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Conferences

2025 Medicare, Medicaid, Duals & Commercial Markets Forum

Dates:
Mar 25 - 27, 2025
Location:
Baltimore, MD

Registration is now closed - The 2025 Medicare, Medicaid, Duals & Commercial Markets Forum focuses on the most pressing policy priorities, emerging issues and regulatory updates for Medicare, Medicaid, Duals, and the commercial market.

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Sessions

, Continental Breakfast

Key Ballroom South Foyer, Level 2

, General Sessions

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    Strengthening Primary Care for a Healthier Future

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    Primary care is essential to achieving better health outcomes and reducing health disparities. Consistent access to primary care leads to better overall care, more coordination among health services, improved outcomes, and lower costs. In this session, a panel of experts will explore approaches, solutions and strategies to reinforce primary care infrastructure and workforce to meet the evolving health care demands of the U.S. population.

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    Closing Gaps in Coverage and Care

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    This fireside chat brings together industry leaders to discuss the evolving health care landscape and strategies to address gaps in coverage and care. The panel will explore both successes achieved and ongoing challenges in the health care system, focusing on populations disproportionately impacted by disparities. Speakers will share their unique perspectives on policy shifts, system-level changes, and opportunities to improve health care access and outcomes. Gain insights into navigating the changing health care environment while continuing to serve vulnerable populations effectively, balancing financial constraints with the delivery of high-quality care.

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    Tech Policy Landscape in 2025 and Beyond: Implications for Health Plans

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    As technology continues to transform health care, the policy landscape is rapidly evolving—shaping how health plans leverage innovation, data, and AI-driven solutions. What key regulatory and legislative developments should health plans prepare for in 2025 and beyond? Speakers in this session will provide an in-depth analysis of emerging tech policy trends, including cybersecurity and privacy regulations, AI oversight, interoperability mandates, and digital health.

, Concurrent Sessions

  • SERIES 4

    • Medicare Advantage & Part D

      MA and Part D Advance Rate Notice/Regulation: Implications for 2026 and Beyond

      Speakers
      Details

      In this session, speakers with expertise in Medicare Advantage (MA) will review key elements of the 2026 Advance Rate Notice and proposed regulations for MA and Part D and share insights on the impact and implications for health plans.

    • Medicaid Managed Care & Dual Eligibles

      MACPAC Update: Emerging Trends and Policy Recommendations

      Speakers
      Details

      In this session, speakers from the Medicaid and CHIP Payment and Access Commission (MACPAC) will comment on the status of the Medicaid program and MACPAC’s initiatives and priorities for 2025.

    • Care Delivery Innovation

      The Tipping Point for Value-Based Care

      Presented by Davita Kidney Care
      Speaker
      Details

      Value-based care (VBC) is a core tenet for the future of health care, but the term is over-used, impeding adoption of a revitalized care model at scale. Join this session to learn how to design VBC models that collectively benefit patients, providers, and payers. Gain insights from value-based kidney care to help develop care models that support improved outcomes, foster trust with physicians and can be replicated across the industry.

    • Market Trends & Business Insights

      Creative and Cost-Effective Approaches to Managing Obesity

      Presented by Teladoc Health
      Speakers
      Details

      Obesity is a prevalent, financially burdensome, and complex chronic health issue that is affecting an increasing portion of the population. As federal and state regulators consider new coverage policies, including expanded coverage for GLP-1 medications, the costs associated with managing obesity will continue to grow. Join us to explore the innovative use of virtual care solutions to transform obesity management, especially for Medicare, Medicaid, and Duals lines of business.

, Lunch & Learns

    • Care Delivery Innovation

      Optimize VBC: Leverage Analytics to Enhance Care Delivery & Improve Outcomes

      Presented by Gray Matter Analytics
      Speakers
      Details

      In alternative payment models and value-based contracts, quality and outcomes improvements are balanced with optimal utilization and costs. Using advanced analytics, health plans can improve member engagement and capture actionable insights on health outcomes, utilization, cost efficiency and overall quality of care. Join this session to learn how advanced analytics can help identify risks, project financial performance, and predict health outcomes to maximize value-based partnerships.

    • Market Trends & Business Insights

      Leveraging AI to Improve Outcomes and Reduce Costs Through Imaging Innovation

      Presented by Covera Health
      Speaker
      Details

      The U.S. health care system is moving toward value in all aspects of care delivery, including imaging advancements to expedite accurate diagnoses. Discover how AI-driven imaging advancements are transforming care delivery. Learn to improve radiology quality, reduce misdiagnosis costs, and enhance outcomes. Gain insights on analyzing routine imaging to identify diagnostic gaps and accelerate the detection of 40+ conditions, driving better care at lower costs.

    • Medicaid Managed Care & Dual Eligibles

      AI Advancements Bridge the Gap to Dual Eligibility Enrollment

      Presented by Optum – An AHIP Select Member
      Speakers
      Details

      Of the 66 million current Medicare beneficiaries, 37% live at or below the poverty level, but only 12.2 million of them are dual-enrolled. Dual eligibility enrollment remains challenging due to the differences in each state’s qualification process, but AI advancements are helping to overcome these challenges and optimize benefits for members in need. Learn how one health plan leveraged AI technology to increase dual-eligibility conversion and make a positive impact on its members.

    • Closing Gaps in Coverage & Care

      The Future of 1115s: Progress Made and What’s at Stake

      Speakers
      Details

      This session explores the increase of innovative 1115 waivers over the years and the impact a changing federal landscape may have on current and future waiver applications.

, Concurrent Sessions

  • SERIES 5

    • Medicaid Managed Care & Dual Eligibles

      Policy Agenda for Medicaid Managed Care

      Speakers
      Details

      Join us for an in-depth conversation on the future direction for Medicaid, CHIP and Duals policy. Our panel will provide a deep dive into potential regulatory action Medicaid Managed Care could see over the next 4 years.

    • Commercial Market & Employer-Provided Coverage

      Prioritizing the Whole Person in Employee Benefits

      Speakers
      Details

      As the workplace and workforce have both rapidly evolved, employers are increasingly recognizing the importance of addressing the "whole person" when designing and offering health benefits. This panel discussion will explore how leading American companies have reimagined and expanded employee benefit offerings beyond traditional health benefits to a more holistic approach that considers the physical, mental, emotional, and social well-being of their employees and their families.

    • Care Delivery Innovation

      Transforming Chronic Care through Daily, Async Video Coaching

      Presented by Scene Health
      Speakers
      Details

      When members struggle with adherence to prescribed treatment, the impacts can be significant. This session spotlights a video coaching model that can improve clinical measures and hospitalizations while strengthening member trust. Hear real patients share how daily video engagement helped reshape their medication habits and chronic conditions. Explore how to integrate a high-touch, high-tech approach to drive measurable improvements in medication adherence, cost savings, and member satisfaction.

    • Market Trends & Business Insights

      Health Plans at a Crossroads: Transforming Health Plans with AI

      Presented by Healthplans.AI
      Speakers
      Details

      While AI holds immense potential to revolutionize healthcare, it can also seem risky and complex. By securely leveraging AI, plans can dramatically improve operational efficiencies and enhance member experience. Join this session to learn from specific use cases how plans that serve Medicare and Medicaid beneficiaries, and dually eligible individuals can leapfrog by leveraging AI to drive tangible business and ROI outcomes. Explore strategies to turn AI adoption into a game-changing opportunity.

  • SERIES 6

    • Medicare Advantage & Part D

      Part D in 2025: Impacts of the Benefit Redesign

      Speakers
      Details

      Speakers will discuss the impacts and implications of the changes to Part D that took effect in 2025 and provide insights into what’s next for the Part D program.

    • Market Trends & Business Insights

      Enhancing Payer-Provider Collaboration for Better Outcomes and Business Results

      Presented by Cognizant Technology Solutions
      Speakers
      Details

      As the health care ecosystem evolves, health plan leaders must navigate new data exchange standards and regulatory requirements that impact daily decision-making. Initiatives like FHIR, TEFCA, and Da Vinci are reshaping interoperability, requiring professionals to align operations for compliance and efficiency. Join this session to gain insights to help shape your company’s approach, streamline operations, and improve outcomes.

    • Medicaid Managed Care & Dual Eligibles

      What’s Happening in HCBS?

      Speakers
      Details

      This session will feature a trio of national policy leaders who will discuss current issues facing Medicaid managed long term services and supports (MLTSS) plans and states including addressing the growing demand for home- and community-based services (HCBS).

, General Session

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    Current Issues in Medicaid: Insights from State Medicaid Directors

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    This session will explore trends and emerging issues in Medicaid programs and priorities of state Medicaid directors. Learn how health insurance providers can partner with states to improve outcomes for Medicaid beneficiaries.

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    Prevention in the Context of Behavioral Health

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    A panel of experts will explore evidence-based strategies to reduce the risk of mental health disorders and substance abuse. Speakers will examine early intervention practices, the role of community and family support, and the importance of addressing social determinants of health. They will also discuss effective use of technology, access to measurement-informed care, and the integration of behavioral health into primary care, with an emphasis on collaborative efforts across providers, health plans, policymakers, and community leaders to create effective and sustainable efforts to improve prevention in the context of behavioral health.