A team of UnitedHealthcare Community & State leaders had the opportunity to attend and speak at the Health Management Associates (HMA) annual conference earlier this month. The day and a half event focused on emerging opportunities within Medicaid and included more than 500 attendees and an array of informative and engaging keynote addresses, panel presentations, and breakout sessions. Topics ranged from substance abuse treatment and the opioid crisis to Medicaid expansion, value-based purchasing, and social determinants of health.
On day one of the conference, Dennis Mouras, CEO of our Michigan health plan, was a panelist. Along with four fellow health plan leaders, he spoke about the promise of Medicaid managed care. The session highlighted ways in which managed care is positively impacting access and care for various populations. The panelists shared data points and consumer stories that reinforced the value of a managed care environment.
During one of the breakout sessions on day one, Kevin Moore, VP of Health and Human Services Policy, spoke about breakthroughs in addressing social determinants of health (SDOH). Three takeaways from his panel discussion include:
- Understanding the risks and needs of individuals and stratifying them to ensure they are receiving the services and engagement they need are critical components to addressing SDOH.
- In addition to the opportunity to improve overall health outcomes, a focus on SDOH also shows promise of having a financial impact.
- The role of community-based organizations (CBOs) is critical in this effort. However, they need to be resourced appropriately in order to adequately meet the needs of those they serve and to ensure longevity and stability in this new environment.
UnitedHealthcare Community & State’s third speaker, Allison Rizer, was on a keynote panel focused on models of care for the dually eligible population. As the VP of Strategy and Health Policy - Medicare/Medicaid Integration, Allison’s comments were focused on current federal and state policy changes driving integrated care for this population, and the opportunities and challenges created by those changes. Allison and her fellow panelists noted that integration needs to be meaningful for the individual consumer. To get integration right, there needs to be more education, greater flexibility, and an ability to coordinate data - but above all, it needs to be kept simple for the individual.
In addition to panels where UnitedHealthcare leaders were speaking, the Community & State team attended a variety of other sessions and presentations. Here are a few of their comments on what resonated for them.
“Clearly, SDOH continues to be a trend in both the Medicaid and Medicare markets. In the Delivering on the Promise of Medicaid Managed Care keynote session, the emphasis on the role of the provider and caregiver to capture SDOH data and address a consumer’s needs was of particular interest. It is imperative that organizations work collaboratively to ensure resources to stay healthy are not only available to the consumer, but also available for the provider and caregiver to have the greatest impact.” Stacie Wright, VP, Strategic Policy Execution
“The national conversation on value-based payment reform in Medicaid seems to be heading to a flash point. In the opening keynote, Health Affairs Editor-in-Chief Alan Weil closed out his comments by discussing that value-based payment strategies in Medicaid are not ‘ready for primetime’ for either payers or providers. However, several state policymakers over the course of the conference indicated that value-based payment reform is a key priority for their Medicaid programs in 2020. In addition, there continues to be opportunity in data and IT within the Medicaid system. Medicaid programs continue to struggle with gleaning “actionable” data from collections of claims and encounters. States with data warehouses express greater ability to respond to data with informed policy decisions. However, as many states look to catalyze SDOH through the matching of health care data with other systems like criminal justice or education to drive payment reform, the integrity of underlying systems, analysis, and data feeds is crucial.” Samantha O’Leary, VP, Public Market Strategy
I also attended the conference and walked away with some valuable insights and new information about trends in the Medicaid system. I especially appreciated the inclusion of a session on foster care, given the significant recent policy changes related to the child welfare system that have implications for those of us in Medicaid. Specifically, with the recent passage and pending implementation of the Family First Prevention Services Act, states are thinking about cross-agency collaborations to support the effective rollout of the changes made by this new law, which include a focus on prevention, evidence-based practices, and support for the provision of mental health, substance abuse, and family counseling services for families and children at-risk of entering the system. Medicaid can serve as a critical partner in the implementation of this new policy and can support efforts to effectively serve this vulnerable population.
If there was one overarching theme for me from the HMA conference, it’s that the space between Medicaid and the human services sector is getting narrower. Whether housing, criminal justice, child welfare, or early childhood, states are making efforts to bust the silos between these traditionally bifurcated systems and integrate data, policy, and programming to positively change the trajectory of the health outcomes of the populations currently served by both the Medicaid and human services systems.