Medicaid Disproportionate Share Hospital (DSH)
A Conversation: State Approaches to Successfully Manage VBP and Achieve Improved Outcomes
Join us as we facilitate a conversation for state Medicaid professionals on value-based purchasing arrangements. This is a great opportunity for you to get together with your peers and learn from each other what has worked, what hasn’t worked, and what your next steps might be for your state’s VBP program. This educational event is free of charge and is restricted to government employees only.
In addition to informative sessions and experienced speakers and moderators, this private event also includes an evening networking reception on site. You will have many opportunities to share experiences and learn from other governmental agencies to include comparing your approaches to VBP, discussing tools that have been successful, and benefiting from lessons learned by others.
The VBP Forum is an opportunity for states to receive up-to-date information on implementation, management, and outcomes of value-based purchasing arrangements. Please click below for further details.
Day 1: Monday, May 8, 2023
6:00 – 8:00
Day 2: Tuesday, May 9, 2023
Opening and Welcome
8:00 – 8:30
Why We Are Here
8:30 – 9:15
Join us as we explore perspectives of PACE participants to help us all better understand why this work matters. We’ll also look at enrollment statistics and why PACE provides high satisfaction when managed well, along with the benefits of improved outcomes. This session will conclude with a brief highlight of quality issues and the new CMS proposed rule.
Market Analysis – Why it’s Important – An Interview with the SAA from the Commonwealth of Kentucky
9:15 – 10:00
Data is a critical component for state agency decision-making. In this session, we’ll delve deeper into why this is true and shed light on some common pitfalls that occur when PACE is started without adequate market analysis. This session will conclude with a brief highlight of various data sources and a best practices approach to market analysis.
10:00 – 10:15
To Procure or Not to Procure – Selection and Deployment Strategies
10:15 – 11:00
Learn about the various options used to select PACE Organizations and the pros and cons of each option in PO selection. We will also discuss the importance of rate setting estimates prior to procurement and the impact of politics in establishing service areas.
The Application Submission and Readiness Reviews
11:00 – 11:30
Application submission and readiness review requires planning and preparation. Join us to learn about the required submission process including the documentation required for upload, as well as and steps necessary for readiness review.
11:30 – 1:00
HPMS, EUA, CMS Templates, Assurances and Appendices
1:00 – 1:45
Join us as representatives from CMS and Illinois discuss the Health Plan Management System (HPMS) and the Enterprise User Authorization. You will learn more about the process to gain access, resources available, including CMS templates, and also how CMS collaborates with SAA on review of the State Plan Pre-print. This informative session will conclude with CMS’ preliminary review of how State Assurances and Appendices adds efficiency to the process.
State Panel – Round Table with State Representatives
1:45 – 2:45
This is your opportunity to listen and learn from others who‘ve been there and done it before. State representatives will share challenges, lessons learned, and best practices when it comes to PACE implementation, oversight, and quality monitoring. Come ready with questions!
2:45 – 3:00
Capitation Rate Setting
3:00 – 4:00
Experts from Optumas will share everything you need to know about the rate setting process, from data gathering to CMS submission. They’ll also discuss the process to update capitation rates and how often those updates should occur. This session will conclude with a look at the Schedule M Appendix and State Plan.
Quality in PACE – The Federal Requirements
4:00 – 4:30
What are the federal requirements? Join Rose Anne Howland, our subject matter expert, who will describe CMS quality metrics and how those are uploaded, CMS audits and sanctions/corrective action process, and state-specific quality monitoring and oversight.
Quality – State Monitoring
4:30 – 5:30
How does it all come together? Learn from the state of Colorado’s program objectives, measures, and quality initiatives. Our team will also share how ARPA funding was used to build Colorado’s quality program.
5:45 – 7:00
Day 3: Wednesday, May 10, 2023
Opening and Recap
8:00 – 8:30
Esperanza Health Centers (Illinois PO)
8:30 – 9:00
Join Esperanza Health Centers to learn how they are delivering health and hope for underserved communities in Illinois. In this session, you’ll hear about the Esperanza Health Centers organization and their start-up experiences, especially the biggest challenges and lessons learned.
Horizon Adult Health Care (Rural PO)
9:00 – 9:30
Pace Organizations in rural communities present a whole different set of challenges and opportunities. In this session, learn about Horizon Adult Health Care’s 20 year history of serving the elderly in southern and southeastern Kentucky. Hear about strategies to manage multiple PACE Center locations, barriers to enrollment, financial resources needed to reach enrollment breakeven, and how to evaluate a market’s potential.
Blue Grass Care Navigators (Mission Focus – KY)
9:30 – 10:00
Bluegrass Care Navigators provides physical, emotional, and spiritual care to thousands of seriously ill patients and their families in Kentucky. In this session, you’ll learn about their organization and how the mission for hospice care naturally expanded to PACE. You’ll also hear about the strategies they employ to remain mission-focused and the importance of peer mentors for new PACE Organizations.
10:00 – 10:15
TRU PACE (CO PO)
10:15 – 10:45
Learn about Colorado’s TRU PACE program, an innovative model that helps those over the age of 55 who need nursing-home-level care to live as independently as possible. You’ll hear about the organization, its enrolment experie3nces, lessons learned, and biggest challenges faced.
National PACE Association
10:45 – 11:30
Success of a PACE Organization requires lots of support and resources. That’s where the National PACE Associate come sin. Join us to learn about all the available resources provided by the NPA.
Final Question and Answer
11:30 – Noon
Food and Entertainment