Tag: Interviews

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Medicaid Buy-In: Episode#6- Interview with Barbara Otto

Listen to the Podcast

  • Guest Bio
  • Show notes

Barbara OttoBarb is the CEO of Smart Policy Works, a Chicago-based firm that is is a driving force behind building smarter systems of health and social determinants of health for vulnerable people and places across the nation, state of Illinois, and metropolitan Chicago. Before her time at SPW, she worked at the 9to5 National Association of Working Women and at Ernst and Young. 

Highlights from this episode

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  • Previous buy in efforts for IDD populations
  • Medicaid buy in as a path to expand coverage
  • The additional flexibilities and authorities in Medicaid as compared to Medicare. 
  • Unpacking 1332 waivers, including uses beyond just reinsurance
  • How to make Buy In programs successful
  • Importance of well thought out financing model for buy in program stability
  • Why states cant go it alone (ie cant do it without federal matching dollars, and need health system stakeholder participation)
  • The role of actuaries in Medicaid buy in programs
  • Predicting uptake of Medicaid buy ins nationwide

About our Sponsor

This was made possible by support from WEX Health. Please take a moment to learn more about what they do by visiting wexinc.co/public-sector

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Medicaid Buy-In: Episode#4- Interview with Bryan Cutler

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  • Guest Bio
  • Show notes

Bryan CutlerBryan is the majority leader in the PA State House, where he has served for 14 years. Before his time in the legislature, he worked in hospital administration and as a radiology technician. He also is an attorney who currently practices law at Nikolaus and Hohenadel.

Highlights from this episode

  • Background of effort in PA
  • Dealing with impact of decreasing federal funds under ACA
  • Importance of wide support from provider, plan and regulators in getting the 1332 waiver for reinsurance
  • Overview of the public option in PA
  • Legislative groundwork needed to prepare for the public option
  • Timeline for PA exchange rollout
  • Key steps for states to exit federal marketplace successfully
  • Impact of the reinsurance waiver; transparent reporting to consumer comparing costs with and without the 1332 waiver
  • Using a public option model as way to reform Medicaid, including incorporation of social determinants
  • Provider response to the proposed model has been overwelmingly positive
  • Previous provider quality initiatives laid groundwork for smoother transition today
  • Increasing impact of Medicaid spending on other state budget priorities like education and roads
  • Predicting national uptake of public option models

About our Sponsor

This was made possible by support from WEX Health. Please take a moment to learn more about what they do by visiting wexinc.co/public-sector

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Medicaid Buy-In: Episode#3- Interview with Dylan Roberts

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  • Guest Bio
  • Show notes

Dylan RobertsDylan is the state representative for Colorado House District 26. In that role he serves as the chair of multiple committees, including the Rural Affairs and Agriculture Committee, the Capital Development Committee and the Judiciary Committee. He is also the Deputy District Attorney for Colorado’s 5th Judicial District.

Highlights from this episode

  • Demand from his constituents to address the excessive high costs of healthcare and insurance
  • Bringing in more competition and new savings measures
  • Overview of CO plan / proposal
  • Problems with 22 counties that only have 1 option on exchange
  • Bill to examine public option proposal in 2019
  • Stakeholder meetings and actuarial analysis
  • Use of reference-based rates for hospitals as key to allowing plans to offer cheaper products
  • Advice on policies and systems states need to have in place for public option to work
  • High healthcare costs in CO as driver for change; political pressure to find a solution
  • Compared to Washington (state) public option bill in 2019
  • Provider support of plan
  • Using Medicare rates as benchmark for public option plan facility rates
  • Longer term benefits to facilities of public option models
  • Predicting uptake of public option model nationwide

About our Sponsor

This was made possible by support from WEX Health. Please take a moment to learn more about what they do by visiting wexinc.co/public-sector

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Medicaid Buy-In: Episode#2- Interview with Adam Fox

Listen to the Podcast

  • Guest Bio
  • Show notes

Adam FoxAdam is theDirector of Strategic Engagement at Colorado Consumer Health Initiative  . He advocates for better consumer access to healthcare in Colorado and has been featured as a thought leader on national news outlets such as CNN. In his role at CHHI he focuses on communication strategies, media engagement and driving the policy agenda in his state. 

Highlights from this episode

  • Background of the public option effort in CO, including the legislative path
  • Why its less feasible for CO to pursue a Medicaid buy-in path (the CO Taxpayer Bill of Rights)
  • Clarification of Colorado Public Option key details, including
    • premiums and subsidies on CO exchange under new option
    • increasing number of carriers operating in various counties
    • regulatory authority under the CO public option
    • benefit design and MLR
  • A better understanding of what is meant by the “public/private partnership” model
  • Why rate caps for hospitals are key to the plan
  • Key changes and systems needed to operate a public option plan
  • Importance of strong consumer outreach and enrollment functions
  • Effectively engaging legislators in the effort
  • Provider pushback on the price controls component
  • Plan response to the proposed model

About our Sponsor

This was made possible by support from WEX Health. Please take a moment to learn more about what they do by visiting wexinc.co/public-sector

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Episode#5: Interview with Roger Hebden

Guest bio

Roger is the CEO of Livanta, which is a Medicare Quality Improvement Organization (a QIO). Before his time at Livanta, Roger has spent more than 20 years in IT and healthcare space, including roles at Microsoft, Dell, and Sutherland.

Highlights from this episode

  1. How medical records still are sent via snail mail and fax as primary mechanism for Medicare QIOs
  2. FIHR, BlueButton 2.0
  3. Using member education in an interoperable system that helps patients manage medical records
  4. Improving communications channels, including the limits of telephones and the opportunities with secure text
  5. What we make available vs what people use
  6. The limits of provider portals

the journey to appropriate consent management

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Episode # 4- Interview with Mary Alice Hunt

Guest Bio

Mary Alice is the North American Solutions lead at IBM Watson Government Health and Human Services. She has spent nearly 20 years developing solutions for state clients that focus on integrated eligibility, care management and healthcare reform. Before her time at IBM, she taught information technology at the State University of Albany, led product development at Curam and helped to modernize New York State technology systems.

Highlights from Episode

  • How quickly technology is advancing and the impact that has on interoperability efforts
  • Multiple challenges in interoperability, such as
    • Challenges of integrating various types of data being integrated before we are even ready for it in the private sector, and in government world it lagging
    • challenge of different terminology for same information
    • challenges in matching patient records
    • how our patient identifiers change over our lifetime
  • A plain language explanation of APIs
  • Various topics around patient data access, including:
    • Providing patients with meaningful insights about their health using their data
    • Challenge of getting data to Medicaid members
    • Challenges in consent management
  • Importance of starting with the right data model when designing consent management functions
  • Key data governance and design insights, including
    • designing for exceptions
    • making sure data is shared but not propagated; using a central repository model
    • challenges of converting data from old system to new system
  • 360 degree views of patient data in an interoperable system
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Summer 2020 Virtual Conference: Caresource COVID 19 Response- Housing

This video is part of our Summer 2020 Virtual Conference- Medicaid as the Most Important Part of the COVID 19 response. To learn more about our virtual conferences, including opportunities for patrons, please use the form below.

Session information

– After attending this session, attendees will understand the fundamental housing crisis that existed prior to COVID19, how it has intensified the needs, and illuminated the faults in the response system.

– Attendees will have examples of the intersection between stable housing, health, and other social factors.

– After attending this session attendees will know how they can prepare for the long term impacts of increased housing instability.

Speaker information

Amy Riegel

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Summer 2020 Virtual Conference: Future of clinical practice and data analytics

This video is part of our Summer 2020 Virtual Conference- Medicaid as the Most Important Part of the COVID 19 response. To learn more about our virtual conferences, including opportunities for patrons, please use the form below.

Session information

Be able to identify the accelerated changes that clinical healthcare is currently witnessing

Become familiar with practical examples to guide changes in their local communities

Understand the role of a value-based payment system in these changes

Speaker information

Craigan Gray

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Summer 2020 Virtual Conference: COVID and long term care members in PACE

This video is part of our Summer 2020 Virtual Conference- Medicaid as the Most Important Part of the COVID 19 response. To learn more about our virtual conferences, including opportunities for patrons, please use the form below.

Session information

After attending this session, attendees will be familiar with key concepts related to what is the Program of All Inclusive Care for the Elderly (PACE); the creative care methods utilized, including telehealth and other home based care services to safely deliver primary and long term care for Medicare/Medicaid members in their homes; and how to support and keep employees during this COVID-19 pandemic.   The final concept to be learned is how a provider organization moved quicker than the state partners in coming up with a solution for medical and long term care for frail seniors during a pandemic.

Speaker information

Cindi Jones

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Summer 2020 Virtual Conference: Medicaid Technology and COVID Use Cases

This video is part of our Summer 2020 Virtual Conference- Medicaid as the Most Important Part of the COVID 19 response. To learn more about our virtual conferences, including opportunities for patrons, please use the form below.

Session information

– Understand the unique population health challenges facing providers who manage Medicaid beneficiaries with complex physical, behavioral and mental health needs

– See how real-time updates and a health IT infrastructure is proven to effectively and efficiently help deliver complex, high-risk patients the specialized medical services they require—especially during a pandemic

– Discuss how Medicaid plans/agencies can facilitate collaboration between care teams resulting in lower costs and higher quality outcomes and prepare for a post-COVID world

Speaker information

 Chris Klomp 

Learn more about our virtual conferences