National Association of Medicaid Directors 2023 fall conference recap

The annual National Association of Medicaid Directors (NAMD) conference serves as a vital platform for Medicaid directors, industry partners and key stakeholders to come together and learn from each other. The conference is a place for exchanging insights regarding innovative strategies as we collectively strive to advance the crucial work of the Medicaid program. This year’s conference was held on October 1-3 in Washington, D.C., with topics centering around maternal health, behavioral health, long-term care and redeterminations of Medicaid eligibility.

Progress, Priorities and Pivots at the Midpoint of Unwinding

Following the Consolidated Appropriations Act of 2023, Congress ended the continuous Medicaid enrollment provision put in place during the COVID-19 public health emergency. The unwinding of the automatic enrollment process was a key topic in Monday’s plenary session which opened with discussion of the progress made to prevent loss of coverage for Medicaid members. State government agencies were recognized as making significant efforts in outreach and partnership with providers to ensure members re-enroll.

With half of all births covered by Medicaid, the redetermination process has sparked conversation around improving eligibility for children. Panelist Joan Alker, Executive Director & Research Professor of the Georgetown University Center for Children & Family, stated, “No baby should leave the hospital or birthing center uninsured.” Aligned with this sentiment, many states are moving to extend postpartum coverage through ages five or six.

Next steps were centered around the concept of “resetting the baseline”. In order to lay the foundation for the new standard, it was determined that the ex parte process and data dashboards need to be improved. Additionally, flexibilities that have improved the care experience – particularly for members requiring long-term care – were cited as requiring assessment for permanent placement in Medicaid policy.

Building a trustworthy health care system for pregnant and parenting individuals

One of the first breakout sessions on Monday underscored the significance of establishing a health care system that ensures safety and reliability for individuals during pregnancy. To encourage individuals who are pregnant to seek the care they require, it is imperative to offer consistent and personalized health care services.

This session emphasized the pivotal role of effective centering methods, accountability approaches and culturally sensitive provider training for creating a trustworthy health care environment. Midwives and doulas were highlighted as valuable primary health care providers and non-clinical supports for expectant parents, offering comprehensive care throughout the childbirth experience. The session also emphasized the importance of incorporating consumer voices in policy decisions, as exemplified by Colorado's Maternal Advisory Committee (MAC).1

In addition, there was a session focused on reducing fragmentation in the postpartum period. Speakers discussed the overwhelming trend in states to extend postpartum coverage in Medicaid from 60 days to 12 months. Unique state initiatives were also highlighted including Connecticut’s coverage of postpartum coverage navigators and Virginia’s use of data to drill down at the zip code level to support targeted partnerships and deployment of needed services.

How can we better center consumer voice

A number of sessions, including the lunch plenary session focused on the importance of incorporating consumer voice. In the maternal health sessions not only did speakers speak to examples of bringing consumers to the table to support decision-making, but the sessions themselves included panelists with lived experience.

The plenary session during lunch on the first day of the conference also emphasized the focus of elevating consumer voice. The session included a panel discussion driven by and including all young people. The youth talked about their experiences navigating the health care system and the Medicaid program. Ideas elevated by these advocates included greater need for translation services, targeted care coordination for high-risk medical needs, increased youth engagement in call centers and increased education on Medicaid offerings in locations that are easily accessible and available for youth.

UnitedHealthcare Community & State: tech forward solutions

Each year, UnitedHealthcare Community & State sets up a booth to showcase a particular area of focus for our business and the Medicaid program as a whole. This year, our exhibit highlighted three noteworthy examples of collaboration with partners to leverage technology for improved caregiver support with Careforth, behavioral health support with Reema and maternal health support with My Maternity Journey.

Careforth, a mobile application, facilitates the coordination of services between coaches and caregivers, delivering quality, person-centered care at scale. It has been proven to enhance members' quality of life, increase access to resources and reduce caregiver burnout.

Reema, a predictive engagement software and data engine, closes care gaps for difficult-to-reach members who have high rates of behavioral health concerns.

My Maternity Journey is a platform within the UnitedHealthcare member portal that centralizes multiple maternal health programs designed to provide connection to resources and personalized guidance.

We additionally unveiled a new policy report, developed in collaboration with Healthsperien, titled "Advancing technology to meet the greatest challenges in Medicaid: access, workforce and equity." This report was developed to highlight the opportunities and challenges in implementing comprehensive technology solutions. It addresses barriers to integration and emphasizes that states are not alone in their implementation efforts.

Alongside the content at our booth, we continued our tradition of engaging conference attendees in a meaningful community project. We provided blankets that attendees could choose to take as conference swag, use during the event and return or request that we donate on their behalf. We were delighted to donate 170 blankets to the Downtown DC Foundation for individuals experiencing homelessness. This initiative allowed us to make a positive impact on the local community and emphasize the importance of community engagement for positive population health outcomes.

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