Overview: Roadmap to Implementation
Stan Dorn
Senior Research Associate
Urban Institute
Health Insurance Exchanges: Goals and Strategies
This session will examine the potential value of state-based health insurance exchanges. What do states need to understand regarding whether they want their exchange to be a market organizer or an active purchaser? What are the important issues related to procurement and contracting dynamics with qualified health plans? Panelists will discuss how local market dynamics (carriers/providers) can affect the goals of an exchange.
PowerPoint Presentation
Panelists
Enrique Martinez-Vidal
Director, State Coverage Initiatives
Patrick Holland
Managing Director
Wakely Consulting Group
Norman Thurston
Health Policy and Reform Initiatives Coordinator
Utah Department of Health
Health Insurance Exchanges: Governance & Structure
This session will explore the key administrative issues related to the implementation of health insurance exchanges. Will the structure be statewide, regional, or multi-state? Will it be handled by an independent organization or become a part of an existing state entity? Panelists will give insight into how state officials can best communicate and coordinate their efforts.
PowerPoint Presentation
Panelists
Enrique Martinez-Vidal
Director, State Coverage Initiatives
Patrick Holland
Managing Director
Wakely Consulting Group
Norman Thurston
Health Policy and Reform Initiatives Coordinator
Utah Department of Health
Tracking and Coordinating Newly Eligible Populations
This session will discuss the tracking and coordination of newly eligible populations, such as new Medicaid populations, new subsidized populations, and other populations created by individual mandate. Participants will learn strategies for maximizing enrollment in new programs through effective data management, simple application requirements and careful outreach. This session will also look at the number and characteristics of the currently uninsured populations and whether they will be eligible for Medicaid/tax credit subsidies or may not be eligible for either due to income level or because of immigration status.
Panelists
Stan Dorn
Senior Research Associate
Julie Sonier
Deputy Director
Communications Strategies
This session will outline the various communications strategies required for implementation. Participants will learn how to conduct effective outreach to key stakeholders, including consumers/beneficiaries, commercial/Medicaid plans, brokers, employers, providers, and the public.
Panelists
Alison Betty
Senior Vice President
Greer Margolis Mitchell Burns (GMMB)
Nicole Stallings
Director, Maryland Health Quality Cost Council
Holding Insurance Carriers Accountable
This session will discuss ways insurance departments are working to hold insurance carriers accountable through increased reporting requirements, additional transparency, the rate review process, medical loss ratio requirements, and more aggressive oversight of consumer complaints and appeals. The session will highlight existing state initiatives and the additional responsibilities states will undertake in the context of federal reform. It will describe how insurance department regulations can be used by states to compliment other efforts to improve quality and control costs.
Moderator
Deborah Bae
Program Officer
Robert Wood Johnson Foundation
Panelists
Joel Ario
Insurance Commissioner
Commonwealth of Pennsylvania
Joshua Goldberg
Health Policy and Legislative Analyst
State Roundtable: Strategic Planning for Implementation
This roundtable consists of state officials who are leading their state’s effort to implement federal reform. Panelists will focus on the development of their strategic planning process and key issues facing each of their states given the economic and political environment.
Moderator
Enrique Martinez-Vidal
Director, State Coverage Initiatives
Panelists
Susan Besio
Director
Office of Vermont Health Access
Alice Burton
Principal, Riverside Consulting, LLC
Maryland Health Care Reform Coordinating Council
Cynthia Jones
Director, Virginia Health Reform Initiative
Office of the Secretary of Health and Human Resources
Lorez Meinhold
Director of Health Reform Implementation &
Senior Policy Analyst for Health,
Office of Colorado Governor Bill Ritter, Jr.
Cristine Vogel
Deputy Commissioner, Division of Health Care Access
Connecticut Department of Public Health
Special Advisor to the Governor on Health Care Reform
Additional Resources
Key Drivers of Cost Growth
The United States spends far more than any other country on health care and yet this is not correlated with improved health outcomes or high quality and efficiency in the delivery of services. This plenary will lay the foundation for the day’s discussion by identifying key cost drivers in the health care system.
Jonathan Gruber
Professor of Economics
Approaches to Slowing Cost Growth in Public Programs
States can make high quality health care services accessible to a broader population when efforts are taken to increase the efficiency of public programs like Medicaid, the Children’s Health Insurance Program and state employee health plans. Panelists will share strategies that—with an eye toward improving quality and decreasing cost growth—focus on high-cost populations; engage in value-based purchasing; and encourage consumer engagement strategies.
Moderator
Enrique Martinez-Vidal
Director, State Coverage Initiatives
Panelists:
Nikki Highsmith
Senior Vice President
Sarah Iselin
President
James Johnston
Bureau Director
Efforts to Promote Best Practices/Reward Evidence-based Care
One method for improving health care quality and efficiency is to promote the delivery of health care that meets best-practice standards and to make it easier for providers to consistently deliver high quality of care. This session will present the characteristics of programs that have met with success and the lessons learned that would improve similar programs and efforts.
Moderator
Shelly Ten Napel
Senior Associate, State Coverage Initiatives
Panelists
Richard Onizuka
Director, Health Care Policy
Rob Tester
Consultant
Overview of Activities in Minnesota
Minnesota has been at the forefront among states in its work to improve the health of its population through its efforts to expand and sustain coverage, strengthen the delivery system, and broaden the scope of its public health outreach. Topics of discussion will include various initiatives focusing on greater transparency in cost and quality information, public health strategies, payment reform innovations, health care homes, provider peer grouping and more.
Moderator
Sanne Magnan
Commissioner
Panelists
Jim Golden
Director, Division of Health
Carol Backstrom
Assistant to the Commissioner for Health Reform
Minnesota Department of Health
Cara McNulty
Statewide Health Improvement Initiatives Manager
Julie Ring
Director
Local Public Health Association of Minnesota
David Wessner
Senior Fellow
Division of Health Policy and Management
University of Minnesota School of Public Health
Approaches to Slowing Cost Growth in Private Health Plans
How can states hold health plans accountable for reasonable premium rate increases? Can state insurance regulation and rate review create incentives to deal with provider costs, a fragmented delivery system, and inefficient administrative structures? Learn about innovative strategies in state oversight to address increases in premium costs.
Moderator
Enrique Martinez-Vidal
Director, State Coverage Initiatives
Panelists
Deborah Faulkner
Health Insurance Consultant
Office of the Health Insurance Commissioner, Rhode Island
Larry Kirsch
Managing Partner
Imr Health Economics, LLC
Additional Resources
Delivery and Payment System Reforms Contained in Federal Reform
This session will outline many of the numerous opportunities under the new federal law that will be available to states to support their work on delivery and payment system reforms.
Robert Berenson
Senior Fellow
Public Health and Prevention
While many states focus on improving health care as a way to address escalating costs, there are important reasons to consider ways to understand and affect the upstream determinants of health. This session highlights ways to have an impact on population health. Presenters will describe what’s being done in this area and describe some creative new possibilities.
Moderator
Enrique Martinez-Vidal
Director, State Coverage Initiatives
Panelists
Bridget Booske
Senior Scientist, Population Health Institute
Shaunna Burbidge
Principal, Transportation Planner
Annie Toro
Director of Government Relations
Care Coordination and Care Transitions
Improved care coordination, a transformed primary care environment, better chronic care management, and reduced preventable hospital readmissions are all important goals. This session will highlight ways states can support delivery and payment system reforms to accomplish these goals using strategies such as patient-centered medical homes, care transition programs, and accountable care organizations.
Moderator
Shelly Ten Napel
Senior Associate, State Coverage Initiatives
Panelists
Robert Berenson
Senior Fellow
Amy Boutwell
Content Director
Brian Ebersole
Chronic Care Project Manager
