Medicaid Who’s Who Interview: Lauretta Converse

Lauretta Converse is Director of Payment Reform and Financial Analytics at Rhode Island Medicaid Program

Check out her LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I am currently working as the Director of Payment Reform and Financial Analytics at the Rhode Island Medicaid program. 

How many years have you been in the Medicaid industry?

I have been in the industry for seven years.  In that time, I have had payer experience inside a Medicaid agency, provider experience at a national pharmacy, and have worked on Medicaid as state legislative staff.  Each experience has given me a distinct perspective on this very complex program and I believe this helps me advocate for strategies and solutions that are workable for all stakeholders.

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

When it comes to Medicaid, I’m passionate about data and analytics.  Our mission is Goliath-size and our resources are David-size.  There simply aren’t enough resources to go around, so it’s critical that we bring a data-driven discipline to our program so we know what is working and what isn’t- so that we know how to efficiently allocate our very scarce resources.  All of us have our pet initiatives but without data, it’s a free-for-all. It’s like the quote: “If we have data, let’s look at data. If all we have are opinions, let’s go with mine.”

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

A top item on my bucket list is to visit all of our country’s national parks.  I better get going, though, since I’ve only visited 12 and there are 58.  I love mountains, so my favorite ones so far have been Grand Teton and Hawaii Volcano National Park.

What do you enjoy doing most with your personal time?

Tennis.  It’s both physically and mentally challenging, and people regularly play the game into their 80s!

Who is your favorite historical figure and why?

I recently had the chance to visit in person some of Michelangelo’s work .  I’m not an art aficionado by any means but the beauty, variety, and sheer volume of his work left me breathless.

What is your favorite junk food?

Harvest Cheddar Sun Chips

Of what accomplishment are you most proud?

I have three grown daughters who are among the most amazing and interesting people I know.  That I had a part in that continues to amaze me.

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

I wish I could go back and begin working in the healthcare industry earlier in my career.  I spent a decade in a sector of the manufacturing industry that was very stodgy and mature and changed little year to year.  Conversely, the healthcare space is dynamic and will likely look very different in ten years.  The problems we are trying to solve are so difficult that sometimes I think my head will explode, but at the same time I love that part of the work and that I get to be part of creating something new that doesn’t exist yet.

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

That’s hard for me to answer because my perspective is slanted.  Being from a progressive state, I’m somewhat disconnected from the reality that many states are still talking about expansion and work requirements.  Those things aren’t even issues here!  But I’d love to see value-based payment for pharmacy become more important in every state.  And I’m looking for a maturing of actionable ideas around how best to address social determinants of health.  I’m also tracking with the application of blockchain technology to healthcare which would be a total game changer.


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