Wednesday, October 25th

Lunch Roundtables provide an opportunity for informal conversation on a specified topic. Each roundtable is hosted by an expert resource on the subject and facilitated by a NASHP representative. Additional roundtable offerings will be added to the agenda soon.

Adding Even More Substance to Managed Care: Optimizing Medicaid to Respond to Substance Use Disorders
During this highly interactive, discussion-based session, the audience will hear from state leaders who have taken big steps to modernize and transform their statewide substance use disorder (SUD) programs. This wide ranging conversation will offer insights for officials interested in leveraging Medicaid and/or managed care to effectively treat SUDs in a more comprehensive and integrated manner. Attendees will be encouraged to share lessons learned and innovative approaches as well as to discuss next-generation ideas to positively impact outcomes related to quality, access, and cost containment.

Expert Resources:

  • David Kelley, MD, MPA, Chief Medical Officer, Pennsylvania Department of Public Welfare
  • Patricia Lincourt, LCSW, Director, New York State Office of Alcoholism and Substance Abuse Services’ (OASAS) Division of Practice Innovation and Care Management
  • Laura K. Nelson, MD, Principal, Mercer Government Human Services Consulting

The Drive for Independence Among the Intellectual/Developmental Disabilities Population
Supportive and informed decision-making is a key tenant for the I/DD community. For those with an intellectual and developmental disability the desire to make their own choices and live independently is a constant challenge. Join this discussion to learn more about this critical issue in the lives of people living with an intellectual and development disability. Share how your state or community is working to better engage people in their own decision-making. How can government, advocates, the health system and other stakeholders work together to make sure individuals live the life they are seeking? What the systems of checks and balances look like? What would a framework for supportive/information decision-making look like? Join us and to find out.

Expert Resources:

  • Dan Ohler, Vice President, State & Local Government Programs, Optum
  • Jaime Daignault, Executive Director, Oregon Council on Developmental Disabilities

The Effect of Health Care Reform on LTSS Populations
With the House passing the American Health Care Act (AHCA), the Senate working on its own bill, and leaders looking to regulatory actions in an effort to advance their policy interests, health care reform could evolve in many different directions in the coming months.

This roundtable will discuss the myriad issues that any serious attempt at health care reform will face, and how various proposals will specifically affect the states’ ability to deliver Long Term Services and Supports (LTSS), as well as services to other populations. Join experts from Health Management Associates (HMA) and National Association of States Uniting for Aging and Disabilities (NASUAD) to discuss the following critical questions:

  • What role, if any, will age rating rules play in any subsequent legislation and what affect will age rating rules have on state coverage and cost for this most-expensive segment of the Medicaid population?
  • How would LTSS populations fare under block granting or per capita caps?
  • What impact would elimination of Medicaid Expansion to support Adults 55-64 have on this population’s health care and would older consumers enter Medicare less healthy?
  • How will state officials handle a significant increase in the LTSS population (in some cases as much as 300%) at the same time that overall Medicaid funding could decline?
  • What will happen to the Medicaid expansion?
  • How will states deal with the exit of a number of plans from the Health Insurance Exchanges?
  • To ensure that states make the most of the funding they do have, what program changes can states make to “do more with less?”

Expert Resource(s): TBD

How can Medicaid reform address racial, ethnic and rural disparities?
Join us in this conversation on how state health departments can work towards eliminating health disparities for their Medicaid members. Oregon has an ambitious Medicaid transformation model that explicitly and uniquely identified eliminating health disparities as one of its goal, along with the creation of Coordinated Care Organizations to improve health outcomes and control costs regionally. In this session, we will discuss Oregon’s statewide and regional efforts to achieve health equity. Learn about early findings from a research project to evaluate the effectiveness of Oregon’s Medicaid efforts in reducing disparities. How are other states thinking about health equity? Hear about the interests, challenges and activities with addressing health equity from interviews of Medicaid Directors from a geographically and politically diverse cross-section of eight states. Share your thoughts on how states can overcome the challenges of health disparities.

Expert Resources:

  • Curtis S. Harrod, PhD, MPH, Associate Research Director, Center for Evidence-based Policy, Oregon Health & Science University
  • Leann Johnson, MS, Director, Office of Equity and Inclusion, Oregon Health Authority
  • John McConnell, PhD, Director, Center for Health Systems Effectiveness, Oregon Health & Science University

Changing Dartmouth: Understanding the Impact of Local Practice Patterns on Intensity of Service Use at the End of Life and Implementing Tools for Change
The end of life is a time of intense engagement with the health care system, with important implications for quality and spending. Wide variation exists in intensity of care and hospice use – both between states and within states. A growing body of literature suggests that provider practice patterns play a significant role in driving differences in service use, to a far greater extent than differences in patient preferences for care. This roundtable discussion will focus on better understanding how and why provider practices vary between regions, as well as discuss tools providers and policymakers from around the country are using to change provider behavior to ensure that patients receive high quality care consistent with their goals and preferences at the end of life.

Expert Resources:

  • TBD

Covering Diabetes Prevention in Medicaid: What you Need to Know
This roundtable discussion will provide key learnings to Medicaid and public health officials interested in implementing sustainable, evidence-based programs focused on prevention or improving population health. Participants will hear from Maryland and Oregon, two states who are evaluating different pathways to long-term sustainable coverage of the National Diabetes Prevention Program (National DPP) lifestyle change program in Medicaid. Key learnings include:

  • Identifying, enrolling, and retaining at-risk Medicaid beneficiaries in the National DPP lifestyle change program
  • Billing and coding models that align with Medicaid authorities
  • Methods for sustainability after the demonstration project ends

Expert Resources

  • Kelly McCracken, Public Health Consultant, NACDD
  • Laura Summers, Senior Director, Leavitt Partners
  • State resources: TBD

Leveraging the Consumer Advocates in Your State
State officials relate frequently with lots of consumer groups and often express interest in finding better ways to connect with real consumers. Truly independent consumer advocates can provide a vital and helpful role in policymaking. For example, they can provide real time feedback on how policies are playing out on the ground in a way that more formal data system cannot capture. (For example, 85% of consumers do not realize they have a state insurance regulator – therefore, formal complaint systems are failing to capture most of the consumer experience.)  Consumer groups can counter-balance the perspectives of other stakeholders and ensure proposed policies are evidence-based and consumer-friendly. They can generate understanding and support for proposed policies.

Come to this roundtable to learn how to identify truly independent consumer groups in your state (and nationally) and receive a checklist of when and how to utilize advocates’ expertise in policymaking.

Expert Resources

  • Lynn Quincy, Directory, Healthcare Value Hub
  • Danielle Garrett, Strategic Policy Manager, Community Catalyst
  • Jesse O’Brien, Policy Director, Oregon State Public Interest Research Grou