The 2017 State Healthcare IT Connect Summit Agenda Agenda
Day 1 | Tuesday March 28
Registration, Breakfast & Networking
Opening Remarks: Rob Waters, VP Development, Healthcare IT Connect
Rob Waters, VP Development, Healthcare IT Connect
Opening Keynote: Sustaining Innovation to Build a More Responsive, Cost Effective H&HS System
Tracy Wareing Evans, CEO & President, American Public Human Services Administration (APHSA)
Jared Linder, CIO, State of Indiana Family and Social Services Administration
Jeff Myers, President & CEO, Medicaid Health Plans of America
Shane Hatchett, Deputy Medicaid Director, Indiana Family & Social Services Administration
Arun Natarajan, Senior Policy Analyst ONC/DHHS
Networking Break in the Connect Exhibit Hall
What comes first? Building a 21st Century Modular HHS Ecosystem
Moderator: Robin (Chacon) Dufresne, VP and Director, Healthcare and Human Services at CSG Government Solutions
Jess Kahn, Director Data of Data and Systems Group, CMCS/CMS
John Stern, H&HS Portfolio Director, State of Vermont
Tom Graves, Senior VP, Government Solutions, Optum
Chris Lunt, VP Engineering, Consumer at GetInsured
Sharif Hussein, SVP for Health and Human Services, CNSI
Buffet Served for Meet the Innovators Lunch
Meet the Innovators Keynote: Blockchain as the Foundation for Transformation of Health Information
Moderator: Andrea Danes, Medicaid Futurist, HHS Integration Advocate
Mike Wons, CTO, State of Illinois
Sunil Thomas, CIO Business and Workforce Cluster, State of Illinois (TBC)
Corey Todoro, COO Hashed Health
Dr. Shahram Ebadollahi, Vice President of Innovations (R&D) and Chief Science Officer, IBM Watson Health
Blockchain technology has the potential to completely disrupt many industries, including healthcare. It’s foundational concept of transparency and asset ownership creates a near seamless mechanism for validating health information, including sharing with identified stakeholders. The potential implication for data exchange, combatting fraud and abuse, disease management, care coordination, and so many other critical Medicaid functions is amazing! Join a panel of experts to learn more about the basics, industry collaboration for the advancement of blockchain solutions, state and vendor visions, and an opportunity to engage in the conversation, perhaps even as a proof of concept participant.
Short Break in the Connect Exhibit Hall
Meet the Innovators Working Lunch Roundtables
Roundtable 01:Presenter: Brad Kramer, Senior Business Tech Architect, CA Technologies
Creating a Software Factory for your Healthcare Constituents
Your healthcare constituents within the Federal Government and your State are driving the need to delivering innovative, high-quality Health and Human Services applications faster; and with a greater degree of quality and customer interaction. The change to becoming an “Application Agency” can be a chaotic and a complex process, particularly if your application delivery systems and processes were designed to push out one or two releases a year or deliver only multi-year projects. Learn during this roundtable, how can you create a “Software Factory” built on a continuous delivery model that removes development obstacles and streamlines the delivery pipeline to improve velocity without sacrificing quality.
Roundtable 02: Presenter:Carrie Gott, Business Development Manager, Eccovia Solutions
How Care Coordination is expanding to include the Social Determinants of Health to achieve the Triple Aim
Medicaid populations with complex health conditions represent a growing cost for states. State agencies must work with providers across the health spectrum to develop care coordination strategies that improve health outcomes and reduce costly emergency room visits and hospitalizations.
In this interactive round table discussion, Carrie Gott, Business Development Manager at Eccovia Solutions will discuss community-based care coordination initiatives and ACO expansion, and share best practices for using technology to coordinate between primary care, behavioral health, and community-based social service organizations.
Roundtable 03: Presenter:Shekhar Kanade, Senior Project Manager, Infosys Public Services
Keeping the lights-on while modernizing legacy HHS systems
A major challenge in health and human services modernization is to balance the modernization initiative with management of existing systems. Modernization happens in phases; i.e., only a few programs move over from the legacy system to the new system in each phase. With recent guidance from the CMS on modular development and procurement, multi-pronged, phased implementations and operations will soon become the norm. How can agencies manage these multiple systems - some legacy, some new in production, and some in implementation? What are the implications of agile development for multiple systems in transition, both in procurement and development? What are the applications of the Gartner’s BiModal IT to this situation? Join the roundtable for practical insights from industry and government experts.
Roundtable 04: Presenter: Nestor V. Figueroa Principal and Co-Founder, Nagnoi, LLC
Achieving Triple Aim Initiatives through Data Analytics
Achieving higher quality of care that leads to improved outcomes at a lower cost with increased patient satisfaction has long been the desired state. With its most recent regulatory releases, 2390P and 2392F, CMS continues to emphasize quality of care, from a population health perspective by “closing” the gaps in care, to reporting on evidence based member and provider management and coinciding outcomes . With States increasingly implementing value-based purchasing agreements the need for action-driven analytics Nagnoi’s advanced reporting technologies can give these organizations and its providers a comprehensive unbiased view of quality across the entire continuum of care. This demands the extraction of data from virtually any source, EMRs, APCDs, MMIS, DW, Exchanges, among others, at any level of granularity and as frequent as needed. In this roundtable, we will discuss various analytic approaches and show examples of actionable analytics that can impact Federal and State quality outcomes, cost of care, and patient satisfaction for MMIS’s, Data Warehouses, ASO’s, or virtually any operational enterprise.
Roundtable 05: Presenters:Chad Bennett, Director, State IT Solutions, Telligen
The Health Care Continuum – Approaches to Population Health Management Across your Entire Population
Brian Barry, Vice President, Information Management, Telligen
Whether operating in a fee for service or managed care environment, having a strategy to manage risk, improve clinical outcomes and lower costs for your entire population is vital to sustainability.
This discussion will be a collaborative roundtable focused on approaches to population management across all provider groups and patient categories. Topics covered include: Predictive Analytics, Risk Stratification, Performance Measurement, Quality Improvement, and proven intervention strategies leading to improved clinical and financial performance.
With the changing Healthcare landscape in 2017, we will discuss:
What challenges do you have managing the health and costs of your healthy and at risk populations?
What are the best approaches for improving clinical outcomes and lowering costs?
Data for improvement vs. data for evaluation
Enterprise data management – managing diverse data sets to drive analytics and intervention strategies
Population Health Analytics within an integrated software product
How Care Management and Analytics modules plug in to your enterprise
Roundtable 06: Presenters:Catharine Evans, Director, U.S. Government Healthcare, Teradata
Combatting the Opioid Epidemic with advanced Analytics
There were more than 52,000 lethal drug overdoses in 2015. Over 20,000 of those overdoses were related to prescription pain relievers. Every day, over 650,000 opioid prescriptions are dispensed in the US. The use of prescription opioids is often clinically indicated for pain management, but can quickly become addictive.
What if we could predict the overutilization before it happened? What if we could proactively identify which prescriptions were medically necessary for pain and which have become part of the problem? What if we could easily identify the fraud rings that perpetuate this national crisis?
This roundtable will discuss using advanced analytics to augment States’ existing efforts to reduce Opioid abuse.
Roundtable 07: Presenters:Joshua Moore, Executive Account Manager, Conduent
Navigating the Medicaid Modernization Minefield: Role of the System Integrator
Janelle Sheen, Pharmacy Solutions Director, Clinical Pharmacy Services, Conduent
Join Conduent for a discussion on the role systems integrators play in supporting platform modernization projects.
Medicaid administrators must support changing regulations while ensuring their program goals are achieved. Technology transformation enables data sharing and improved access to information; while business transformation allows modernization projects to address program change. Balancing IT and business is an enterprise-wide effort which vendors and State must support.
This discussion will cover issues including:
· What will drive your modernization initiative?
· Do you consider the SI a strategic advisor or integration vendor or both?
· Is program and business re-engineering part of your modernization effort?
· How are scope changes managed across vendor contracts?
· Does a potential ACA repeal affect your modernization plans?
Track 1Moderator: Ryan Howells, Principal, Leavitt Partners Panelists: Jess Kahn, Director Data of Data and Systems Group, CMS
The Medicaid Technology Alliance: A multi-sector public private partnership
Anshuman Sharma, Entrepreneur in Residence, Medicaid Data & Systems Group, CMS
Robin Arnold-Williams, Principal, Leavitt Partners; former two-time State Medicaid Director
Elena Nicolella, Executive Director of the New England States Consortium Systems Organization (NESCSO)
Hemi Tewarson serves as Program Director, NGA Center for Best Practices’ Health Division
Julie Boughn, Audacious Inquiry, LLC; former Deputy Director, Center for Medicaid and CHIP, CMS
Tom Graves, SVP, Optum Government Solutions
Chris Underwood, Office Director, Health Information Office, CO Department of Health Care Policy and Financing
Nicole McNeal, Management Consultant, Public Knowledge LLC
Andrea Danes, Medicaid Futurist, HHS Integration Advocate
Frank Guinan, Information Technology Program Manager, Commonwealth of Virginia, Department of Medical Assistance Services
John Stern, Agency of Human Services, HSE Portfolio Director, State of Vermont
Andrew Laing, Business Architect, Agency of Human Services, State of Vermont
In December 2015, CMS issued the MMIS 90/10 final regulation. There are significant questions from states, vendors, and consultants regarding how to implement the rule.
In 2016, Leavitt Partners, NESCSO, the NGA, and CMS convened a multi-sector, public private partnership called the Medicaid Technology Alliance to facilitate a consensus-driven process to solve many of those questions. The goals of the Alliance are to accelerate the development of new technologies, develop consensus-driven modular definitions for states and vendors, promote more effective procurement practices, and identify best practices to help states with implementation.
Our presentation will provide an update on the Alliance's progress to date, how other states and interested parties can get involved, and describe the Alliance's vision for the future.
Financing and Governing Health IT Services through Public/Private Partnerships
Moderator: Carol Robinson, Principal of CedarBridge Group LLC
Mark Schaefer, PhD, Director of Healthcare Innovation, Connecticut Office of the Healthcare Advocate
Amy Zimmerman, Rhode Island State HIT Coordinator, Rhode Island Executive Office of Health and Human Services (EOHHS)
Carrie Yasemin Paykoc, Colorado State Health IT Coordinator
Sheldon Wolf, Director of North Dakota Health Information Technology
Developing trust and consensus among public and private sector stakeholders, particularly around financing and governance of new health IT assets, can be difficult. Yet, collaboration is essential for successful HITECH 90/10 funding requests from CMS, and is even more important when governing implementations and operations of technology and data exchange services. Many states are tapping the time-limited Medicaid HITECH funds to implement care management tools, electronic clinical quality measurement systems, population health registries, and other technology-enabled services. Hear about governance strategies and financing tactics from State Innovation Model (SIM) testing states, Colorado and Connecticut, and learn how forward-thinking North Dakota is advancing a five-year plan to provide comprehensive HIE and analytic services without SIM funding.
Public Health IT Maturity Index: Evaluating and Improving the Adoption and Effective Use of Public Health IT
Kenyon Crowley, Deputy Director, Center for Health Information & Decision Systems, University of Maryland,
Robert H. Smith School of Business, University of Maryland Doctoral Scholar, University of Maryland iSchool
The Public Health IT Maturity Index represents a practical approach to aid public health system stakeholders, notably health departments, in the evaluation of their information technology deployment decisions. The Index details a set of stages that progressively and incrementally detail better use of information technologies to achieve the public health mission. It was developed in collaboration with a large suburban health department and primary care coalition during an EHR rollout, and informed by an extensive literature review and a Delphi exercise with experts from state and local public health departments and national multi-stakeholder groups. The Index’s composition and its applicability as a tool for public health IT strategy, and lessons from a public health EHR implementation will be discussed.
Building a Foundation of Trust for State Health IT Systems: Risk mitigation strategies to better protect healthcare data against the threat of cybersecurity
Lee Barrett, Executive Director of the Electronic Healthcare Network Accreditation Commission (EHNAC)
The incidence of healthcare cyberattacks have more than doubled in the last five years, and the financial and reputational impacts of a breach can have a monumental impact on a healthcare entity. In a race against the hackers, creating comprehensive risk mitigation strategies is essential; this is especially true as technology continues to evolve and hackers also continue to become more sophisticated in their infiltration techniques. This session will focus on the overarching threat and offer practical strategies, best practices and third party certification/accreditation that state Health IT systems can follow to adjust to the shifting cybercrime landscape and determine the stability of its IT partners, vendors and stakeholders within the organization and reduce their risks for breach or attack.
Break in the Exhibit Hall
Breakouts - Industry
Enterprise Transformation Strategies: From Oversight to Ownership
Melody Hayes, Deputy Director CA-MMIS Division California Department of Health Care Services
Carl Engel, CEO, Elyon Enterprise Strategies, Inc.
The California Medicaid Management Information System (CA-MMIS) has completed a new Strategic Plan and Visioning effort that is driving the overall move of the organization to transform how it assumes more direct state administration for CA-MMIS enterprise services management and shifts to more an "Ownership" model from one of "Oversight". There is no part of CA-MMIS that will remain unaffected by this change, including everything from how the organization is structured and measured, to how the vendor community is evaluated. This is why CA-MMIS is also finalizing its Concept of Operations, a detailed guide for not only the future, but the roadmap that informs every part the organization as to how it will get there.
Unlock the Power of Data for More Effective Health and Human Services
Abha Keshava, Offering Lead - Social Programs, IBM Watson Health
Mark Gillespie, Offering Lead, Truven Health Analytics, an IBM Company
In an evolving health and human services environment with impending health policy changes, leaders need deeper and broader insight to carry out their missions. A new partnership has emerged between humanity and technology, one that takes analytics to a new level and drives insights to action. In this session, learn more about how the evolution of analytics enables new models that can deliver a single view of the citizen to support individualized approaches to care; how predictive models and anomaly detection can help maintain program integrity; and how evolutionary cognitive computing technology can aid decision-making to match citizens with optimal service providers.
HIX 2.0: Considering an Exchange Operator
Eugene Sayan, Founder and Chief Executive Officer, Softheon
Now that federal grants authorized by the Affordable Care Act (ACA) no longer subsidize states for
Marketplace operations and information technology (IT), states that run their own health insurance
exchanges are feeling budgetary and political pressure to find the most efficient ways to do so. At the same
time, a new field of vendors – “Exchange Operators” - that specialize in IT services to health insurers and
exchanges has emerged; these vendors use software as a service (SaaS) models to support plan comparison
and selection, enrollment, financial management and other transactions. The development of Exchange
Operators enables states to take advantage of more efficient ways to organize and divide responsibilities
for operating their public Marketplaces and – potentially – to achieve significant cost savings.
Putting Identity at the Core of Modernization for the Centers for Medicare and Medicaid Services
Ted Girard, Director Public Sector, Okta
Ted Girard, Director Public Sector, Okta
Putting Identity at the Core of Modernization for the Centers for Medicare and Medicaid Services
Approximately one in every three Americans is currently enrolled in a CMS program. In order to accomplish its mission of providing all Americans better access to healthcare coverage, a higher level of care and improved health, the federal agency recognized the need to modernize its technology. Adopting best-of-breed technologies would be critical, and the organization also needed to maintain security and scale effectively. Hear CMS QPP Chief Security Architect, Barton Day explain how putting identity at the center of its transformation provides an agile, secure and user-friendly solution to better serve its millions of providers and employees alike.
Networking Cocktail Reception in Exhibit Hall
Day 2 | Wednesday March 29
Breakfast & Networking
States of Implementation Roundtables
Roundtable 01: FHIR and Cloud-based Modular Enterprise Framework
Karen Hale, SVP Strategic Development, Nagnoi, MITA Technical Architecture Committee
Jess Kahn, Director Data of Data and Systems Group, CMCS/CM
Dave Walsh, MITA Technical Architecture Committee
Medicaid Management Information Systems (MMIS) have been built as single vendor monolithic systems. CMS has indicated that in the future, federal funding will only be supplied for Medicaid solutions that are modular and interoperable. The goal is to open the door for new vendors and new solutions bringing true innovation to the state Medicaids. The MITA TAC is an industry collaborative that is open to all vendors and states. The mission of the MITA TAC is to identify and recommend approaches to modularity that are inclusive, effective, and secure. This roundtable will discuss an open-source framework that the TAC is developing with states and vendors to form the foundation for Medicaid interoperability using clouds and Fast Healthcare Interoperable Resources (FHIR).
Roundtable 02: Developing a national standard for an Electronic Long-Term Services and Supports Record (e-LTSS)
Tim Cortez, Manager Community Options Section, Manager, Colorado Department of Health Care Policy & Financing
Chris Underwood, Health Information Office Director, Colorado Department of Health Care Policy & Financing
Steve House, Consultant, Orchestrate Healthcare
The Colorado Department of Health Care Policy and Financing launched on an ambitious project to deploy new software systems throughout its Medicaid program that will allow for the integration of member level data across various delivery systems. This integration of data across systems will improve care coordination, health outcomes and the design of Medicaid benefits and public policy. As part of this effort, the Department is one of a few states working with CMS and ONC to establish national standards for an electronic long-terms services and supports record (e-LTSS). Capturing and sharing e-LTSS data between providers meaningfully has the potential to improve the coordination of care that can prevent hospital admissions/readmissions or identify, prevent or mitigate other negative consequences that impact health outcomes. This discussion will discuss the need for and challenges of coordinating information sharing between the LTSS and Health Care Systems of Care and how can setting national standards for e-LTSS mitigate these challenges.
Roundtable 03: Collaborating to Expand Interoperability Across State Lines: The Patient-Centered Data Home
Teresa Rivera, CEO, UHIN
To allow for the best care possible, medical records must follow a patient everywhere in the care continuum and across geographic boarders. Recognizing patients living near state lines, those seeking specialty treatment, and travelers seek care across state lines, UHIN, Utah's state-designated HIE, partnered with the HIEs in Arizona and western Colorado to create a Patient-Centered Data Home (PCDH) to share ADTs across state lines. When patients living in one HIE have a medical encounter at a facility participating in the PCDH in another state, their primary care physician back home receives an ADT. In its first year, the PCDH will send approximately 15,000 ADTs across state lines. UHIN is expanding the PCDH to Idaho, Wyoming, Nevada and California.
Roundtable 04: Using technology to transform care in CB-LTSS settings; initial findings from the TEFT Grant’s PHR and eLTSS components
Capri Dye, Sr. Consultant, Health Management Associates
Allison Lynn Weaver, Division of Community System Transformation (DCST), CMCS/CMS
Bonnie Young, HIT Program Manager, Georgia Department of Community Health
Shane Owens, Senior Research Engineer, Georgia Tech Research Institute
Evelyn Gallego, MBA, MPH, CPHIMS, Chief Executive Officer, EMI Advisors LLC
In March 2014, CMS awarded Testing Experience and Functional Tools (TEFT) grants to nine states to test quality measurement tools and demonstrate e-health in Medicaid Community-Based Long-Term Services and Supports (CB-LTSS). Two of the grant components are to demonstrate the use of personal health records (PHR), and create a standard electronic LTSS plan. The PHR and eLTSS components of TEFT are leading edge health IT transformation for the CB-LTSS beneficiaries, caregivers and non-clinical service providers. This roundtable will include recent insights from CMS, ONC and Georgia (a TEFT grantee) on the eLTSS and PHR components; discussing lessons learned in developing and implementing a PHR and initial findings in the piloting of the eLTSS plan.
Roundtable 05: Exploring Applications for H&HS Services Integration: The Illinois Person 360 Data Model
Gopal Khanna, Director, Enterprise Innovation Incubator (i2) Department of Innovation & Technology
Bradley J. Long, Cluster CIO HHS, Illinois Department of Innovation & Technology
The State of Illinois is piloting a data sharing and interoperability initiative that will transform government health and human services IT, and connect with other critical government functions including justice, workforce and education. This session will explain how Illinois is implementing data sharing and interoperability, and provide a deep dive into the state’s Person 360 data model.
In the past two years, Illinois established innovation incubators (“i2”) - beginning with H&HS, and progressing to public safety and business and workforce agencies - to identify and prioritize business needs for data interoperability. Concurrent with the statewide consolidation of IT resources into the new Department of Innovation and Technology (DoIT), the development of enterprise-level data sharing agreements, and the launch of a state data practice, these i2s are helping agencies build an ecosystem to identify, rapidly prototype, and analyze combined datasets to support immediate operational needs and address strategic issues..
Central to this, the Illinois Person 360 data model is designed to provide state staff, policy makers and/or providers a visual representation of an individual, the individual’s family members and every service/benefit provided to each individual in real time. This approach provides the ability to go beyond H&HS interactions into public safety, education, and employment data. The capability to integrate data on an individual from prenatal to death will provide the comprehensive visibility to support Medicaid modernization, population health management, H&HS services integration, fraud, waste, & abuse prevention, predictive analytics and other mission critical services.
Roundtable 06: Second Generation HIEs: What is Different This Time Around and How to Enable Success
Natalie Blahunka, Public Consulting Group
Janice C. Paterson, Public Consulting Group
New 90/10 HITECH federal funds are available with the release of the February 2016 CMS State Medicaid Director Letter to promote MU of EHR and HIE technology. These funds are an opportunity to facilitate HIE between Medicaid providers that are not incentive-eligible. Given this funding stream, and that HIT experts nationwide are equipped with enterprise systems planning best practices, industry standards and major lessons learned, now is the time for the second generation HIEs. This roundtable will discuss the implications of the letter, and will offer some insights and recommendations regarding how to make the second generation HIEs a success, including a discussion of HIE sustainability planning and the importance of stakeholder engagement.
Roundtable 07: Systems Standardizations Lessons Learned
Troy Aswege, SVP, Senior Vice President at Noridian Healthcare Solutions
Nancy Kaspari, PMP, Manager of Medicare System Support, Noridian Healthcare Solutions
Holly Meyer, PMP, Director Business Development, Noridian Healthcare Solutions
MITA 3.0 is very strong about promoting modular concepts and the re-use of system modules. Modularity is also a requirement within the 7 standards for Medicaid technology. The concept of using the same systems from state to state can be very daunting. However, the Medicare payment system that has been using the same systems for many years. Over the past 15 years the Medicare A/B/DME systems have been running the same core solutions by multiple contractors across the country. Coupling these consistent engines with the ability to uniquely configure the edits and audits long with the ability for contractors to utilize ancillary system such as workflow, document management and EDI solutions costs have consistently been reduced and quality has consistently risen over time. Lessons from the Medicare model likely can be realized. This round table will provide an interactive discussion on the lesson realized by this payment system and discuss how to apply the lessons in this new and changing space within Medicaid.
Roundtable 08: Electronic Visit Verification: A State & Federal Perspective
Jessica Bax, Chief, Bureau of Long Term Services and Supports, Division of Senior and Disability Services, Missouri Department of Health and Senior Services
Wendy Reilly, Manager Government Relations, HID Global Inc.
Texas Health and Human Services
US Energy and Commerce Committee (speaker TBC)
The foundation of an effective and efficient home health service solution must employ a reliable manner by which caregiver services can be accurately verified; this system is known as Electronic Visit Verification or EVV. Recent innovations in technology have paved the way for a more seamless EVV system to verify a caregiver's attendance or "proof of presence," and to assure states that services are being delivered to recipients according to providers' claims. In January 2014, the state of Illinois became the first to mandate the use of EVV. Since 2014, numerous other states have either mandated or encouraged the voluntary use of EVV. Despite recent federal legislation being introduced that would mandate EVV nationwide for certain Medicaid programs, the states still remain a patchwork of policies and with varying adoption rates.
This roundtable discussion will provide a state and federal perspective on how implementing a secure EVV solution provides proof of presence, accountability and accuracy to combat the billion dollar dilemma in Home Healthcare.
Keynote Panel: Accelerating Insights Across H&HS with Integration and Actionable Analytics
Moderator: Jeremy Racine, Healthcare Director, SAS
Ellen Marie Whelan, Senior Advisor, CMMI, CMS
Meghan Vanderstelt, Policy Director, Michigan Department of Health and Human Services
Eugene Sayan, Founder and Chief Executive Officer, Softheon
Bradley J. Long, Cluster CIO HHS, Illinois Department of Innovation & Technology
Breakouts - Industry
Assessing the State of Eligibility and Enrollment
Stephen A. Smith, MBA, Senior Director, General Dynamics Health Solutions
Evolving public programs, such as Medicaid, require processes and technologies that not only keep up with the changes and legislation, but provide comprehensive communications to inform and engage citizens. With the anticipated repeal and/or modification of the Affordable Care Act, many state health organizations question how new legislation will affect eligibility and enrollment processes and requirements. During this session, we will examine potential impacts to state Medicaid enrollment programs, to include limited resources, fixed reimbursement, and asset and income verification.
Medicaid HIT Infrastructure Needed to Support Payment and Healthcare Reform
Tom Novak, Medicaid Interoperability Lead, Office of the National Coordinator
Julie Boughn, Champion for Transformation, or Jason McNamara, Director of Health Information Systems, Audacious Inquiry
Paul Messino, Chief of Health Information Technology Policy with the Maryland Department of Health and Mental Hygiene
Chris Smith, Clinical Data Interoperability Program Manager, Mississippi Division of Medicaid
With various reform efforts underway (DSRIP, Managed Care Modernization, Shared Risk, Value Based, and Global Budgets), Health IT infrastructure is needed to achieve maximum success. With various Health IT efforts supported across governments and communities, large gaps of data mobility and utilization still exist across providers and governments alike. This session will highlight several key areas:
- Pursue a whole new level of data sharing by building patient ecosystems that connect disparate but complementary agencies and providers in a network of care that can improve outcomes and reduce costs.
• Identify current gaps and lessons learned through implementing payment reform
• Recommend a Health IT Framework needed to support future reform efforts in Medicaid
• State of Maryland's ADT Project through the Encounter Notification Service (ENS)
• State of Mississippi's Modernization of Medicaid Infrastructure to Support Clinical Data Project
How Will You Connect? A HealthCare 2020 Perspective
Brian Erdahl, Principal and the Chief Solution Architect, Deloitte
Thomas Beck, Public Sector Chief Technology Officer, Deloitte
Modularization, interoperability, and analytics are the current hot topics for health care technologies. What’s next? Will use of cloud-based and Software-as-a-Service (SaaS) technologies continue to increase? Is there a role for more mobile applications? Can sensors, devices, and “smart” things bring benefits to your state health care programs? And in the midst of it all, how can you leverage your integration platform to support bold new approaches to manage data and support evolving business models? Join in as we explore evolving technological trends, how they may impact your longer-term business models, and what you can do today to prepare.
Enterprise Identity Management in Health Care for Today and Tomorrow: the Evolution of Identity Management Solutions
Justin Hyde, Director of Market Planning, Health and Human Services, LexisNexis Risk Solutions
The government health care ecosystem is under attack. Fraudsters, increasingly organized criminal groups are infiltrating and robbing health care programs using stolen identities. State health insurance exchanges, Medicaid programs, public health plans are all at risk. Simply put if health care benefits or services are being provided, criminals are using stolen identities, likely at scale, to steal them. This presentation will discuss how government health and human services customers are using these tactics in a multi-layered approach to detect fraud, stop fraud and – most importantly – prevent it before the agency allows the fraudster to receive the benefit or service.
Networking Break in Exhibit Hall
What Does your Future Look Like? Taking the Mystery Out of a Services-based Approach
Kay Hallawell, Senior Solution Architect, Optum Government Solutions
Julie Boughn, Audacious Inquiry, LLC; former Deputy Director, Center for Medicaid and CHIP, CMS
Ravilla White, Optum
The Medicaid Enterprise of the future will improve how we manage, measure, transform and evolve our Medicaid programs to support healthier citizens and communities while conserving costs. This vision provides the opportunity to think differently. Join us to learn more about a powerful alternative - a services-based approach – to comprehensively manage Fee-For-Service (FFS) populations. We’ll discuss the benefits of this approach, where it’s being used successfully today, how it supports modularity and Medicaid modernization, and how it can be certified under MMIS procedures.
Analytics Make My Head Hurt! A Prescription for Actionable Insights
Joseph Fiorentino, Managing Director, Health and Human Services, Accenture
Martin Baker, MSc, Senior Director, Strategic Growth and Business Development, UMass Medical School
Analytics has been a challenge in Health and Human Services (HHS), and it’s no wonder. The amount and types of data, data privacy challenges, and the number of technology options can make your head hurt. However, actionable data insight can make the patient care system more person-centered, coordinated and collaborative. • Agencies need a new data mindset if they are going to use data to improve decision-making, align finite resources, measure performance and improve outcomes. This interactive session will challenge attendees to: - Move beyond compliance and operational approaches to creatively use data that reinvents service delivery and builds a stronger network of care.
• Avoid investing in infrastructure as a first step to their analytics strategy and pivot to advanced techniques that solve pressing business problems fast
• Pursue a whole new level of data sharing by building patient ecosystems that connect disparate but complementary agencies and providers in a network of care that can improve outcomes and reduce costs.
The University of Massachusetts Medical School will present on their partnership with a state agency to develop an analytics platform that addresses demands on publicly funded long-term services and places meaningful information in the hands of policy-makers. Even with data residing in multiple systems, in multiple formats, their solution did not require a large data warehouse.
Accenture will introduce an end-to-end analytics solution designed specifically for Publicly Funded Health Services to simplify analytics and deliver actionable insights from across the patient ecosystem to drive better outcomes and person centered care. We will discuss how analytics solutions can be implemented quickly and deliver results fast.
Achieving Health Information Exchange Interoperability
Bonnie Harris, Bonnie Harris, IT Project Manager, Public Consulting Group
Jackie Phan, Senior Project Manager, Public Consulting Group
Health Information Exchange (HIE) brings together information about a patient to the clinician and the care team to enable them to make well-informed, coordinated, patient-centered care. In order to achieve electronic information sharing, electronic health records (EHRs) and other clinical software must be "interoperable" or have the capability to exchange information using agreed upon standards and the willingness of those providing care and services to share information. Interoperability is the extent to which systems and devices can exchange data, and interpret that shared data. Achieving one of the three levels of interoperability (foundational, structural, and semantic), requires three critical pathways:
• Motivating the use of those standards
• Creating a trusted environment for collecting, sharing, and using electronic health information.
Embracing Patient Trust in HIEs
Rob Rhodes, VP of Product Management, Iatric Systems
HIEs hold the crown jewels of personal patient information because of the number of organizations they represent. Thus, HIEs are a target for criminals who steal patient information in order to commit medical or financial fraud. This presentation will discuss why active risk assessments are important, and will describe how using a proactive approach to find inappropriate behavior will reduce the overall risk of a privacy breach. This approach is based on an underlying vision: to build an environment of patient trust, and make that trust a strategic asset.
Networking Lunch & Demonstrations
Breakouts - Industry
Next Generation Stakeholder Engagement: Modularity and Agility Redefined
Faiyaz Shikari, Senior Vice President of Innovation
Join EngagePoint for a discussion and demonstration on the next generation of Health and Human Services solutions changing the face of modularity and agility in the marketplace.
Data Analytics Required to Be Successful in Managed Care
David J. Pierce, Director of Operations, PRM Analytics®, Milliman
Jeremy A. Cunningham, FSA, MAAA, Actuary, Milliman
With the advent of the managed care mega regulation, states, managed care entities, and other stakeholders are having to update their analytics infrastructure. Milliman’s health consulting practices and PRM Analytics have developed innovative analytic techniques and content to address the challenges in managed care.
This session focuses on a brief overview of the managed care regulations, the importance of health plan reporting and data reconciliation, and how to use population health analytics to drive managed care efficiency. We will also walk through success stories from our clients.
Preparing Encounter Data to be Fit For Purpose
Herbert H. Fillmore, Sr. Dir. Strategic Innovations and Population Health, 3M Health Information Systems
Nearly all Medicaid programs have moved or will move soon to managed care products for their population and are receiving encounter data rather than fee for service data. Encounter data can have numerous problems. These problems will undermine quality metrics reporting for the State, MCO's and providers; management of special populations and assuring their access to quality care; and with new CMS regulations, threaten Federal share of Medicaid dollars in 2018.
This presentation will present a decade of experience in monitoring, analyzing, and improving source data including but not limited to encounter data in all payer and Medicaid programs, and describe what States should be reviewing as they assess options for ensuring data integrity. Items discussed will include: source data integrity check processes frequency and depth; reporting and analytics; and services for MCO processes, persons and technologies.
Examples of successes and difficult engagements will be discussed along with best practices for successful resolution. The point will be emphasized that these ideas apply to more than just claims. Patient experience surveys, non claims based quality metric data, and social determinant data all will need source data checks.
MMIS Certification in a Modular Environment
Dawn Boland, Client Executive, Healthcare and Human Services, CSG Government Solutions
Robin Dufresne, Director, Healthcare and Human Services Practice, CSG Government Solutions
Joe Liscinsky, Vermont Health Access Health Enterprise Director and MMIS Program Lead
Lisa Alger, Client Executive, Healthcare and Human Services, CSG Government Solutions
With the concerted move to modular MMIS implementations and system certifications it's increasingly important for states to plan, strategize, and execute modernization projects in alignment with CMS' Final Rule for Mechanized Claims Systems, Medicaid Enterprise Certification Toolkit 2.1, and sub-regulatory guidance. This roundtable discusses applying a modular mindset to your SDLC from strategy and planning through final system certification, recognizing many states are (or will be) going through the milestone review process and are making strides towards modular certifications. We will discuss how to successfully incorporate the Medicaid Enterprise Certification Life Cycle processes and artifacts, including when and how to engage your systems vendors, systems integrator, and IV&V partner, as well as lessons learned from other state's approaches to modularity.
A Population Health Informatics Framework; Chronic Disease Prevention and Management Needs
John Loonsk, Consultant to CDC, CMIO CGI Federal
Jason Bonander, Director of the Office of Informatics and Information Resource Management Centers for Disease Control and Prevention – National Center for Chronic Disease Prevention and
The $34 billion dollar HITECH investment and Meaningful Use requirements have focused considerable attention on Electronic Health Record (EHR) adoption and related system needs. The incentives, standards, and testing and wide-spread adoption of EHRs, critical tools that have begun to deliver on the promises of health information technology.
However, the Affordable Care Act has added new layers to healthcare delivery, layers effecting clinical quality, payment, and public health programs with an increased focus on population health. Indeed, population health IT systems are now emerging in clinical care. These systems and the involved EHRs also have specific needs for requirements, standards, and testing to achieve population health outcomes.
The CDC’s Center for Chronic Disease Prevention and Health Promotion seeks to insure that electronic chronic disease prevention and management capabilities are broadly available to support the health of the public. Under the rubric of a Population Health Informatics Framework, we propose design elements that have the potential to work together with other elements to advance population health functionality and further promote population health outcomes.
Mining C-CDA to Populate Clostridium difficile Case Report Form
KP Sethi, Senior Software Architect, Lantana Consulting Group
Rebecca Perlmutter Maryland DHMH (TBC)
Marc Falcone, Senior Manager HIT Policy, Audacious Inquiry
Lindsey Ferris, Project Manager, CRISP (Chesapeake Regional Information System for our Patients)
Maryland is participating in C. difficile surveillance as part of the Centers for Disease Control and Prevention’s Emerging Infections Program (EIP). This is a population based form of laboratory surveillance that covers a specific catchment area in Maryland, for which all cases of C. difficile Infection (CDI) are reported. New cases of CDI require a chart review to complete a standard case report form. Currently, providers must fax or mail records, which is a manual process, requiring effort by providers and health department surveillance staff. As required by the Office of the National Coordinator for Health IT’s (ONC) 2014&2015 Edition Certification criteria, certified health IT modules must be able to export a patient’s chart in a structured XML format known as C-CDA. The C-CDA XML files contain many of the data elements necessary to populate the Case Report Form for CDI. Our team mapped data elements required for the case report form to data elements found in the C-CDA XML. Once a patient is found using the trigger codes, their data is transformed to the appropriate format required for the Case Report Form. The goal is to populate the Case Report Form automatically, using the C-CDA XML data elements or other HIE-derived data elements.
Tackling prescription drug misuse: Evolving from decentralized management to an interoperable interstate model
Joshua Moore, Executive Account Manager, Conduent
Janelle Sheen, Pharmacy Solutions Director, Clinical Pharmacy Services, Conduent,
Nicole Russell, Manager Government Affairs, NCPDP
Charlie Oltman, Sr Consultant, President NCPDP Foundation
Many programs seek a “magic bullet” to manage prescription opioids, but it takes a coordinated effort. Missouri’s MO HealthNet program uses a multi-pronged strategy of leveraging medical and pharmacy claims data to uncover opioid management opportunities. MO HealthNet’s automated clinical prior authorization criteria prospectively edit opioid prescriptions at the point of sale, while retrospective provider-focused interventions target drugs of abuse.
Closing Remarks and Farewell Networking