Technology Trends in Medicaid

Did you miss last week’s Medicaid Matters Talk Show? Richard Yadon, show host interviewed Gwen Williams VP of Molina Medicaid about the latest trends driving the Medicaid eco-system forward toward 2013. Ms. Williams currently serves as the Chairwomen of the Private Sector Technology Group. Learn more about the PSTG by clicking here.

Listen in to the Medicaid Matters show recording below:


Video streaming by Ustream

Medicaid Matters Summer Broadcast Schedule

Medicaid Matters is excited to announce the 2012 summer broadcast schedule. Be sure to mark your calendar. Show time is 1pm EST/ watch and listen from www.medicaidtalk.com.

6/12 Guest:Matthew “Alex” Yei

Task Order Manager, AdvanceMed Corporation, an NCI Company
Past Director of Program Integrity Utah Department of Health
Past President of the National Association for Medicaid Program Integrity

6/26 Guest: Karen Dale, RN, MSN

EVP Chartered Health Plan

7/10 Guest: Michael Richards

Executive Director Government Relations and External Affairs
Gundersen Lutheran Health Systems

8/7 Guest: Anthony “Tony” Keck

Director of Health and Human Services State of South Carolina

8/21 Live Broadcast from the Medicaid Enterprise Systems Conference

4/10 | The Supreme Court & The Future of Medicaid

CapitalThe arguments are over and now we wait.  In just a few months the Supreme Court will deliver its ruling on the Affordable Care Act.  If the ACA is overturned, what does this mean for Medicaid?

Listen in as Medicaid Matters gathers the opinions from experts across the country on what they see on the horizon for Medicaid.  Of special interest will be the  implications of ACA repeal.

Want to join in the conversation? Call in during the show: 626-657-2125

3/27 |Integrated Care Management | Robert Mendonsa CEO Aetna

Robert Mendonsa, CEO AetnaWe are honored to have Robert Mendonsa CEO Of Aetna Better Health in Illinois as our guest on the March 27th Medicaid Matters Talk Show.

As chief executive officer of Aetna Better Health in Illinois, Robert Mendonsa’s (BIO) primary responsibilities include overseeing health plan staff and establishing and maintaining a system for reviewing, assessing and implementing the state contract.

1PM EST CLICK HERE TO LISTEN LIVE

In addition, he is responsible for the implementation and execution of the health plan’s Integrated
Management Care program. Mr. Mendonsa has had a long career with Aetna. He began as a sales manager in 1991 and, since then, has held six positions in three states. Prior to his current role, he was president of small and middle markets for the 16-state North Central Region. Based in Chicago, he was responsible for profit and loss for health insurance products sold to employers with 2 to 3,000 workers. Before re-joining Aetna, Mr. Mendonsa was the chief financial and administrative officer at Association House of Chicago, a 110-year-old social service institution dedicated to improving the lives of the neediest.Throughout his career, Mr.Mendonsa has devoted a significant amount of time to public service causes.

He has served as chair of the American Heart Association,Community Health, a free clinic on Chicago’s west side, and the Aetna Foundation Regional Grants Council. Mr. Mendonsa earned a master’s degree in business from the University
of Southern California and a bachelor’s degree in economics from the University of California,Los Angeles.

Strategies to Reduce Hospital Re-Admissions| 3/13 1pm EST

Richard Yadon, Host Medicaid Matters Talk Show

Since CMS soon will penalize hospitals that see too many patients return within a month, now is the time to create strategies to avoid re-admissions. This is one of the HOT topics for any company involved in the servicing of Medicaid recipients. Please join Richard Yadon, host of Medicaid Matters as he discusses strategies that help lower the rate of re-admissions with hospital operations experts, Dr. Patrica Hines (BIO) and Dr. Bonnie L. Barndt-Maglio. (BIO)

Tuesday March 13 1PM EST.


Medicaid Video: Care Management

2/28 |The New Face of Medicaid | Linda Hamacher CEO Genesse Health

Listen to the recording (below) of this informative discussion with Linda Hamacher (BIO)  about the changing face of Medicaid. Ms. Hamacher plans on sharing highlights of a recent presentation made at the Medicaid Innovations Forum.

Genesee Health Plan (GHP) is a community-based non-profit that provides primary care & other basic services to 27,000 low-income, uninsured adults in Genesee County, Michigan, one of the most economically depressed areas of the U.S. The Genesee Health Plan is the only local one in Michigan that is funded directly by the community through a special millage. The plan reduced its enrollee’s’ use of emergency department services by 51% and hospital admissions by 15% between 2006-2007. The success of the Genesee Health Plan has demonstrated that any community–even one with scare resources–can provide basic, affordable health services to uninsured adults.



Video streaming by Ustream

Live Broadcast Video: Fraud Panel at Medicaid Innovations

Not able to attend the conference?  No worries, we can’t bring you the Florida sun but we can bring the panel discussion on Enrollment and Fraud prevention to you.   Listen and watch via the video below:

This two day Forum  highlighted the best of the best from the Medicaid industry. Please see the speaker list below.

Listen in as show host Richard Yadon moderates the afternoon panel discussion on Enrollment and Fraud Prevention.

 


Medicaid Innovation Forum
February 8-9th 2012
Orlando Florida

Register
Scheduled Speaker List:

Margaret K. Brockman, RN, MSN, CCM, COHN

Program Specialist, Physician Services
Nebraska Medicaid and Long Term Care

Stephanie Sullivan Chrobak

Director of Commonwealth Care Program
Commonwealth Health Insurance Connector Authority (Health Connector)

Bill Clark

Director, Provider and Member Relations
Department of Vermont Health Access

Robert E. Cooper, Jr.

Manager of Community Affairs
Ameri Health Mercy Health Plan

Robert M. Damler, FSA, MAAA

Consulting Actuary
Milliman

Thomas Derrick

President
MariChris, LLC

Holly Michaels Fisher

Vice President, Government Program Management and Strategies
OptumInsight Consulting
Holly Michaels Fisher is a Vice President in the Government Program and Management

Clint Fuhrman

Director of Government Health Care Programs
LexisNexis Risk Solutions

M. Melanie “Bz” Giese, RN

Deputy Director, Medical and Managed Care Services
South Carolina Department of Health and Human Services

Jeff Gottlieb

Director of Sales, Public Sector
SXC Health Solutions, Inc.

Linda Hamacher, President; CEO,

Genesee Health Plan of Michigan

Dr. Scott Howell

National Senior Medical Director for Clinical Performance and Compliance
OptumInsight

Thomas L. Johnson

President and CEO
Medicaid Health Plans of America

Kevin Kempske

Partner, EVP, Public Relations and Grassroots Outreach
GKV

Register Here for the Forum use code MP52 to get $200 discount!

David C. Kumpf, CEO
Optimetra

Greg Moody

Director, Governor’s Office of Health Transformation
State of Ohio

Beth Nelson

Medicaid Development Director
ClearStone Solutions

Henry W. Osowski

Managing Director
Strategic Health Group LLC

Janet Parenteau

Business Solutions Director, Care Management
DST Health Solutions

Karen Parker

Director, Bureau of Medicaid Financial Management and Administrative Services
State of Michigan

Scott P. Polansky

Chief of Business Development
Boston Medical Center HealthNet Plan
Scott Polansky is Chief of Business Development for Boston Medical Center HealthNet Plan (BMCHP) in Boston, MA. BMCHP serves almost 250,000 members and is the 4th largest HMO in Massachusetts.

Garry Raim

Partner, EVP of Direct and Interactive Marketing
GKV

Robin Raveendran

Chief Program Administrator
Arkansas Department of Human Services, Division of Medical Services – Program Integrity Unit

Michael Richards

Executive Director, Government Relations and External Affairs
Gundersen Lutheran Health System

Robert Robidou

Director, Network Development
Cook Children’s Health Plan

Cheryl Slagle, RN, CMCN, CCM

Vice President, Health Services
CareSource

Debra Smyers

Senior Director, Program Development for Medicaid, Special Needs Plan, and CHIP
University of Pittsburgh Medical Center (UPMC) Health Plan

Hoa Su, MPH

Manager of Health Education
Health Net, Inc.

Jacqueline Thomas

Director, Program Integrity
Alabama Medicaid Agency

Pamela Tropiano, RN, CCM, BSN, MPA,

Senior Vice President, Health Services
CareSource

Care Management Recording | Medicaid Matters Jan 31st

Medicaid MattersListen in to an insightful and relevant discussion. Our panel of Medicaid care management experts share their views and expert opinions about the latest trends, issues, and challenges in the areas of:

Care Coordination |Case Management |Care Management |Field Service Coordination

 

Watch and Listen below

Video streaming by Ustream

This Weeks Guests:

Cheryl Slagle, VP Health Services, CareSource

___________________________________________

Juanica Williams, Past Director
Health Care Management Services, Amerigroup

___________________________________________

Deborah Mitchum, Director Case Management, Denver Health

 

Medicaid Matters Talk Show|Jan 17th|Reducing Cost & Improving Quality

Join Us on Tuesday at 1pm EST

Show Guests:

Jay Mason, CEO

MyHealthDIRECT

Jay Mason leads the organizations strategy and vision, aligning innovative industry business models to the development of its technologies and services. Its application and services are widely-used by health systems, hospitals, managed care organizations and State health information exchange initiatives, resulting in the reduction of unnecessary emergency room visits, cost savings for hospitals and public health programs and better access to care and care coordination for patients. Mason’s future plan also includes a model where consumers can use the solution on their smart phone to find and secure healthcare appointments in their communities.

Mason launched National Employee Benefits in 1988, one of the first chiropractic benefit management firms in the country. In 1998, he sought out and led in the merger with American WholeHealth in that year. As CEO of their managed care division, AWH became the leader in complementary and alternative benefits, with over 30,000 contracted providers and 20 million covered lives.

A strong believer in community service, he has served on the Board of Directors of Congo Initiative, Board of Directors of Christian Stewardship Foundation and Board of Directors of Concordia University of Wisconsin. He also serves on the Advisory Board of Concordia School of Pharmacy. Mason holds a graduate degree in non-profit management from Carroll University, and a business management bachelor’s degree from the University of Wisconsin, La Crosse.

Tom Reilly, Vice President-Health Care Solutions

MyHealthDIRECT

Tom is currently Vice President of Healthcare Solutions for My Health Direct, Inc. In his capacity Tom has a role in shaping the strategic direction of the company. Other responsibilities include generating new business and ensuring that current accounts are renewed and strengthened.
Having held key roles in the for-profit, not-for-profit, and government sectors, Tom Reilly has a nuanced understanding of the unique values and culture associated with each.

In the governmental sector, Tom served as Senior Advisor to the Administrator of the Centers of Medicare and Medicaid Services (CMS). In this role, he reported to the lead person in the agency and was charged with ensuring that critical projects and priorities were successfully completed.

Implementation of new programs, such as the Chronic Care Improvement Program, was among his responsibilities. Management of operational priorities, such as staffing allocation, was also among his responsibilities.

In the non-profit arena, Tom served as Director of Government Affairs for Aurora Health Care. He advocated for Aurora’s integrative approach to health care delivery among federal, state, and local governments. In addition to securing additional governmental funds for Aurora, he successfully advocated for a new initiative to improve care for patients with chronic conditions. As a result of his efforts, Aurora secured onsite access to state Medicaid enrollment specialists.

Tom has also worked in the for-profit sector prior to working for My Health Direct. As Account Manager for Cenpatico Behavioral Health, part of Centene Corporation, it was his responsibility to successfully interface behavioral health services within the health plans. Prior to working for Cenpatico, he founded an independent consulting firm, Evolution Strategies, to find ways to bring community-based solutions to the most challenging demands of business.

Integrated Care Management|Robert Mendonsa CEO Atena

Join Medicaid Matters on March 27th as we take a look at Integrated Care Management.  We are honored to have Robert Mendonsa CEO Of Atena Better Health in Illinois as our guest.

 

Robert Mendonsa, CEO AetnaRobert Mendonza Bio
As chief executive officer of Aetna Better Health in Illinois, Robert Mendonsa’s primary responsibilities
include overseeing health plan staff and establishing and maintaining a system for reviewing, assessing and
implementing the state contract.
In addition, he is responsible for the implementation and execution of the health plan’s Integrated
Management Care program. Mr. Mendonsa has had a long career with Aetna. He began as a sales manager in 1991 and, since then, has held six positions in three states. Prior to his current role, he was president of small and middle markets for the 16-state North Central Region. Based in Chicago, he was responsible for profit and loss for health insurance products sold to employers with 2 to 3,000 workers. Before re-joining Aetna, Mr. Mendonsa was the chief financial and administrative officer at Association House of Chicago, a 110-year-old social service institution dedicated to improving the lives of the neediest.Throughout his career, Mr.Mendonsa has devoted a significant amount of time to public service causes.

He has served as chair of the American Heart Association,Community Health, a free clinic on Chicago’s west side, and the Aetna Foundation Regional Grants Council. Mr. Mendonsa earned a master’s degree in business from the University
of Southern California and a bachelor’s degree in economics from the University of California,Los Angeles.