, Community & State and MHPA discuss policy and regulatory recommendations to modernize the current infrastructure, retain flexibilities to protect members in the future, and how MCOs and Medicaid stakeholders can develop comprehensive technology strategies and better integrate systems to meet each state’s Medicaid program goals.
LEARNING OBJECTIVES:
- Explore the opportunities presented by technological advancements to enhance the experience and health outcomes of the Medicaid population.
- Discuss the importance of improved digital health literacy, system interoperability and flexibilities needed to reduce coverage losses as seen in the redetermination process.
- Discuss how to modernize the current infrastructure and how tech solutions have the potential to improve three of the main friction points facing Medicaid programs today, including access to care, workforce shortages and ensuring equitable health outcomes.
SDoH
Achieving Health Equity Through 1115 Waivers
Thursday, September 12 • 10:00am - 10:50am
Speakers:
Karen Iapoce, RN-BC, MS, CPHQ, CMAC, CAPA, LSSBB,
Senior Director of Government Programs & Products, ZeOmega
Chantel Neece, DNP, MBA, APRN, FNP-BC, GERO-BC, CPHQ, SSBBP,
Sr. Director- Maternal/Child Services & Member SDOH, Sentara Health Plans
While data play a critical role in identifying disparities in healthcare, achieving health equity requires more than just numbers. It demands a deeper understanding of the social determinants of health, systematic policy changes, and collective efforts from all stakeholders. In light of recent developments, it is essential to examine Section 1115 Medicaid Waivers and their approvals to address Health-Related Social Needs (HRSN). Understanding these waivers and their impact is imperative in evaluating and enhancing healthcare systems across the country.
The inclusion of HRSN data in healthcare can significantly improve patient care. Sharing data between internal and external partners is crucial in comprehending and managing HRSNs that impact individuals, populations, and community health. Efficient data sharing can simplify referrals, improve patient care coordination, close gaps in care, and eliminate the unnecessary redundancy of repeated HRSN assessments, significantly improving the efficiency of the assessment process and enabling better allocation of valuable resources. Furthermore, it allows for more organized reporting and analysis of HRSNs at all levels.
Join us for a discussion on promoting health equity through linking data, bridging gaps, and addressing health disparities.
LEARNING OBJECTIVES:
- To promote best practices in the healthcare industry by prioritizing the identification and addressing of health-related social needs (HRSN) through connecting multiple data points within internal and external systems.
- To promote sharing health-related social needs (HRSN) data between internal and external partners to improve patient care, simplify referrals, and enhance care coordination.
- To foster a platform for discussion, collaboration, and learning on promoting health equity through linking data, bridging gaps, and addressing health disparities.
Emerging Trends on Implementing State Coverage of Health-Related Social Needs (HRSN) Within Managed Care
Thursday, September 12 • 11:30am - 12:20pm
Speakers:
Brad Barron, MPA, Director, Managed Care Plan Division, Behavioral and Physical Health and Aging Services Administration, Michigan Department of Health and Human Services
Tricia McGinnis, Executive Vice President, Center for Health Care Strategies
Shannon McMahon, Executive Director, Kaiser Permanente
Join representatives from Kaiser Permanente (KP), the Center for Health Care Strategies (CHCS), and a state Medicaid agency to discuss emerging trends on implementing state coverage of health-related social needs (HRSN) within managed care. CHCS in partnership with KP is leading the Medicaid Health-Related Social Needs Implementation Learning Series, and working with nine early innovator states: California, Massachusetts, Michigan, New York, North Carolina, Oregon, Pennsylvania, Washington State, and Wisconsin. Presenters will share emerging best practices and lessons learned about how states and health plans are working with CBO partners to implement delivery of new HSRN benefits, including contracting, workflow and data sharing processes, and collecting outcome measures.
LEARNING OBJECTIVES:
Understand approaches that early adopter states and plans are using to contract and implement new Medicaid HSRN benefits.
Gain health plan insights on successful strategies for standing up the benefits, including contracting, data sharing and achieving a positive ROI.
Discuss critical challenges and questions around new and evolving HRSN strategies.
Learn about emerging trends around in lieu of services and managed care contract requirements.
How Payer–Provider Partnerships Can Build Trust and Improve Health Outcomes for Vulnerable Medicaid Populations
Thursday, September 12 • 11:30am - 12:20pm
Speakers:
Darrell Gray II, MD, MPH, President, Wellpoint
Amy Miller-Bowman, VP of Business Development, MoIina Healthcare
Michael Radu, Chief Executive Officer, AbsoluteCare
Too often, payers and healthcare providers are at odds when it comes to treating patients, especially vulnerable and complex populations. Overwhelmed by social drivers including income, food insecurity, housing and transportation – combined with high levels of mental health and substance abuse issues – effective care management has historically eluded stakeholders. This presentation, however, will demonstrate that true partnership between payers and providers is not only possible, but also successful.
The speakers will share tools for working together to identify, engage, and provide care for Medicaid members, including a combination of a core, integrated team with a community outreach team. This model has demonstrated significant outcomes in reducing unnecessary hospital visits and lowering healthcare costs, while increasing consistent primary care visits and instilling trust in patients.
LEARNING OBJECTIVES:
How to build trust with vulnerable patient populations who historically have been marginalized by the healthcare system and oftentimes are skeptical of healthcare providers and services.
How to collaborate successfully with health plan partners to identify, engage and treat Medicaid members with chronic and complex conditions.
How to generate positive, enduring health outcomes for Medicaid members, including increases in preventative physician visits and health literacy, while decreasing unnecessary ED visits and inpatient admissions.
Beyond Food as Medicine: Nutrition for Life
Thursday, September 12 • 1:45pm - 2:35pm
Speakers:
Jillian Bridgette Cohen, CEO and Co-Founder, Virtual Health Partners
Suzanne Letang, LCPC, CCM, Clinical Strategy Manager, Health Care Service Corporation (HCSC)
Kathryn Tong, Chief Commercial Officer, Mom's Meals
Gary Jessee, Senior Vice President, Sellers Dorsey (Moderator)
Previously, states have successfully utilized food as medicine interventions in Medicaid through 1115 waivers, value-added services, in lieu of services, and value-based payment programs, among others. Generally, these supports are offered as food prescriptions, food education programs, or meal delivery services. While these methods have had some success and helped prove that nutritionally adequate diets can impact associated health care costs, they are time-limited, provide a narrow view of the needs of the Medicaid population as a whole, don’t provide the education needed to select healthy food or cook healthy meals, and can have a limited impact on preventable conditions and creating lasting change in eating habits. As food as medicine and other nutrition supports continue expanding, our panel of experts has been thinking about what comes next. Support for nutrition for life and the right to food have been gaining support as realistic next steps in Medicaid and the healthcare sector at large. Participants will gain additional knowledge, hear innovative ideas that point to the advancement of programs supporting health through diet, and feel inspired to continue assisting individuals in gaining access to additional resources and programs that will help them take control of their health for the long-term.
LEARNING OBJECTIVES:
- Provide an overview of the current state of the food as medicine movement and discuss changes that state agencies, providers, and other stakeholders could make.
- Trends in the provision of nutrition supports and why they may not be sustainable long-term. Innovations related to next steps and other options to provide food-related education and programming.
- Discuss next steps as it relates to food as a form of healthcare and talk about what nutrition for life could mean for individuals with preventable health conditions.
Advancing Chronic Care Access: Ochsner & Humana's RPM Partnership for Medicaid Beneficiaries
Thursday, September 12 • 1:45pm - 2:35pm
Speakers:
Kenny Cole, MD, System VP of Clinical Improvement, Ochsner Health
Kim Williams, MPP, Director, Health Equity & Population Health, Humana Healthy Horizons, Louisiana
Rob Keefe, National Director - Payer Market, Ochsner Health
Discover how Ochsner and Humana have revolutionized chronic care management through their innovative partnership. By leveraging remote patient monitoring (RPM) tools and a comprehensive care team, they're breaking down barriers for Medicaid beneficiaries in Louisiana, especially those facing social determinants of health challenges. Learn how this collaboration is driving better outcomes for diabetes and hypertension. This partnership started with a Medicaid pilot spearheaded by Ochsner and the Louisiana Department of Health, and then became an initiative between Ochsner and the community of MCO's in the State, including Humana.
See a recent health care publication press release on the relationship here:
https://mhealthintelligence.com/features/why-ochsner-humana-struck-an-rpm-partnership-for-chronic-care
LEARNING OBJECTIVES:
- Understand the significance of provider-payer partnerships in improving chronic care access for Medicaid populations.
- Explore the implementation of remote patient monitoring (RPM) programs targeting diabetes and hypertension.
- Learn strategies for addressing social determinants of health challenges to ensure equitable access to quality care.
The Unspoken Social Determinant of Health - Crafting a Loneliness Strategy for Optimal Outcomes
Friday, September 13 • 10:00am - 10:50am
Speakers:
Natalie Cooper, Plan President and CEO, Wellpoint Tennessee
Suze Cucci, EVP, Engagement and Outcomes, Pyx Health
Jami Snyder, President and CEO, JSN Strategies
WHO describes SDOH as “the non-medical factors that influence health outcomes… and the wider set of forces and systems shaping the conditions of daily life.” Within that wider set of forces is the construct of loneliness. With the COVID-19 pandemic, the devastating effects of loneliness and its comorbidity with other health-related social needs have come to the forefront of healthcare’s concern, particularly for those caring for the most vulnerable. Medicaid plans are increasingly vigilant about finding ways they can provide early intervention and support for their members who have a greater propensity for poor health outcomes as a result of unmet SDOH needs. Solving for social health factors like loneliness is one such way.
Led by a former state Medicaid Director, a panel of senior health plan and social health partner executives will explore interventions and additional support services to identify and combat loneliness as a solution for mitigating SDOH risks. They’ll present data on an innovative tech+human program that engages members via empathetic peer-to-peer engagement and a 24/7 resource-driven mobile platform to expand access to connectedness and support, and ultimately uncover and address a breadth of health-related social needs that exacerbate at-risk members’ challenges.
LEARNING OBJECTIVES:
- Learn to recognize loneliness as a significant social determinant of health, particularly its impact on vulnerable groups, within the WHO-defined framework of social determinants.
- Develop skills in crafting and integrating a loneliness strategy within Medicaid plans to address risks associated with social determinants of health, emphasizing early intervention and innovative support services.
- Acquire knowledge in implementing tech-driven programs and mobile platforms aimed at fostering empathetic peer-to-peer engagement and providing 24/7 support, with a focus on addressing loneliness and identifying broader health-related social needs among at-risk members.
Beyond Barriers: Utilizing Technology to Overcome SDOH and Engage Medicaid Populations
Friday, September 13 • 1:45pm - 2:35pm
Speakers:
Suzanne Moxham, Director of Quality, Accreditation, & Government Programs, CareFirst BlueCross BlueShield
Sebastian Seiguer, CEO and Co-Founder, Scene Health
Medicaid members are challenging to reach and engage, leaving MCOs in the dark. Without the necessary insights for targeted interventions, plans are forced to rely on generic alternatives that deliver subpar outcomes.
In this presentation, Suzanne Moxham, (CareFirst BlueCross BlueShield) and Sebastian Seiguer (Scene) explore how CareFirst Community Health Plan Maryland (CareFirst CHPMD) and Scene Health partnered to understand and address the Social Determinants of Health (SDoH) faced by a hard-to-reach Medicaid cohort.
Through a MedEngagement approach that uses 1:1 asynchronous video, chat, phone, and mail to deliver personalized medication support, Scene’s care team built trusted relationships with CareFirst CHPMD members, learned about their lived experiences and challenges, and linked members to care and resources. Through an average of 166 engagements per member, Scene’s care team motivated pro-health behaviors and shattered preconceived notions about engagement within this population.
Supplemented by real-world data, the presentation will highlight the tangible results of this collaboration, including improved medication adherence rates, expanded access to preventative care, elevated member engagement, and improved clinical outcomes and HEDIS measures, including HBD, AAP, KED, EED, SPD, and AMR.
LEARNING OBJECTIVES:
- Discover how personalized 1:1 async video engagement eliminates accessibility barriers and encourages Medicaid members to share challenges and insights while challenging preconceived ideas about “hard-to-reach” populations.
- Learn how to reach Medicaid members where they are and achieve an average of 166 engagements per member.
Understand the impact of the - CareFirst CHPMD and Scene Health partnership to improve medication adherence, HEDIS measures, and clinical outcomes for a Medicaid cohort with chronic conditions.