2010 Medicaid Managed Care Conference

About the Conference

2010 Medicaid Managed Care Conference
Innovative Strategies for Controlling Costs and Maximizing Revenue while Maintaining Quality in the Era of Healthcare Reform

September 27-28, 2010 • Washington, DC

The passage of healthcare reform brings massive changes to not only the entire healthcare system but also specifically to Medicaid managed care programs. According to the Kaiser Family Foundation, the expansion of Medicaid eligibility will bring an estimated additional 16 million people under coverage by 2019. This new population brings new types of market segments that state health plans need to serve, including enrollees with different healthcare needs, demands and risk profiles, thus translating to new benefits, new payment rates and increased costs. At the same time, this program expansion creates enormous prospects for commercial health plans.

The Medicaid Managed Care Challenge!

In an era of state budget deficits with federal stimulus packages ending later this year, managed care programs need systems and strategies in place to ensure they are able to deliver quality care in a cost-effective manner. In this high-level conference, we bring together industry and government leaders to share their insights and expertise on how the new health legislation will impact Medicaid managed care, including challenges and prospects. Our speaking faculty, comprised of state Medicaid program directors, health plan chief executives and industry experts, reveal best practices for optimizing Medicaid managed care in an evolving world. This exclusive event targets senior level government officials and executives in order to maximize educational and networking opportunities.

The Medicaid Managed Care Issues!

Learn what others in the Medicaid arena are doing to be prepared for the challenges that lie ahead in 2010, 2014 and beyond.

The 2010 Medicaid Managed Care Conference, taking place in Washington, DC on September 27-28, 2010 will provide you with the strategies necessary to:

•		Learn from states with experience providing Medicaid coverage to childless adults and adults earning 133% of the FPL
•		Explore the challenges and opportunities of finding and assisting high risk/high cost members
•		Analyze how state Medicaid programs and health plans can collaborate to create policy concerning prescription drug rebates
•		Understand how to reduce administrative costs and maximize efficiency
•		Hear case studies of a successful Medicaid long-term care structure, how to incorporate a medical home into a managed care setting and integrated behavioral/physical health models
•		Examine the Mental Health Parity Law and how it will impact health plans
•		Participate in a discussion debating whether Medicaid-only managed care organizations are sustainable
•		Optimize network development in order to attract members
•		Enhance marketing and outreach efforts
•		Utilize technology to expand eligibility and enrollment
•		Implement models for managing long-term care for dual eligibles
•		Evaluate successful children’s programs and strategies plans are employing to increase the number of child visits provided

The Medicaid Managed Care Solution!

www.2010medicaid.com

Who Should Attend

WHO SHOULD ATTEND

From State & Government Agencies:

Directors and Managers of:

• State Medicaid

• Policy Analysis

• Managed Care

• Compliance

• Health Services/Healthcare Programs

• Quality Assurance

• Human/Social Services

• Quality Improvement

• Medical Assistance

• Healthcare Financing

• Strategic Planning

From Health Plans & Managed Care Organizations:

Chief Executive Officers, Chief Operating Officers, Chief Financial Officers, Chief Medical Officers, Chief Strategy Officers, and Chief Information Officers

Also, Presidents, Vice Presidents, Directors and Managers of:

• Medicaid

• Compliance

• CHIP

• Government/State-Sponsored Programs

• Long-Term Care

• Clinical Affairs

• Behavioral Health

• Finance

• Sales and Marketing

• Operations

• Network Development

This Program is Also Relevant to:

Chief Executive Officers, Presidents, Vice Presidents, Directors and Managers from organizations providing the following programs/services:

• Purchasing Pools

• Non-Emergency Medical Transportation Management

• Care Management Technology

• Healthcare/Medicaid Consulting

• Radiology Management

• Reinsurance Services

• Third Party Recoveries

• Business Development Management

• Pharmacy Benefit Administrators

• Healthcare Administrative Management

• Risk Adjustment

• Business Process Organizations

• Behavioral Health Management

• Revenue Enhancement Services

• Health Management Solutions

• Care Management for the Elderly

Conference Workshop Sessions

WORKSHOP A:
Monday, September 27, 2010 • 5:15 p.m. – 7:15 p.m.

Coping with the Evolution of Health Reform: Key Medicaid Impacts for States and Health Plans

About Your Workshop Leader: Joel Menges is a Managing Director at THE LEWIN GROUP. He has worked extensively designing, developing, strengthening and evaluating Medicaid managed care initiatives. He has directed or co-directed engagements for dozens of health plans and for more than 30 state Medicaid agencies. He has conducted work in the Medicare and Medicaid managed care arenas throughout the past 25 years. Mr. Menges is a nationally recognized leader in identifying and promoting growth opportunities for the Medicaid managed care industry as a whole. He has led several studies in this arena and is regularly invited to make key industry presentations at meetings with Administration and Congressional leadership staff. Prior to joining The Lewin Group, Mr. Menges worked for AmeriChoice, helping develop the firm’s New York City health plan. He also worked for six years at a managed care consulting firm after beginning his career at the Department of Health and Human Services.

WORKSHOP B:
Tuesday, September 28, 2010 • 12:45 p.m. – 2:45 p.m.

Achieving Actuarial Soundness: Creating Medicaid Reimbursement Models and Capitation Rates

About Your Workshop Leader: Jeremy Palmer, FSA, MAAA is a Principal and Consulting Actuary at MILLIMAN, INC. He has developed an expertise in the financial forecasting, reporting and reserving of all types of health insurance, including individual, group and Medicare supplement populations. He has extensive experience in the evaluation of commercial HMO and PPO networks, including negotiation and strategy of hospital and professional reimbursement mechanisms, as well as healthcare trend analysis. Prior to joining Milliman, Mr. Palmer worked with Anthem Blue Cross Blue Shield for eight years.

Conference Day One

Day One – September 27, 2010

8:00	Conference Registration & Morning Breakfast
8:50	Chairperson’s Opening Remarks Nancy C. Everitt, MBA President & CEO HEOPS, INC. Tennessee Supreme Court Rule 31 Listed Mediator
9:00	Keynote Presentation: Turning Straw into Gold: Harnessing HCBS Networks (Home and Community Based Services) as a Provider Network Strategy for Global Health Reform Nancy C. Everitt, MBA Tennessee Supreme Court Rule 31 Listed Mediator President & CEO HEOPS, INC. Connie L. Hein, PMP Project Manager HEOPS, INC.
9:45	Redefining Medicaid: Ensuring Sustainability in Caring for the “New” Population Terence Dougherty Medicaid Director MASSACHUSETTS DEPARTMENT OF HEALTH AND HUMAN SERVICES Tom Traylor Vice President, Federal, State & Local Programs BOSTON MEDICAL CENTER/ BMC HEALTHNET PLAN Molly Voris, MPH Program Director, Health Division, Center for Best Practices NATIONAL GOVERNORS ASSOCIATION
10:30	Networking Break and Refreshments
11:00	Healthcare Reform Expansion Populations: Are They "Sicker"? Brian Wheelan Vice President, Strategy & Development BEACON HEALTH STRATEGIES, LLC
11:45	Keynote Presentation: Complex Care Management: Forget About 80/20; Focus on One and Thirty Thomas Kelly Head of Medicaid AETNA Coleen Kivlahan, MD Chief Medical Officer AETNA MEDICAID
12:30	Luncheon for Speakers and Delegates TRACK A: Integrated and Innovative Managed Care Models
1:30	Case study: An Example of a Medicaid Long-Term Care Model Sandra Esner Director, Program Development, HomeFirst METROPOLITAN JEWISH HEALTH SYSTEM
2:15	Managing Long-Term Care Services for Dual Eligibles Patrick Roohan Director, Division of Quality & Evaluation Office of Health Insurance Programs NEW YORK STATE DEPARTMENT OF HEALTH Maya Altman Executive Director HEALTH PLAN OF SAN MATEO
3:00	Networking Break and Refreshments
3:30	Case Study: Implementing a Medical Home Model in a Managed Care Setting Mark Reynolds Chief Executive Officer NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND Vivianne Chaumont Director, Division of Medicaid & Long-Term Care NEBRASKA DEPARTMENT OF HEALTH & HUMAN SERVICES Dr. Craigan Gray Director, Division of Medical Assistance NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES
4:15	Designing an Integrated Behavioral and Physical Health Program Moderator: Tony Kotin, MD Chief Medical Officer MAGELLAN HEALTH SERVICES Panelists: John Lovelace President UPMC for You Vice President, Medicaid Services UPMC HEALTH PLAN John Mathewson Executive Vice President HSC FOUNDATION HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS TRACK B: Enhancing Network Development
1:30	Best Practices for Extending Health Plan Marketing and Outreach to the Newly Eligible Robert Robidou Director, Network Development COOK CHILDREN’S HEALTH PLAN
2:15	Methodologies for Building a Medicaid Provider Network Lyle Luman Chief Executive Officer CenCal HEALTH
3:00	Networking Break and Refreshments
3:30	Surveying Technology Solutions for Expanding Eligibility and Enrollment Cate Bowman Director, Product Management RELAYHEALTH PAYOR SERVICES Tom Early Chief Executive Officer HEALTH PLUS Teri Green State Medicaid Director WYOMING DEPARTMENT OF HEALTH
4:15	Analyzing the Competitive Landscape for Medicaid Managed Care Thomas Johnson President & CEO MEDICAID HEALTH PLANS OF AMERICA Ingrid Lamirault Chief Executive Officer ALAMEDA ALLIANCE FOR HEALTH Dr. Michael Garner President & CEO FLORIDA ASSOCIATION OF HEALTH PLANS
5:00	End of Day One

Conference Day Two

Day Two – Tueday, September 28, 2010

7:30	Morning Breakfast
8:10	Recap of Day One
8:15	Exploring the Changes to Medicaid Prescription Drug Rebate Programs: Developing Successful Policy to Maximize Opportunities Meg Murray Chief Executive Officer ASSOCIATION FOR COMMUNITY AFFILIATED PLANS Janet Grant Executive Vice President CARESOURCE
9:00	Improving Products and Programs for Children Cheryl Roberts Deputy Director, Programs and Operations VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES John Grgurina Chief Executive Officer SAN FRANCISCO HEALTH PLAN Joe Vesowate Deputy Director, Managed Care Operations, Medicaid/CHIP TEXAS HEALTH & HUMAN SERVICES
9:45	CMS UPDATE: How Federal Innovations Will Affect Medicaid Managed Care Mary Kennedy Senior Advisor, Center for Medicaid, CHIP and Survey & Certification CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)
10:30	Networking Break and Refreshments
	TRACK A: Cost Containment Mechanisms
11:00	Doing More with Less: Effectively Managing the Escalation of Medicaid Managed Care Costs Gary Alexander Secretary RHODE ISLAND EXECUTIVE OFFICE OF HEALTH & HUMAN SERVICES Director RHODE ISLAND DEPARTMENT OF HUMAN SERVICES Judy Zerzan, MD Medicaid Medical Director COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING Curtis Cunningham Deputy Director, Bureau of Fiscal Management WISCONSIN DEPARTMENT OF HEALTH SERVICES
11:45	Increasing Administrative Efficiencies through Medicaid Education Marie Schwartz-Day, PMP, MCMP-II Managing Director THE MEDICAID LEARNING CENTER
	TRACK B: Ensuring Quality through Information Technology
11:00	Leveraging State and Managed Care Organizations for Encouraging HIT Adoption Cheryl Bupp Director, Managed Care Plan Division MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Dianne Hasselman Director, Quality & Equality CENTER FOR HEALTH CARE STRATEGIES
11:45	Utilizing Information Exchanges to Improve Quality of Care Ivan Handler Chief Information Officer ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
12:30	Conference Concludes

Speaking Faculty

Terence Dougherty Medicaid Director MASSACHUSETTS DEPARTMENT OF HEALTH AND HUMAN SERVICES		Tom Traylor Vice President, Federal, State & Local Programs BOSTON MEDICAL CENTER/ BMC HEALTHNET PLAN
Molly Voris, MPH Program Director, Health Division, Center for Best Practices NATIONAL GOVERNORS ASSOCIATION		Brian Wheelan Vice President, Strategy & Development BEACON HEALTH STRATEGIES, LLC
Thomas Kelly Head of Medicaid AETNA		Coleen Kivlahan, MD Chief Medical Officer AETNA MEDICAID
Nancy C. Everitt, MBA Tennessee Supreme Court Rule 31 Listed Mediator President & CEO HEOPS, INC.		Connie L. Hein, PMP Project Manager HEOPS, INC.
Jeremy Palmer, FSA, MAAA Principal & Consulting Actuary MILLIMAN, INC.		Sandra Esner Director, Program Development, HomeFirst METROPOLITAN JEWISH HEALTH SYSTEM
Patrick Roohan Director, Division of Quality & Evaluation Office of Health Insurance Programs NEW YORK STATE DEPARTMENT OF HEALTH		Maya Altman Executive Director HEALTH PLAN OF SAN MATEO
Mark Reynolds Chief Executive Officer NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND		Vivianne Chaumont Director, Division of Medicaid & Long-Term Care NEBRASKA DEPARTMENT OF HEALTH & HUMAN SERVICES
Dr. Craigan Gray Director, Division of Medical Assistance NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES		John Lovelace President UPMC for You Vice President, Medicaid Services UPMC HEALTH PLAN
John Mathewson Executive Vice President HSC FOUNDATION HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS		Joel Menges Managing Director THE LEWIN GROUP
Robert Robidou Director, Network Development COOK CHILDREN’S HEALTH PLAN		Lyle Luman Chief Executive Officer CenCal HEALTH
Tom Early Chief Executive Officer HEALTH PLUS		Thomas Johnson President & CEO MEDICAID HEALTH PLANS OF AMERICA
Teri Green State Medicaid Director WYOMING DEPARTMENT OF HEALTH		Ingrid Lamirault Chief Executive Officer ALAMEDA ALLIANCE FOR HEALTH
Dr. Michael Garner President & CEO FLORIDA ASSOCIATION OF HEALTH PLANS		Meg Murray Chief Executive Officer ASSOCIATION FOR COMMUNITY AFFILIATED PLANS
Janet Grant Executive Vice President CARESOURCE		Cheryl Roberts Deputy Director, Programs and Operations VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
John Grgurina Chief Executive Officer SAN FRANCISCO HEALTH PLAN		Joe Vesowate Deputy Director Managed Care Operations, Medicaid/CHIP TEXAS HEALTH & HUMAN SERVICES
Gary Alexander Secretary RHODE ISLAND EXECUTIVE OFFICE OF HEALTH & HUMAN SERVICES Director RHODE ISLAND DEPARTMENT OF HUMAN SERVICES		Judy Zerzan, MD Medicaid Medical Director COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
Curtis Cunningham Deputy Director, Bureau of Fiscal Management WISCONSIN DEPARTMENT OF HEALTH SERVICES		Cheryl Bupp Director, Managed Care Plan Division MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
Dianne Hasselman Director, Quality & Equality CENTER FOR HEALTH CARE STRATEGIES		Ivan Handler Chief Information Officer ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
Cate Bowman Director, Product Management RELAYHEALTH PAYOR SERVICES		Mary Kennedy Senior Advisor, Center for Medicaid, CHIP and Survey & Certification CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)
Tony Kotin, MD Chief Medical Officer MAGELLAN HEALTH SERVICES		Marie Schwartz-Day, PMP, MCMP-II Managing Director THE MEDICAID LEARNING CENTER

Venue and Pricing

Standard Rate/Vendors/Solution Providers	Register by September 10, 2010	Register by September 27, 2010
Conference Only	$1395	$1595
Conference + 1 Workshop	$1595	$1795
Conference + 2 Workshops	$1795	$1995

Health Plans	Register by September 10, 2010	Register by September 27, 2010
Conference Only	$1195	$1395
Conference + 1 Workshop	$1395	$1595
Conference + 2 Workshops	$1595	$1795

Government/Public Sector	Register by September 10, 2010	Register by September 27, 2010
Conference Only	$395	$595
Conference + 1 Workshop	$495	$695
Conference + 2 Workshops	$595	$795

Venue:

Grand Hyatt Washington
1000 H Street NW
Washington, DC 20001
800-233-1234

*Mention priority code 'Global Media Dynamics' to secure special hotel rate of $210/night.

You can also use the following link to make your hotel reservations:

https://resweb.passkey.com/Resweb.do?mode=welcome_ei_new&eventID=2562454

Sponsors & Exhibitors

Platinum Sponsor

HEOPS Inc. provides patient access solutions to public sector health plans, state agencies, commercial insurers, self insured employers and patients through the strategic design and creation of provider networks, call centers, competitive intelligence, data analytics and transportation solutions. HEOPS is the most robust full source patient access partner in the nation, providing turnkey support services such as custom mailing, email communication, contract administration, provider networks, call centers, data analytics, complex mapping and disruption analysis. Clients look to HEOPS for inspired concepts and performance excellence when stakes are high, time is short and results are a requirement.

Through proven ISO processes, HEOPS delivers quick quality results that impact Client success and profitability. Over the past three years, HEOPS has successfully led 125+ network development projects for many of the nation’s top health plans yielding best practices and unparalleled industry perspective. Choose HEOPS for insight and strength in preparing and executing key strategies for health care reform.

Gold Sponsor

Beacon Health Strategies LLC is a leading care management company that specializes in customized behavioral health solutions on behalf of health insurance companies, managed care organizations, and state and local governments. Beacon's suite of care management and population health programs helps individuals access timely, appropriate and effective mental health and substance abuse services. Through proven clinical protocols, rigorous analytics and an understanding of the co-morbidity of behavioral health with chronic psychical health conditions, Beacon is able to lower healthcare spending trends on behalf its clients and improve health outcomes for its members. Founded in 1996 and headquartered in Woburn, Massachusetts, the Company is considered a pioneer in the implementation and administration of behavioral health managed care programs, particularly for Medicaid, disabled and dually eligible populations.

Silver Sponsors

About RelayHealth -- RelayPayor^_TM

RelayHealth, McKesson's connectivity business, operates as a neutral partner in an open network environment, offering connectivity services and integration among all organizations, systems, and solutions.

RelayHealth securely processes more than 12.8 billion financial and clinical transactions annually. RelayHealth has extensive expertise in revenue cycle management, healthcare financial transactions and information technology. By providing end to end solutions, the gap between providers and payers is reduced and electronic transactions are significantly simplified.

RelayHealth Payor Connectivity Services (PCS) is a HIPAA compliant gateway and a flexible platform for managing transactions and connectivity. Built to handle health plan requirements such as HIPAA 5010 compliance, clinical data transactions, and pre-adjudication processing, PCS is the next evolution in connectivity solutions. For more information, call (800) 778-6711, or visit www.fasttrack5010.com.

Magellan Health Services is the nation's premier diversified specialty health care management company focused on the Medicaid population in managed care plans and fee-for-service. Our public sector behavioral health experience is unrivaled --- managing the mental health and substance abuse services of more than 1.9 million Medicaid beneficiaries today.

Magellan's radiology, specialty pharmaceutical, and Medicaid pharmacy administration solutions deliver improved clinical and quality outcomes, increased consumer engagement, and guaranteed cost savings to public budgets.

Exhibitors

Milliman is a firm of actuaries and consultants serving the full spectrum of business, governmental and financial organizations. Founded in 1947 and incorporated in 1957, Milliman is located in 32 cities throughout the United States. Milliman employs more than 2,000 persons, over 900 of which are Fellows and Associates of the Society of Actuaries and the Casualty Actuarial Society. Milliman utilizes National Steering Committees to provide overall coordination and quality control for each consulting discipline. The Committees establish policy, develop guidelines, implement the peer review process, and provide support to local offices.

Milliman has grown over the years by expanding into new cities and by offering additional services. Growth has come occasionally by merger but most often, by attracting new professionals who are committed to the basic principles of the firm. Our professionals have backgrounds in actuarial science, insurance, mathematics, investments, compensation, communications, accounting, computer science, health care, finance, marketing, and economics. This allows us to offer our clients the diversity of experience that is required of today's effective consultant. We are known for our client centered approach, accumulated experience, and exceptional technical expertise.

Recognized as a leading provider of business process outsourcing solutions to healthcare payers, Firstsource delivers operational excellence and proven best practices to provide clients with focused, industry-recognized solutions to achieve greater business return on investment and decrease risk associated with business challenges. Firstsource focuses on creating cost-effective business process outsourcing solutions that apply advanced technologies, ensure process efficiency, and utilize skill-based assignment of work processes. With more than 20 years of experience, Firstsource has processed hundreds of millions of claims for some of the nation’s leading healthcare payers, including many Blue Cross and Blue Shield plans, third-party administrators and provider-based health plans.

Human Arc provides dual eligibility outreach/retention and documentation/adjustment services to Medicare Advantage plans, dual status re-determination programs for SNP’s, SSI enrollment assistance to Medicaid plans, plus the only complete solution for commercial insurance plans to the challenges of federal disability program enrollment and the opportunities of Medicare conversion. See www.HumanArc.com/healthplanservices.

Sellers Dorsey is a national health care consulting firm, recognized for its work in over 30 states and with national health care stakeholders. Sellers Dorsey provides strategic consulting services to state or local governments, private sector companies, and advocacy organizations. Our consultants add value by providing insight on how politics, policy and business intersect to affect businesses, state governments and consumers. We work to redefine the possibilities for our clients.

HealthHelp, a leader in specialty benefit management, generates significant savings and return on investment for health care payers by enhancing physician knowledge, improving quality of care, and reducing unnecessary radiation exposure. Each of its programs addresses a different aspect of diagnostic imaging, cardiology, and radiation oncology. The clients of Houston-based HealthHelp administer local, statewide, and national health care plans across the country. For more information about HealthHelp's programs, visit www.healthhelp.com.

TMG Health is a technology-enabled, Business Process Outsourcing (BPO) services firm providing a variety of administrative services to the Medicare, Medicaid and retiree health plan markets. As the leading vendor in this field, TMG Health provides operational outsourcing solutions and information systems for health plans, providers and insurers. Visit our website at: www.tmghealth.com.

The Assist Group is the industry leader in complex claims resolution services, leveraging advanced technology and industry experts to develop, ClinAssist, the next generation of claims management solutions. ClinAssist provides comprehensive claim resolution services from screening through settlement that significantly reduce costs. Our products also include CareAssist, offering complete clinical and financial management of complex newborns. Founded in 1999, The Assist Group has offices in Lakewood, Colo. and Irvine, Calif.

For sponsorship opportunities please contact Justin Sanders at 800-646-9581 or email him at jsanders@globalmediadynamics.com

Media Partners

Medicaid Health Plans of America (MHPA) is the leading trade association solely focused on representing Medicaid health plans. MHPA is a nonprofit, tax-exempt organization formed in 1993 and incorporated in 1995. The mission of MHPA is to develop and advance public policy that controls costs and improves access and delivery of quality health care to Medicaid members.

Medicare Advantage News is a biweekly newsletter from AIS with news and analysis of changes to the Medicare Advantage and Part D programs, plus intelligence on strategies to boost enrollees and reduce costs. Visit http://www.aishealth.com/Products/NewsMAN.html to learn more.

About The Managed Care Information Center: Trusted and relied upon for more than 20 years by healthcare providers, payors, consultants, pharmaceutical companies, suppliers and government agencies, the Managed Care Information Center (MCIC) gathers, collects, compiles, analyzes, studies, interprets and distributes business news and information on the managed care industry. The MCIC delivers this strategic business information to its clients via senior executive newsletters, yearbooks, leading industry databases and directories, management reports, teleconferences, webcasts and client research studies. The information is available in print, on CD-ROM and online.

To become to a supporting partner, please contact Jack Parrish at 800-646-9581 or email him at jparrish@globalmediadynamics.com