health insurance exchanges summit

K E Y N O T E F A C U L T Y F E A T U R I N G :

Suzanne Brennan Medicaid Director COLORAdO HEALTH CARE POLICY ANd FINANCING

Bill Hagan Chief Growth Officer UNITEdHEALTH GROUP

Julie Hamos Director ILLINOIS dEPARTmENT OF HEALTHCARE ANd FAmILY SERvICES

Lindy Hinman Chief Operating Officer CONNECT FOR HEALTH COLORAdO

Heather Howard Director, Health Reform Assistance Network ROBERT WOOd JOHNSON FOUNdATION

Pam Sedmak President, Chief Executive Officer, Medicaid AETNA

Henry A. Waxman U.S. HOUSE OF REPRESENTATIvES

Scott Leitz Chief Executive Officer mNSURE

maryAnne Lindebald Medicaid Director WASHINGTON HEALTH CARE AUTHORITY

Chuck milligan Deputy Secretary, Health Care Financing, STATE OF mARYLANd dEPARTmENT OF HEALTH ANd mENTAL HYGIENE

Judith A. monroe, md, FAAFP Deputy Director, State, Tribal, Local, and Territorial Support Efforts, CENTERS FOR dISEASE CONTROL ANd PREvENTION

Richard K. Onizuka, Phd Chief Executive Officer WASHINGTON HEALTH BENEFIT ExCHANGE

Aneesh Kumar Head, Consumer Engagement Strategy AETNA

Peter van Loon Chief Operating Officer ACCESS HEALTH CT

Save $300 on your regiStration fee when you regiSter by June 6, 2014

To RegisTeR, please visiT www.woRldcongRess.com/gov • phone: 800-767-9499 • Fax: 781-939-2543 • email: [email protected]

E xC H A N G E S :

• HEAR from CT, NC, IL,

CO, WA, and more

• LEARN from leading

exchange health plans

• UNdERSTANd

enrollment strategies

for 2014 and beyond

Silver SponSor

educational underwriterS

Supporting organizationS and publicationS

HEALTH PLAN MARKET TRENDS LETTERStrategic Insights on the Future of the Health Insurance Industry

organized by

HealtH inSurance excHangeS SummitJuly 15-17, 2014 • Tysons Corner MarrioTT • Tysons Corner, Va

The 5th Annual

day one – tueSday, July 15, 2014 – pre-congreSS workSHop12:30 pm – 1:30 pm Workshop Registration

1:30 pm – 5:00 pm woRkshop: an introduction to the affordable care act as it Relates to

medicare, medicaid, and the health insurance marketplacesThis workshop provides an overview of the major provisions and anticipated impacts of the Patient Protection and Affordable Care Act (ACA) related to Medicare, Medicaid, and Health Insurance Marketplaces. A basic overview of the Medicare and Medicaid programs and the private health insurance marketplaces is provided, leading into a detailed discussion of the ACA Medicaid expansion, creation and implementation of the ACA health insurance marketplaces, and ACA provisions reforming elements of Medicare. Topics to be addressed include:

• Medicaidexpansionandhealthworkforceconcerns• ImpactonvulnerablepopulationsinstateswherenoMedicaidexpansionistakingplace• ACAprovisionsrelatedtoMedicaretargetingqualityandefficiencyonthedeliveryof

health care• ExplanationoftheACAhealthinsurancemarketplacerulesforprovidingqualified

health plans that cover essential health benefits• Subsidiesprovidedforeligibleindividualstopurchaseinsurancethroughthemarketplace

Workshop Leaders: Nancy Lopez, JD, MPH, Lead Research Scientist, GeorGe WasHiNGtoN UNiversity

Nancy Lopez is a senior research scientist and professorial lecturer in the Department of Health Policy at The George Washington University School of Public Health and Health Services. She specializes in legal and policy matters related to health insurance marketplaces, private health insurance, and health reform imple mentation. Her research has been used to produce analyses and papers regarding state and federal health insurance marketplaces; various aspects of the Affordable Care Act; health care fraud; and reimbursement policies of state Medicaid programs and private insurance for obesity treatment or prevention. Ms. Lopez is currently managing multiple projects related to the design of qualified health plans being offered in the marketplaces.

Juliette Forstenzer espinosa, Ma, JD, LLM Assistant Research Professor, GeorGe WasHiNGtoN UNiversity

Juliette Forstenzer Espinosa is an Assistant Research Professor at George Washington University School of Public Health and Health Services, Department of Health Policy and is the Founder and Executive Director of the Health Care Rights Initiative (HCRI) – a national non-profit dedicated to patient education and advocacy. Ms. Espinosa specializes in the regulatory implementation of the Affordable Care Act (ACA). Ms. Espinosa has led dozens of workshops and trainings on health reform topics related to Medicare, Medicaid, employer-based insurance coverage, and private insurance market reforms.

5:00 pm – 6:00 pm Opening Night Reception

day two – wedneSday, July 16, 2014 – main congreSS7:15 am – 8:15 am Main Congress Registration and Welcome Coffee

8:15 am – 8:25 am

Chairperson’s Welcome and Opening Remarks Carl Mercurio

President and Head of Research CorPorate researCH GroUP

8:25 am – 9:10 am

CONGRESSIONAL OPENING KEYNOTE AddRESS: The Future Outlook of medicare, medicaid, and Government Sponsored Health Care and the Affordable Care ActCongressmanWaxmanplanstoretireattheendof2014.Hehasworkedtirelessly,inofficefor20terms,forhealthcarereform.Fewpeoplehaveabetterideaofwhatthefutureholdsforhealthcarethanhim.Asheexitsofficehewillhonestly,andopenlysharewhatthefutureholdsforMedicaid,Medicare,thehealthinsuranceexchanges,andhealthreform.InthisKeynoteAddress,hearfromaveteranoftheHillonexactlywherehealthcareisheadedincluding:• HowmuchmoneywillbeappropriatedtowardMedicare,Medicaid,andgovernmentsponsoredcare?• Whatregulationsareonthehorizon?• WhatdoesachangingpoliticalenvironmentmeanforhealthcareinAmerica?• Wherecanyouexpecttoseecuts,increasesinfunding,andthemostdramaticchangestothehealthcaresystem?

Henry Waxman (D-Ca) U.s. HoUse oF rePreseNtatives

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day two – wedneSday, July 16, 2014 – main congreSS (continued)9:10 am – 9:55 am

CdC KEYNOTE AddRESS: Changing the Health of AmericaWecanchangeahealthplan,wecanchangeahospital,andwecanchangeanentirehealthcaresystem;butifwedon’tchangehowpeopletakecareofthemselvesandengageinhealthcare, we will never change the health of America.

• Hearanoverviewofcurrentsuccessfulhealthprograms—Reducingobesity,heartdisease,etc.• Learnaboutpoliciesthegovernmentplanstoputinplacethatwillimpacthealthcare• DiscussstrategiestochangethecultureofhealthinAmerica

Judith a. Monroe, MD, FaaFP Deputy Director, State, Tribal, Local, and Territorial Support Efforts, CeNters For Disease CoNtroL aND PreveNtioN Director, oFFiCe For state, tribaL, LoCaL aND territoriaL sUPPort (ostLts)

9:55 am – 10:30 am

discuss the Importance of Patient Engagement in Government Sponsored Health CareTheAffordableCareActcallsformanychangesinthewayhealthsystemsandhealthplansconducttheirbusiness,butwhataboutthepatient?Inthissessionhear:

• Howhealthplansareengagingtheirpatients• Whatstrategiesareworkingforpatientsingovernmentsponsoredcare• Insightsonhowyourorganizationcanbetterengageitspatients

aneesh Kumar Head, Consumer Engagement Strategy aetNa

10:30 am – 11:00 am Networking and Refreshment Break

11:00 am – 12:30 pm

Prepare for October 1 — Strategies for Attracting New Exchange Enrollees in 2014Enrollmentisn’tjustaboutgettingasmanypeopleaspossible;it’salsoabouttargetingallsegmentsoftheuninsuredpopulation.Statesareactivelyworkingtomakethishappen.Inthissession,hearkeystrategiesbeingimplementedtoincreasethevolumeandvarietyofenrollees.

• Learnwhichdemographicsarehardesttoreachandhowstatesarereachingthem• Understandthedifferentstatestrategiesforenrollmentandwhatisworking• Hearstrategiesthatextendthereachforadditionalenrolleesin2014

brian Gorman Director, Outreach and Consumer Education, iLLiNois HeaLtH iNsUraNCe MarKetPLaCe

Jennifer simmons Navigator Project Director LeGaL aiD oF NortH CaroLiNa

Jennifer sullivan Director, Best Practices Institute eNroLL aMeriCa

12:30 pm – 1:30 pm Luncheon

1:30 pm – 2:15 pm

Navigating the Exchanges Theexchangesarenewterritoryforeveryone,andhealthplansaren’texcluded.Howarehealthplansnavigatingtheexchanges?

• Understandregulationsandguidelines• Createproductsforthemarketplace• Identifylessonslearnedsofarin2014

sandy Hill Senior Director, Health Reform and Exchange Office bLUe Cross bLUe sHieLD oF MiNNesota


day two – wedneSday, July 16, 2014 – main congreSS (continued)2:15 pm – 3:00 pm Analyze the New Exchange Population — Who Has Enrolled and What do They Need?

Understandingwhomakesupthenewexchangepopulationiscritical.Thissessiondissectsthisnewpopulationandoffersinsightintohowtheindustrycanaddresstheneeds ofthisgroupandtheimpacttheyarehavingonthelargerhealthcarelandscape.

• Identifywhomakesupthenewexchangepopulation—Demographics,characteristics,etc.• Determinewhattypeofcaretheywillneed• Explorewhatexpertspredict2015maylooklikeforenrollees• Understandwhatthisallmeansforthefederalandstateexchanges

Matthew saniie National Director, Analytics and Data eNroLL aMeriCa

3:00 pm – 3:30 pm Networking and Refreshment Break

3:30 pm – 4:15 pm Market InsIght sessIons

If you have a topic area, product, or solution that you would like to showcase in the Market Insight Discussions, please contact David Capobianco, Vice President of Business Development, at 781-939-2635 or [email protected]

mARKET INSIGHTS —CHOOSE FROm 2 OPTIONS: OPTION A: “Try Before You Buy” — market Testing Your medicare Efforts Prior to ExecutionManynewproductandhealthplanlaunchesfailtoliveuptoourexpectationsasweinsufficientlytesthowwelltheseproductswillperformpriortolaunch.Andevenwithpre-testing,manyexistingresearchmethodsareinsufficientintellingushowtheseproductswillperforminacompetitivemarketplace.Learnhowtouseamock-upmarketplacetoevaluatenewplanMedicaredesigns,products,andservices,andbetterunderstandhowMedicareconsumersbehavewhenpurchasing.LearnhowBlueCrossBlueShieldofRhodeIslandpartneredwithStonegateAdvisors,aresearchanddataanalyticscompanyfocusedsolelyonthehealthandwellnessindustry,tousetheirproprietaryPlanFastmarketplacetotestaportfolioofMedicareproductstobetterunderstandwhatconsumersbuy,howtheybuy,andwhytheymakethechoicestheydo.

• BetterunderstandhowtheMedicareconsumerthinks •Identifypotentialissuesandpitfallsbeforetheyhappen• Knowmorethanyourcompetitors •Significantlyincreasethechanceofsuccess

Marc Pierce President and Founder stoNeGate aDvisors

mARKET INSIGHTS —CHOOSE FROm 2 OPTIONS: OPTION B: Case Studies from the First Year of the Exchange• Hearcasestudiesfromplansthatparticipatedinyearone• Learnexchangesalesbestpractices• Learnhowtoleveragedistributiontomaximizeresults

brooke ivey Vice President of Sales and Account Management bLooM iNsUraNCe aGeNCy

4:15 pm – 4:20 pm Session Transition Time


4:20 pm – 5:45 pm

HEALTH PLAN KEYNOTE AddRESS: Plan Perspectives on the Business of Health Care in a Time of ReformPlansfacemanynewchallengesinhealthcare.Theymustdomorewithlessineverypartoftheirbusiness.Findingopportunitiesamongstthechallengeshasbecometheirbusiness. Inthissession,hearapresentationfromeachindustryexpert,andthenengageinafacilitatedQ&Awithencouragedaudienceparticipation.

• Hearhowplansaremanagingtheirbusinessinatimeofexpansionandreform• Discoverhowplansaremanagingtheirprovidersthroughinnovativenewapproaches• LearnhowplanleadersseethefutureofMedicare,Medicaid,Duals,andthehealthinsuranceexchangesandhowtheybelieveitwillimpacttheirbusinessandthebusinessofhealthcare

bill Hagan Chief Growth Officer UNiteDHeaLtH GroUP

Pam sedmak Chief Executive Officer, Medicaid aetNa

additional thought Leaders tba

5:45 pm – 6:45 pm Close of Day Two, Cocktail and Networking Reception

day tHree – tHurSday, July 17, 2014 – main congreSS 7:30 am – 8:00 am Morning Coffee

8:00 am – 8:05 am

Chairperson’s Welcome and Review of day Two Carl Mercurio

President and Head of Research CorPorate researCH GroUP

8:05 am – 9:15 am

ExCHANGE KEYNOTE dISCUSSION: Operating an Exchange — Current Status of the ExchangesManystateshaveexperienceddifficultieslaunchingtheexchanges.Othershavebeensuccessful.Understandingthechallengesandlearningfromthesuccesseshelpallofthestateandfederalexchanges improve their operations in the long run. In this high-level overview, hear four state perspectives on:

• Currentoperationalchallengesandsuccesses•Networkadequacy•Fundingthestateexchanges•Newproductsfortheexchanges

Moderator:

rob san Martin Director, Public Sector aKaMai teCHNoLoGies

Panelists:

Lindy Hinman Chief Operating Officer CoNNeCt For HeaLtH CoLoraDo

scott Leitz Chief Executive Officer MNsUre

richard K. onizuka, PhD Chief Executive Officer, WasHiNGtoN HeaLtH beNeFit exCHaNGe

Peter van Loon Chief Operating Officer aCCess HeaLtH Ct

9:15 am – 10:15 am

mEdICAId dIRECTORS’ KEYNOTE PANEL dISCUSSION: A view of medicaid Expansion and the Future of medicaidMedicaidisrapidlychanginginstatesthatareexpanding,andinthestatesthathavechosennottoexpand.InthisKeynotePanelDiscussion,MedicaidDirectorsfromavarietyofstatesdiscussthechanging environment and initiatives being implemented to ensure sustainable success.

• Discusshowstatesarehandlingexpansionandwhatprogresshasbeenmadein2014• Learnthemethodsstatesareusingtohandlemanagedcare,quality/accessinitiatives• RealizehowthedirectorsplantocreatesustainabilityintheirprogramsModerator:

Chuck Milligan Deputy Secretary, Health Care Financing, state oF MaryLaND, DePartMeNt oF HeaLtH aND MeNtaL HyGieNe

Panelists:

suzanne brennan Medicaid Director CoLoraDo HeaLtH Care PoLiCy aND FiNaNCiNG

Julie Hamos Director iLLiNois DePartMeNt oF HeaLtHCare aND FaMiLy serviCes

Maryanne Lindebald Medicaid Director WasHiNGtoN HeaLtH Care aUtHority

10:15 am – 10:45 am Networking and Refreshment Break


day tHree – tHurSday, July 17, 2014 – main congreSS (continued)10:45 am – 11:30 am

Churning — Best Practices to manage the In BetweenWhenitcomestoMedicaidandtheexchanges,thechurndilemmaisonmanystates’minds.Thissessionexplorestheintricaciesofthechurnandstrategiestomanagethe‘inbetween.’

• Discusshowbesttomanagethechurn•Understandwhatstrategieswillbeemployedbystatesandhealthplans•Hearhowtheproposedsolutionswillaffectyourbusiness

Heather Howard Director, Health Reform Assistance Network robert WooD JoHNsoN FoUNDatioN

11:30 am – 11:35 am Session Transition

11:35 am – 12:20 pm

INTERACTIvE dISCUSSION: Look Ahead to the Exchanges in 2020Theexchangesarethenewest,mostfragile,andsomesaymostimportantpartoftheAffordableCareAct.UnlikeMedicaidandMedicaretheyarenewwithlittlefoundation.Whatisthefuturefortheexchangesconsideringthecomplicationsinthepastandmanyhopesforitsfuture?DuringthisInteractiveDiscussion,theStateExchangeDirectorssharetheirinsightsonthistopic,plustakeadditionalquestionsfromtheaudiencearoundothertopicsthatmaynothavebeenaddressedduringtheKeynotesession.

Lindy Hinman Chief Operating Officer CoNNeCt For HeaLtH CoLoraDo

scott Leitz Chief Executive Officer MNsUre

richard K. onizuka, PhD Chief Executive Officer WasHiNGtoN HeaLtH beNeFit exCHaNGe

Peter van Loon Chief Operating Officer aCCess HeaLtH Ct

12:20 pm – 1:30 pm Luncheon

roundtable diScuSSion groupS1:30 pm – 3:30 pm

Duringtheseinteractiveroundtablediscussions,attendeeshavetheopportunitytoengageininformaldiscussionswiththemeeting’sexpertspeakingfacultyanddiversenetworkofpeersparticipatinginthemeeting.Learnfromstateexperts,industryleaders,andoneanotherontheissuesthatyoucareaboutmost.Participateinavarietyofroundtablediscussionstonetwork,exchangeideas,identifynewopportunities, and develop solutions to common obstacles.

Several more roundtables are scheduled to be added in the coming months. Participate in the current roundtables, check back for future roundtables, or submit an idea for a roundtable and see your topic added to the program!

3:30 pm Close of Congress

TOPIC #1: TOPIC #3: Care Coordination/Behavioral Health• DiscusshowstatesareredesigninghowtheycoordinatecareforMedicaidpatients• Sharebestpracticesforintegratingbehavioralhealth

into patient care plans

Facilitator: Molly siegel

Project Manager, Care Coordination Entities iLLiNois DePartMeNt oF HeaLtHCare aND FaMiLy serviCes

Navigating Federal Insurance Exchange Laws• Understandthelawsimpactingyourorganization• RealizefuturelawsthatcouldhaveanimpactFaciliators:

Juliette Forstenzer espinosa, Ma, JD, LLM Assistant Research Professor GeorGe WasHiNGtoN UNiversity

Nancy Lopez, JD, MPH Lead Research Scientist GeorGe WasHiNGtoN UNiversity

TOPIC #2: TOPIC #4: Strategies to Reduce Readmissions• ExploredifferentMedicarereadmissionsstrategies• LearnaboutthePACTprogramforreducingallreadmissions

Facilitator: Jodi smith

Head, PACT Program Kaiser PerMaNeNte HeaLtH PLaN oF CoLoraDo

Accountable Care OrganizationsDiscussavarietyofACOmodels,including:

• MedicaidACOs• MedicareACOs• CommercialACOs

Faciliator: rob Houston, Mba, MPP

Program Officer CeNter For HeaLtH Care strateGies

sponsoRship and execUTive neTwoRking oppoRTUniTiesBenefit from face-to-face corporate marketing, branding, and relationship building by participating in the World Congress Government Health Care Congress

as an active supporter and sponsor. To inquire about Sponsorship and Executive Networking Opportunities, Please contact

David Capobianco, VP, Business Development, World Congress • Call 781-939-2635 or email [email protected]

Silver Sponsor

Exhibitors

Educational Underwriters


tHe HealtH inSurance excHangeS SummitJuly 15-17, 2014 • Tysons Corner MarrioTT • Tysons Corner, Va

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isTeR, please visiT w

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iLLiNois HeaLtH iNsUraNCe

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Jennifer sim

mons

Navigator Project Director

LeGaL aiD oF NortH CaroLiNa

Jennifer sullivan

Director, Best Practices Institute

eNroLL aMeriCa

sandy Hill

Senior Director,

Health Reform and Exchange Office

bLUe Cross bLUe sHieLD oF MiNNesota

M

atthew saniie

National Director, Analytics and Data

eNroLL aMeriCa

Lindy Hinm

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Chief Operating Officer

CoNNeCt For HeaLtH CoLoraDo

scott Leitz

Chief Executive Officer

MNsUre

richard K. onizuka, PhD

Chief Executive Officer

WasHiNGtoN HeaLtH beNeFit exCHaNGe

Peter van Loon

Chief Operating Officer

aCCess HeaLtH Ct

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The 5

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Healthcare