8:30 -9:00 am

Breakfast

9:00 - 9:45 am

State Officials Panel:  Strengthening the Critical Partnerships between Medicaid & Managed Care ​

Moderator 

Mary Kaschak, Chief Executive Officer, MLTSS Association 

Panelists 

• Katie Evans, Chief of Long-Term Supports and Services, Division of TennCare 

• Sabrena Lea, Deputy Director for Long-Term Supports and Services, Division of Health Benefits, North Carolina Department of Health and Human Services 

• Jennifer Langer Jacobs, Former Medicaid Director, State of New Jersey 

State officials have one of the hardest jobs – caring for their most vulnerable and disadvantaged populations with limited budgets, outdated technology and ever-changing federal regulations. This panel will include two current state officials, and former New Jersey Medicaid Director Jennifer Langer, as they discuss how states are tackling issues that improve health equity and access to services. These state leaders will also reflect on their experiences partnering with managed care plans, navigating these challenges together, to deliver innovative and high-quality care to their state residents

9:45 - 10:10 am

Federal Partners Highlight: The Power of Partnerships in Coordinating and Advancing Care for Older Americans & Persons with Disabilities​

Moderator 

Sharon Alexander, President, LTSS, AmeriHealth Caritas 

Speaker 

• Kelly Cronin, Deputy Administrator for Innovation and Partnership, Administration for Community Living, U.S. Department of Health and Human Services 

As State Medicaid Agencies and managed care organizations continue to tackle the challenges with providing high-quality care coordination and home and community- based services to a growing diverse and complex LTSS population, leveraging aging and disability networks is more vital than ever before.  ACL Deputy Administrator Kelly Cronin will discuss trends in how area agencies on aging (AAAs), aging & disability resource centers (ADRCs), and centers for independent living (CILs) are strategically partnering with MLTSS plans and state regulators to address gaps in care, as well as the impact of recent updates in the Federal regulatory landscape intended to improve access, quality and value of HCBS for older adults and individuals with disabilities.  

10:10 - 10:20 am

BREAK

10:20 - 11:05 am

General Session: Transitions for Integrated Care

​Moderators 

Ann Mary Ferrie, Vice President Strategy & Policy, VNS Health 

Panelists  

• Edo Banach, Partner, Manatt, Phelps & Phillips, LLP  

• Michelle Martin, Senior Policy Director, Complex Care, UnitedHealthcare Community & State 

• Drew Gerber, Analyst, Medicaid and CHIP Payment and Access Commission (MACPAC)   

Policymakers have long aimed to improve integrated care and enrollment for dually eligible individuals while preserving consumer protections and choice. In 2024, Congress and CMS introduced policies focused on shaping integrated care for this population. This session will explore the opportunities and challenges within current frameworks for aligning care and improving the enrollment experience for duals navigating Medicare and Medicaid. Panelists will discuss federal and state rules on consumer choice, the DUALS Act of 2024, insights from the Massachusetts SCO demonstration, and lessons from the Financial Alignment Initiative. MACPAC will also share its June 2024 recommendations for optimizing State Medicaid Agency Contracts (SMACs) and strategies for improving care coordination, monitoring, and oversight.

11:05 am - 11:50 pm

General Session: Opportunities & Challenges for Building Successful Value-Based Models in MLTSS

Moderator 

Tomas Bednar, Senior Policy Advisor, National MLTSS Health Plan Association, Senior Vice President and Counsel, Healthsperien 

Panelists 

• Patti Killingsworth, Chief Strategy Officer, CareBridge 

• Dr. Lisa Mills, Subject Matter Expert 

• Anna Keith, Vice President, Long-Term Services & Supports, Centene Corporation 

• Ashley Bunnell, Manager, Special Projects, UPMC Community HealthChoices  

Value-based contracting continues to be a predominant theme throughout the health care space, with CMS aiming to have all Medicare beneficiaries and most Medicaid beneficiaries in accountable care relationships by 2030. Despite this goal and the overall evolution of value-based approaches, advancement of meaningful value-based models in LTSS / MLTSS has lagged that of other health care sectors. In 2024, as a response to conversations that occurred during the 2023 Leadership Summit on these broad VBC themes, the National MLTSS Health Plan Association convened a working group of plan members focused on the advancement of VBC in MLTSS.  
 

This panel will explore some of themes emerging from the working group with a panel of experts at the forefront of VBC efforts in LTSS / MLTSS. We will explore the challenges faced by those who seek to proliferate VBC in this space along with the uniquely personal and participant-driven definitions of value that are the hallmark of true potential and success. 

11:50 -12:50 pm

Lunch

12:10 -12:40 pm

Lunch Session: The GUIDE Model: Guiding an Improved Dementia Experience
Sponsored by Isaac Health

Moderator 

John Barth, Vice President, Business Development, Molina Healthcare 

Presenter 

• Julius Bruch, Chief Executive Officer, Isaac Health 

• Elizabeth Burke, Health Insurance Specialist, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services (CMS) 

The Guiding an Improved Dementia Experience (GUIDE) Model is a new voluntary nationwide model test that aims to support people with dementia and their unpaid caregivers.  The GUIDE Model focuses on comprehensive, coordinated dementia care and aims to improve quality of life for people with dementia, reduce strain on their unpaid caregivers, and enable people with dementia to remain in their homes and communities. It will achieve these goals through Medicare payments for a comprehensive package of care coordination and care management, caregiver education and support, and respite services. GUIDE delivers on the Biden Administration’s April 2023 Executive Order 14095 on Increasing Access to High-Quality Care and Supporting Caregivers, and advances key goals of the National Plan to Address Alzheimer’s Disease. Through the GUIDE Model, CMS is testing an alternative payment methodology for participants that deliver comprehensive, coordinated dementia care.  
 

A significant portion of dually eligible beneficiaries with an ADRD diagnosis also receive LTSS services. Thus, the GUIDE model lends itself to multi-payer stakeholder engagement. During this presentation, participants will learn more about the specific elements and requirements of the GUIDE model, hear CMS’ strategy for expanding the GUIDE model across the country in the future, explore the significant overlap between the GUIDE model

12:50 -1:35 pm

General Session: Preserving the Backbone of LTSS:  Advancing Caregiver Supports as a Driver for MLTSS Innovation  
Sponsored by Trualta 

​

Moderator 
Laura Chaise, Founder, Impact 120 Strategy Consulting 

Panelists 

• Jonathan Davis, Founder and Chief Executive Officer, Trualta 

• Marvell Adams, Jr., President and Chief Executive Officer, Caregiver Action Network 

• Joy Tomlin, Associate Vice President, Molina Healthcare 

Caregivers play an essential role in sustaining MLTSS systems as they supplement paid services, divert members from costly settings, participate in person-centered planning, and support health-related decision-making. The importance of caregivers has been increasingly acknowledged at a national level, such as through the 2022 National Strategy to Support Caregivers and President Biden’s 2023 Executive Order. However, states are taking many different approaches to supporting caregivers within their MLTSS program designs, such as including caregiver support as a covered benefit, encouraging plans to innovate and/or offer relevant value-added benefits, incorporating it into plan contract requirements, or asking caregiver-focused RFP questions.  
 

Throughout the panel discussion, we will reference the many opportunities for plan action documented in the comprehensive “Family Caregiver Strategy Action Guide for MLTSS Plans” developed by the National MLTSS Health Plan Association and the Long-Term Quality Alliance. Participants will engage in an interactive discussion about the most effective strategies for and barriers to plan implementation of caregiver support initiatives, the connections between caregiver support and workforce initiatives, and the models and channels that maximize caregiver engagement and individual outcomes

1:35 - 2:25 pm

General Session: Improving MLTSS Quality of Care to Achieve Optimal Independence for individuals with IDD

Sponsored by Independent Living Systems

​

Moderator 

Josh Boynton, Senior Vice President, Complex Health Solutions, CareSource  

Panelists 

• Thomas Mangrum, Self Advocate 

• Lorene Reagan, Strategic Consultant, IntellectAbility 

• David Rogers, President, Independent Living Systems-Florida Community Care 

• Kris Kubnick, Senior Director, LTSS Center of Excellence, Elevance Health 
   

People with intellectual and developmental disabilities (IDD) have, for many years, been carved out of Medicaid managed care, primarily because managed care plans are perceived as having insufficient experience to effectively serve the population. But this is changing as more states look to the advantages of managed care to deliver comprehensive, person-centered care, and bend the cost trend for services for people with IDD. 

This panel will share successful strategies for demonstrating organizational readiness for the IDD population from the RFP process through go-live and implementation. The panel comprised of a person with lived experience, two managed care executives, and a former state IDD director with managed care experience. The panelists will identify pain points and describe interventions designed to promote health equity, minimize member and provider abrasion, and manage costs across all aspects of managed care operations. Using real-life scenarios, panelists will draw on their lived experience and professional expertise to highlight the opportunities and pitfalls associated with managed care organizational readiness to serve people with IDD and provide a framework for structuring an effective organizational readiness review process. Attendees will be encouraged to share their experiences (both positive and challenging) while demonstrating readiness to serve the IDD population.   ​​​​

2:25-2:45 pm

BREAK
Sponsored by Vesta Health

2:45 - 3:25 pm

Breakout Sessions:  

• Breakout:  Making Care Coordination Work 
  Co-Moderators 

  • Rebecca Voss, Vice President of Client Business Solutions at Virtual Health 

  • Brendan Harris, President of UPMC for You and State Programs at UPMC 
    
    Effective care coordination of LTSS populations is impaired by a rapidly changing regulatory environment, the prevalence of complex and chronic care needs, the multi-touch care continuum required, and the fragmented setup of the payer, provider, and CMS data. These major challenges require unique approaches that optimize person-centered coordinated care for positive outcomes at the member, organization, and care team levels, as well as nimbly adapt to evolving environmental changes while driving health improvements within LTSS populations. This session will explore unique approaches to bridging seamless data interoperability practices with flexible configuration management to support a plan’s integrated care processes and deliver more effective, efficient, productive coordinated care for diverse LTSS populations. In this session, leaders will discuss strategies for implementing interoperability within care management systems, which allows for the flexibility needed for complex populations and enables operational teams to spend more time with participants and less time working to meet shifting regulatory requirements.  
     

• Breakout: Achieving High Quality MLTSS Assessment Outcomes
  Co-Moderators:

  • Matt King, Chief Executive Officer, QCSS Health 

  • Elaine Aguirre, Vice President, Clinical Operations and Strategic Growth, The Columbus Organization 
    
    Determining holistic needs, ensuring appropriate care, and building care plans for individuals who require assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) presents a unique set of challenges that are amplified within Medicaid populations who are often the most vulnerable and underserved members of our communities. Creating a person-centered care plan begins with assessing the needs of Medicaid members in the community. It is a core business process of MLTSS health plans, and these assessments can be fraught with complexities that MLTSS plans need to overcome. In this session, moderators will facilitate an interactive discussion regarding the following issues: managing a field-based, remote workforce; addressing the variation in quality of assessments between individual assessors and/or assessment organizations; conducting an assessment and achieving consistent interpretation; addressing comprehensive health assessments that are prone to misalignment across domains (such as cognition, behavioral health, physical functioning, diseases, supports, and other health related domains); the downstream impacts of health assessments on health plan operations and member outcomes; and other areas where regulatory agencies can assist in improving these core business processes. Promising practices and innovative strategies to overcome challenges in these areas will be highlighted. 
     

• Breakout: Leveraging Enabling Technologies to Advance Independence First
  Co- Moderators 

  • Rachel Chinetti, Staff Vice President, Elevance Health  

  • Michelle Martin, Senior Director of Policy, Complex Care, UnitedHealthcare Community & State 
    
    This facilitated session will explore the latest developments, policy questions, and strategies for increasing access of older adults and individuals with disabilities to enabling technologies. Participants will have an opportunity to share challenges faced with balancing demand for enabling technologies and ensuring coverage of such technologies leads to intended improved health and quality of life outcomes. 

3:30 - 4:10 pm

Breakout Sessions:  

• Breakout:  Taking Value-Based Care to the Next Level
  Sponsored by BAYADA
  Co-Moderators 

  • Anna Keith, Vice President, Long-Term Services & Supports, Centene Corporation 

  • Matt Lippitt, Vice President, Payer Contracting and Strategy, BAYADA Home Health Care 
    
    Strong collaboration between managed care organizations (MCOs) and providers is crucial to the success of value-based contracting (VBC) in MLTSS. The LTSS landscape consists of a variety of service providers, many of whom are smaller, community-based organizations that may lack the resources, infrastructure, or knowledge necessary to engage effectively in value-based arrangements. This fragmentation presents challenges for plans and providers alike, including difficulties in tracking and reporting metrics, managing financial risk, and aligning care goals. To overcome these barriers, it is essential that MCOs and providers work together to build capacity, share resources, and establish clear expectations for performance. 
    
    Based on input from its member plans, the National MLTSS Health Plan Association has developed a stepwise framework in the planning, execution, and evaluation of a plan-provider VBC relationship. In this session, leaders will discuss the key steps for the development of a successful value-based contracting relationship, highlighting recommendations from the Value-Based Contracting Workgroup paper. 
     

• Breakout: Strategies for Improving Self-Direction  
  Sponsored by Consumer Direct Care Network
  Moderator 

  • Bed Bledsoe, President and Chief Executive Officer, Consumer Direct Care Network 
    
    The ongoing caregiver shortage and workforce crisis, along with rising costs of care, necessitates different approaches to assuring members eligible for LTSS get what they need when they need it to live optimally independent lives in their homes and communities. Self-direction offers a compelling strategy to provide greater flexibility, opportunities for creative solution-building, and more personalized supports for individuals with LTSS needs. But operationalizing the core principles of self-direction in a Medicaid managed care model is easier said than done. This breakout session will discuss the challenges states are facing in developing successful consumer-directed programs, and strategies and approaches MLTSS plans can take toward realizing the full potential of this innovative model in the years to come.  
     

• Breakout: Success and Challenges of Coordinating Unaligned Dually Eligible Population     
  Co-Moderators 

  • David Kagan, MD, Senior Medical Director, Enterprise Medical Management, LA Care Health Plan 

  • Judy Cua-Razonable, Senior Director, MLTSS, LA Care Health Plan  
    
    “Alignment” in the context of MLTSS occurs when the parent organization of a dually-eligible beneficiary’s MLTSS plan is the same organization as that beneficiary’s Medicare Advantage plan – typically some form of a dually-eligible special needs plan (D-SNP). While alignment of beneficiary’s service delivery remains an overarching goal for most Medicaid and Medicare stakeholders, the practical reality is that the majority of dually-eligible MLTSS (and LTSS) beneficiaries remain unaligned. Until broader policy reforms, service delivery adjustments, and evolutions in beneficiary preference for alignment change this reality, MLTSS plans must continue to focus on the care coordination needs of unaligned beneficiaries at least as much as the needs of unaligned beneficiaries. 
    
    This panel will explore the inherent challenges of this coordination process as well as practical approaches in addressing it. The breakout seeks to foster a dialogue that can lead to the identification of recommendations in policy reform as well as best practices in care coordination. 

4:10 - 4:30 pm

BREAK

4:30 -5:30pm

Federal Partners Highlight:   Candid Conversations Regarding Innovations in Medicare/Medicaid LTSS 

Moderator 

Mary Kaschak, Chief Executive Officer, MLTSS Association 

Speakers 

• Tim Engelhardt, Director, Medicare-Medicaid Coordination Office, Centers for Medicare and Medicaid Services (CMS) 

• Gretchen Nye, Technical Advisor, Models, Demonstrations and Analysis Group, Medicare-Medicaid Coordination Office, Centers for Medicare and Medicaid Services (CMS) 
   

Over the past several years, the Centers for Medicare and Medicaid Services (CMS) Medicare and Medicaid Coordination Office (MMCO) has implemented transformative policies to improve the delivery of integrated care for dually eligible individuals. The recent contract year (CY) 2025 Medicare Advantage and Part D final rule codifying significant changes to D-SNP enrollment policies to support and enhance alignment efforts for dually eligible individuals across states. As states and health plans prepare for major changes like the upcoming sunset of the Financial Alignment Initiative and transition to new dually eligible special needs plan (D-SNP) models in participating states, the implementation of new special enrollment periods, and enrollment limitations for integrated D-SNPs, there has been much discourse and scenario planning for the varied potential implications for states, health plans and beneficiaries. In this session, we will hear from MMCO about the office’s vision for the future of integrated care, their work with states and other stakeholders in preparation for upcoming policy deadlines

5:30 - 6:30 pm

Showcase Reception
Sponsored by CareBridge