Medicaid Industry Who’s Who Series: Calder Lynch

Calder Lynch is a featured panelist for the upcoming Nebraska State Medicaid Spotlight Webinar on October 21st.

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Medicaid Who’s Who: Calder Lynch – Nebraska Medicaid Director

 1.  What segment of the industry are you currently involved?

A: I’m a state health policy nerd, but I like to think I work at the intersection of policy and politics – where we really can make things happen. However, my real passion and focus comes after the policy-making—at the executing and operationalizing of reforms and programs. That’s the fun stuff!

 2.  What is your current position and with what organization?

A: I am the Director of the Division of Medicaid and Long-term Care within the Department of Health and Human Services for the State of Nebraska. Put more simply, I’m the Nebraska Medicaid Director.

 3.  How many years have you been in the Medicaid industry?

A: I’ve been in my role here in Nebraska for a little over 18 months. Before this, I worked in the health care and Medicaid arena for the State of Louisiana for about six and a half years.

 4.  What is your focus/passion? (Industry related or not)

A: We’ll always have the debates about what government should and shouldn’t do, can or can’t provide–but the fact is that we are going to do something, we should do it well. Good government is non-partisan, and a well-run government is something every citizen and taxpayer deserves. And in my experience some of the most dedicated and passionate people work in the health and human services programs of the public sector. In Nebraska, we are totally rethinking and restructuring how our Medicaid program is administered – from our eligibility and MMIS systems, to our managed care programs, our policies & regulations, our staffing structure, and our contract oversight. With the right tools, planning and leadership, we can accomplish amazing things. My passion is to help create that structure and empower our team to show how effective we can be at making programs, processes, and outcomes better for the people we serve and the citizens who fund out programs.

 5.  What is the top item on your “bucket list?”

A: I am excited about our vision for modernizing the systems that support our Medicaid program and how we view our role and structure in the future. We like to talk about how we are implementing a “No MMIS” approach – where the state will no longer own or operate a claims processing system. I would love to see us completely decommission or legacy self-administered system and move to a services based architecture.

 6.  What do you enjoy doing most with your personal time?

A: I like to cook, especially for others. I really enjoy sharing a good meal that I’ve prepared, and I’ve enjoyed bringing my Cajun flavors to Nebraska. I also enjoy traveling, especially when it leads to spending time with friends and family in places that lend themselves to photography and being outdoors.

 7.  Who is your favorite historical figure and why?

 A: While not my favorite in terms of his beliefs or politics, I have always been deeply fascinated by Huey Long. As a child, I actually appeared as an extra in a TV movie about him called ‘The Kingfish.’ He is an incredible figure in American politics, and particularly for me in Louisiana history. His story is both a cautionary tale against government corruption and an interesting lesson in the roots of populism that I think continue to have influences on today’s politics.

 8.  What is your favorite junk food?

A: I’m a Louisiana native, and it’s not all that often I can get my hands on some Zapp’s Cajun Crawtator potato chips. And that’s probably a good thing!

 9.  Of what accomplishment are you most proud?

A: I think one of the most important functions of a leader and manager is the recognition and cultivation of talent. I am most proud of the team of folks we’ve assembled here in Nebraska, where we have our complete leadership team in place for the first time in a number of years. Seeing their daily successes, growth, and future potential is the most rewarding part of my job.

 10.  For what one thing do you wish you could get a mulligan?

A: One of the very first projects I was given to manage was the carve-in of pharmacy to managed care in Louisiana, coupled with the implementation of a new reimbursement methodology. We did it, and in many ways it was successful. But it was a lot of change very quickly. Looking back, I would have recommended some different policy prescriptions as it related to how the benefit would be managed in a carve-in environment (like retention of a common PDL). Sometimes the trick to implementing lasting reform is to work incrementally. I learned some important lessons that have influenced our decision-making here in Nebraska.

 11.  What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months? 

 A: In the short term, the most impactful thing will be the federal leadership transition and the selection of new leadership at CMS. This will ultimately have tremendous impact on how the recent flurry of federal regulations will be implemented, like the managed care regulation and guidance around specific provisions like the IMD rule.

 Other timely things to watch will be how CMS applies the Access Rule to ongoing state plan amendments, the impact of Part B premium increases on state budgets and the expiration of the Money Follows the Person program.