Tag: Interviews

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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 

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Summer 2020 Virtual Conference: Day 3 Keynote (Calder Lynch)- CMS COVID 19 Update

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.

https://youtu.be/TJYrdEf0-nw

Session information

In this session, you will hear directly from the Deputy Administrator of the Centers for Medicare & Medicaid Services – Calder Lynch, and what CMS is doing during this time of global pandemic.

Speaker information

Calder Lynch

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Summer 2020 Virtual Conference: Eligibility Estimate Methodologies and Requirements in the Families First Coronavirus Response Act

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 key concepts that should be taken into consideration when estimating eligibility increases.

After attending this session, attendees will better appreciate the complexities around estimating enrollment increases, comparing to historical conditions.  

After attending this session, attendees will understand the requirements for compliance with the 6.2% Federal Medical Assistance Percentage (FMAP) increase offered to state Medicaid programs under the Families First Coronavirus Response Act.

Speaker information

Carol Steckel

Andrew Dilworth

Learn more about our virtual conferences