2024 Medicare, Medicaid, Duals & Commercial Markets Forum

Evidence is mounting on the benefits of food as medicine programs as they gain popularity in managed care. However, few programs report on member outcomes longitudinally. Learn how a comprehensive nutrition program positively impacted dually eligible members with heart failure and achieved health insurance provider cost savings 6 and 12 months after member participation ended. Gain valuable insights on designing a program to support successful long-term behavior change and cost savings.

Establishing trust is key to effectively engaging members in their care. A peer-to-peer approach that builds community and social support for members can have a significant impact on health outcomes, equity, engagement, cost of care, and retention. Join this session to review outcomes of a national community-based solution for MA, DSNP, and Medicaid populations, and share best practices and results from an actuarially validated methodology.

This session will explore the multifaceted value of caregiver support. Learn how to activate caregivers with an effective care plan to enhance outcomes and positively impact well-being for both members and caregivers. Join us to examine strategies to develop a well-supported caregiver network to engage and align caregivers with health management goals, leading to enhanced patient care.

Health insurance providers are leveling up standard short message service (SMS) campaigns to personalized mobile experiences that drive members to action. Panelists will discuss mobile strategies, from onboarding to retention, that drive behaviors and usage of plan benefits and identify key parts of a member’s journey that influence critical metrics. Gain insights to improve access to care metrics, drive improvements to Star Ratings, and proactively influence the member experience.

Improving care for older adults requires a whole-person approach and early interventions to prevent frailty, which can lead to a higher risk of long-term care. Falls, dementia and social determinants of health deficits worsen frailty. Join this session to learn how a comprehensive, multi-disciplinary clinical care plan can improve health and reduce the risk of long-term care. Explore how to engage older adults with a customized care plan and assistive technology for aging in place.

This session will explore the importance and use of health data in addressing health disparities, the barriers that persist in limiting health data, and policy levers that can improve health data collection and utilization at the federal level including changes to data standards and systems, incentives and requirements, education and technical assistance, and regulation.

Sweeping changes to the Medicare program, such as the Inflation Reduction Act and the Health Equity Index for Star Ratings are poised to reshape the MA landscape. These changes place increased emphasis on elevating quality ratings amidst lower CMS payment rates. As a result, health insurers are turning to innovative supplemental benefits to address these challenges. Learn how MA leaders can leverage digital health solutions as a valuable supplemental benefit to close care gaps and boost quality.

GLP-1s and other anti-obesity medications are changing the treatment landscape for patients and providers. Although literature shows these drugs can be life changing, these products are not universally accessible, including to Medicare and Medicaid beneficiaries. Join us to explore how a managed solution combining behavior change and pharmacotherapy can achieve high-quality outcomes, improve cardiometabolic care, offset near term Rx costs and produce long term medical cost savings.

Closing gaps in care continues to be a critical concern for the U.S. health care system. Join this session to gain insights on using data analytics to create a robust, patient-centric program and examine the regulatory environment for dual eligible populations and patients with multiple chronic conditions. Learn how to solve for multiple points of failure within complex care to not only increase patient engagement and success, but ultimately challenge and improve the entire ecosystem.

The future of health care will require new partnerships to support innovative member engagement strategies. Effective solutions will be community-focused and culturally sensitive, both in-person and through digital channels. Join this session to gain insights into creative intervention strategies, reimbursement options, and opportunities to address health equity. Speakers will share highlights from a recent survey of health insurance providers and examine methods to maximize member engagement.

Speakers will discuss the Inflation Reduction Act (IRA) implementation priorities and impacts on Part D plans.

The ACA Marketplaces reached a record high number of sign-ups during 2024 open enrollment, with over 20 million people enrolling in coverage in the Federally facilitated and State-based Marketplaces. Join this session to explore unique efforts, successful strategies, and key learnings from State-based Marketplaces to grow enrollment and support coverage transitions through Medicaid unwinding. Examine the impact temporary enhanced subsidies have had on access to affordable health care.

Join us as we explore innovative solutions to identify and reduce disparities among socially and economically disadvantaged groups. Explore key elements of the Health Equity Index, how to use data-driven approaches to anticipate how your plan will score and identify areas with largest disparities that can most improve outcomes. Gain insights from one health insurance provider that is proactively preparing for the changes to MA Star Ratings, including reward factor calculations.

Legal experts will review the current landscape of legal issues affecting the policy and regulatory agenda for Medicare Advantage and Part D plans.

Housing quality, availability, and stability greatly impact health, but many health care organizations are unsure of how best to promote health through housing interventions. This session will present best practice strategies and policy opportunities that health care organizations and health insurance providers can employ to advance health and health equity through housing.

In this session, speakers will provide insight on the new Medicare marketing rules and share best practices to protect Medicare enrollees from misleading or inappropriate marketing activities.