Medicaid Health Plans of America

Specialty Care Management: The Hidden Lever Plans Can't Afford to Overlook
2025-06-11 13:00 - 14:00 (America/New_York)
Market forces, including margin erosion, looming budget cuts, and ongoing clinician shortages, are pressuring managed care leaders to deliver care more cost-effectively – without compromising quality. Yet when it comes to trimming costs, specialty services, such as eye care, outpatient therapy, dermatology, and others, are often overlooked. And this could be costing you millions. For example, in eye care, several commonly used Part B injectable drug treatments for various retinal conditions can cost $2,000 to $3,000 for a single injection. But with a step therapy program that utilizes a low-cost alternative with a similar safety and effectiveness profile when indicated, health plans have been shown to save $1.6M per 100K members. Therefore, strategic specialty care management can generate significant savings while improving outcomes. It can also help improve HEDIS scores and other quality measures.
Don’t leave specialty care on autopilot. Join this webinar to learn how your health plan can:
• Lower costs
• Improve quality metrics
• Reduce administrative burden
• Drive network efficiency
• Enhance member experience
Speakers:
H. Kelley Riley, MD, MBA, Chief Medical Officer, Health Network One
Afrouz Motedaeiny, OD, Senior Medical Director, Premier Eye Care
Moderator:
Kristin Gasteazoro, Chief Growth Officer, Health Network One

Health Network One (HN1) is a leading specialty management company providing value-based solutions that help health plans improve outcomes. With a nationwide network of credentialed providers, HN1 ensures high-quality specialty care in eye care, outpatient therapies, behavior analysis, dermatology, podiatry, and more. With over 20 years of experience, HN1 designs and manages specialty networks and clinically guided programs that support care delivery for more than 7 million members.
Through expertise in clinical quality programs and alternative payment models, we empower health plans to enhance provider collaboration and improve care delivery. For more information, visit www.healthnetworkone.com.

Post OBBBA in Medicaid: Navigating in a New Landscape
2025-07-23 13:00 - 14:00
How to Reach, Retain and Support Medicaid Members at Scale
July 23, 2025
1:00 PM ET
With the passing of the OBBBA, Medicaid redetermination has shifted to a high-stakes, high-volume challenge for MCO plans. Millions of vulnerable members risk losing coverage due to administrative complexity, outdated contact information, and confusing additional eligibility requirements. The pressure is real — but so is the opportunity to modernize how you engage and support members throughout this critical time.
Join MHPA and Ushur for a powerful conversation as we break down how this new legislation impacts Medicaid MCOs, what eligibility will look like moving forward, and strategies and solutions that will empower Medicaid MCOs to drive member redetermination / recertification process completion and keep members enrolled—without overwhelming operations or compromising compliance.
What you’ll learn:

What the eligibility landscape will look like with the passing of the OBBBA
Engagement challenges, and what will it take to keep members enrolled in Medicaid
How compliance and regulations come into play
What it takes to support vulnerable members across diverse eligibility paths
The criticality of preferred means of communication
What “compassionate offboarding and transition support” looks like when Medicaid coverage ends

Speakers:

Craig Kennedy, President and CEO, Medicaid Health Plans of America (MHPA)
Yvonne Daugherty, Global Head of Industries, Ushur

“Ushur delivers the world’s first Customer Experience Automation platform built specifically for regulated industries. Purpose-built for delivering ideal self-service, Ushur infuses intelligence into digital experiences for the most delightful and impactful customer engagements. Equipped with guardrails and compliance-ready infrastructure, Ushur powers vertical AI Agents for healthcare, financial services and insurance use cases. Designed for rapid code-less deployment with flexible, advanced capabilities for IT and business teams, enterprises can transform customer and employee journeys at scale in the fastest time to value. To learn more about Ushur, visit us at ushur.ai.“

Improving Maternal Health for Hard-to-Reach Populations
2025-08-20 13:00 - 14:00 | Webinar, United States
Wednesday, August 20, 2025
1:00 PM ET
Why Health Plan Leaders Cannot Miss This Webinar
Click here to register
Be at the Forefront of Transforming Maternal Health for Hard-to-Reach Populations

Are you ready to elevate your organization’s maternal health strategy, drive measurable improvements, and lead groundbreaking change for communities that need it the most? Join fellow healthcare executives and industry visionaries for this exclusive national webinar focused on practical, data-driven solutions designed for hard-to-reach populations.
What Makes This Session Unmissable?
Expert Speakers: Hear directly from Dr. Debra Jones, Senior Medical Director, andShameet Luhar, CEO at Vheda Health, leaders in maternal health innovation, plus experience a live member journey demonstration.
Real-World Demonstrations: Get practical tactics to overcome access barriers using technology, remote monitoring, and culturally sensitive care.
Actionable Knowledge: Learn how to address social determinants, close tech gaps, and ensure equitable engagement during and after pregnancy.
Proven Outcomes: Analyze white-paper-backed results :

23–36% reduction in NICU admissions
Up to 50% reduction in pre-term births
84% monthly engagement—demonstrating sustained impact

Together, we can bridge gaps, break barriers, and transform care, because every mother and every family deserves the best possible start. Secure Your Seat Today!

From Access to Outcomes: Transforming Maternal and Infant Health
2025-10-01 14:00 - 15:00, 2025-10-15 13:00 - 14:00 | Webinar, United States
Access to reliable healthcare is critical for maternal and infant health—but for too many Medicaid families, transportation challenges create barriers that put mothers and babies at risk. Missed prenatal appointments, delayed postpartum care, and limited access to support services can contribute to serious complications and poor outcomes. MTM Health is committed to breaking down these barriers. Through innovative non-emergency medical transportation (NEMT) solutions, including on-demand rides, specially trained drivers, and concierge-level coordination, we help pregnant and postpartum members access the care they need, when they need it.
In this webinar, we’ll explore how MTM Health partners with health plans and communities to improve maternal and infant outcomes by combining transportation access with Mobile Integrated Health (MIH) solutions. Our certified Community Health Workers bring care directly into the home to connect Medicaid members with midwives, doulas, and chronic condition management resources, while building trust and empowering mothers to take charge of their birth experience. Join us to hear success stories, learn how we’re supporting states in the Transforming Maternal Health (TMaH) Model, and discover proven strategies for ensuring healthier beginnings for mothers and babies across rural, suburban, and urban communities.

The Future of Specialty Care is Value Based
2025-10-22 13:00 - 14:00
In specialty care, challenges like overutilization; fraud, waste, and abuse (FWA); and wide variations in provider performance drive up costs. Health plans often respond by making blanket reimbursement cuts, narrowing networks, and implementing complex utilization management (UM) protocols. But these approaches often delay care, frustrate providers, and rarely deliver meaningful impact.
In this webinar, we’ll explore how value-based therapy models offer a smarter, more sustainable solution. By aligning incentives, reducing administrative burden, and rewarding quality outcomes, value-based programs can address inefficiencies without penalizing high-performing providers. While not one-size-fits-all, this model works for most and delivers measurable benefits for payers, providers, and members.
We’ll also be joined by CORA Physical Therapy, a leading outpatient therapy provider with more than 250 clinics across 10 states. They will share insights into the strategic application of value-based care and explain why therapy is a strong candidate for innovative payment and care delivery models. Learning Objectives • Identify the key challenges in specialty care and understand why traditional cost-control strategies often fall short.

Explore how value-based care models can be applied to specialty disciplines to improve outcomes, reduce administrative burden, and ensure fair provider compensation.
Examine a real-world case study from CORA Physical Therapy to understand how value-based care can be implemented and the measurable impact on cost, quality, and provider satisfaction.

Speakers H. Kelley Riley, MD, MBA, Chief Medical Officer, Health Network One
Martin Bilowich, Senior Advisor, Health Network One
Tom Austin, Senior Vice President, Strategic Finance, CORA Physical Therapy
Moderator: Kristin Gasteazoro, Chief Growth Officer, Health Network One

Connecting Care: Virtual Solutions for Chronic, Maternal, and Behavioral Health Challenges
2025-10-29 13:00 - 14:00 | Webinar, United States
Why Health Plan Leaders Cannot Miss This Webinar Learn about the Blueprint Health Plans Nationwide are adopting to Accelerate Outcomes in Chronic, Maternal, and Behavioral Health Care through Adaptive, Virtual Engagement. Join us for a national webinar focused on how simple member technology and culturally concordant dialogue leads to long-term Medicaid engagement for chronic, behavioral health and maternity populations Through real-world application, you will gain expert insight on how to accelerate member engagement, outcomes, and boost your quality bonuses.
What You’ll Learn and Why It Matters:

Expert perspectives from Vheda Health’s clinical leadership on key quality metrics.
Proven virtual care model delivering member engagement, clinical monitoring, and CMS-compliant quality reporting.
Targeted digital interventions reducing care gaps and costs.
Virtual care’s ability to positively impact medical cost, hospitalizations, and quality bonuses.

Key Topics & Takeaways:

How to optimally manage rising costs and risks in unmanaged chronic, behavioral, and maternal health.
Better understand payer incentives and penalties tied to HEDIS and equity stratification.
Learn how the right virtual care models deliver 5:1 ROI and better quality outcomes.
Learn strategies leading to higher adoption of culturally concordant, multichannel outreach.
Preparing for future guidelines with adaptable virtual care.

HR 1 – Cultivating a Framework for Success
2025-11-19 14:00 - 15:00 | Webinar, United States
The One Big Beautiful Bill Act is reshaping the Medicaid landscape for states, health plans, and enrollees. As collaborators in the care of our most vulnerable members, we have an interest in ensuring that members who meet eligibility requirements obtain and retain their coverage.
In this webinar, we will discuss:

Implementation of key areas of interest such as frequency of redeterminations, medical frailty definitions, and work requirements.
How different states may approach the implementation of these requirements and the administrative costs associated.
Recommendations about how to ‘get ready’ and effectively work with state partners.
Policies that will not only allow eligible members to keep benefits, but also minimize the cost of administration for those who are no longer eligible.

Learning Objectives:

Levers that will shape implementation of HR 1 (OBBBA)
Engage stakeholders to influence where possible (FCC, SSA, States)
Identify things that can be prepared now and/or engagement recommendations
Identify ways to partner with states to assist where possible
Identify pending guidance and the potential implications to your plan

Presenters:

Linda Roman, SVP Centauri Health Solutions (Moderator)
Jeff Jackson, COO, Executive Chair, Centauri Health Solutions
Laura Pence, Director, Leavitt Partners, The Enrollment Coalition
Bill Snyder, Principal, Leavitt Partners, The Enrollment Coalition

Register Now

Transitions of Care in Mental Health
2025-12-03 14:00 - 15:00
Transitions of Care in Mental Health is an unbranded educational presentation for mental health professionals and leaders looking for evidence based practices to reduce hospital readmissions/criminal recidivism among patients with serious mental illness in their communities. Review specific examples of successful transitional care programs, explore how a multidisciplinary/collaborative approach can support successful transitions, and identify actionable strategies for potential implementation.

Hannah Yterdal, MS is a Licensed Professional Counselor (Texas) with several years of experience working in inpatient and outpatient programs. As a Community Medical Liaison representing Johnson & Johnson Neuroscience she provides free and unbranded mental health education with a goal of empowering adults diagnosed with schizophrenia/SMI to live full, meaningful lives and be active participants in their treatment. She has presented at leading mental health advocacy organizations, professional advanced training programs, and accredited behavioral health treatment centers in multiple states.

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Modernizing NEMT in Medicaid: Access, Integrity, and Accountability at Scale
2026-02-25 14:00 - 15:00
Access to care breaks down, and fraud, waste, and abuse persist in traditional non-emergency medical transportation programs, which rely on fragmented, legacy models built for reactive oversight rather than real-time control. This webinar brings together payer, state, and federal leaders to discuss how modernized NEMT infrastructure is improving beneficiary access, strengthening provider networks, and embedding program integrity into day-to-day operations.

Panelists will share real-world lessons on how data-driven visibility, standardized workflows, and interoperable systems are delivering better member and provider outcomes, while reducing FWA risk particularly in rural and hard-to-serve communities, without sacrificing statewide consistency or cost control.

Presenters:
· Becca Geist, National Director of Government Programs, Kaiser Permanente (moderator)
· Sufian Chowdhury, Co-Founder & CEO, Kinetik
· Andrew Peterson, CEO, UHC New Mexico

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From Skepticism to Connection: How Community-Based Peer Support Improves Health Outcomes and Member Trust
2026-03-04 14:00 - 15:00
Wednesday, March 4, 2026
2:00 PM ET
Health plans and providers increasingly recognize that addressing social determinants of health requires more than referrals, it requires trust, relationships, and sustained community connection.
In this interactive webinar, join leaders from Highmark Health Options of West Virginia and Wider Circle as they share how peer-driven, community-based social support is transforming member engagement, improving quality outcomes, and strengthening retention—particularly in rural and underserved communities.
Drawing on real-world implementation and member stories, speakers will explore how Wider Circle’s Connect for Life®program integrates seamlessly into managed care operations while remaining flexible enough to meet members where they are—through phone-based outreach, in-person gatherings, community events, and peer-led support.
The conversation will also examine how this approach aligns with state and payer priorities, including Highmark’s focus on scalable, plug-and-play solutions that deliver measurable impact quickly.
What You’ll Learn
How trust drives outcomes: Why peer-led, community-based support outperforms referrals in engaging members and improving quality
A scalable model in action: How community support integrates seamlessly into managed care operations with measurable impact
Results that matter: How peer connection improves gap closure, retention, and member satisfaction—especially in rural and underserved populations
Presenters:
William Friedman, Vice President of Payer Engagement, Wider Circle
Jason Landers, Market President, Highmark Health Options, West Virginia
Jocelyn Williams, Community Engagement Specialist, Wider Circle
Crystal Belisky, Community Engagement Specialist, Highmark Health Options

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In the AI of the Storm: Practical Guidance for the Medicaid Expert
2026-03-18 14:00 - 15:00
Wednesday, March 18, 2026
2:00 PM ET
Artificial intelligence is advancing faster than anything we’ve seen in the PBM industry – from technology capabilities to regulatory frameworks and the policies designed to govern them – creating both opportunity and risk. Aimed at providing both a strategic overview and a tactical look at how AI is being used in healthcare today, this session will also explore the future of AI within the regulated markets space – examining where systems can fail and why safeguards, transparency and human oversight matter. Join us to learn about emerging AI/ML-focused trends, Medicaid relevant frameworks and how responsible governance can support innovation while protecting trust, equity and accountability in an increasingly complex AI landscape.
Presenters:
Thomas Brascia
Director, Technology Growth and Intelligence
Evernorth Health Services
Ember Montunnas
Senior Director, Regulated Markets Business Development
Evernorth Health Services

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Navigating Medicaid Headwinds: Scaling Impact Through Whole Health AI
2026-03-25 14:00 - 15:00
Wednesday, March 25, 2026
2:00 PM ET
As Medicaid Managed Care Organizations (MCOs) navigate new headwinds marked by significant federal funding cuts, administrative work requirements, and rising uncompensated care, the traditional episodic care model is no longer practicable. For populations facing complex chronic conditions and deep-seated social determinants of health (SDOH), overextended clinical teams need a smart digital solution that preserves member dignity while driving clinical efficiency.
Join digital health leader and CMS early adopter Welldoc for an in-depth discussion exploring how a whole-person AI platform acts as a “digital companion” to help MCOs operate efficiently under financial pressure while providing the continuous, dignified support necessary to improve health equity and clinical outcomes.
Learning objectives:

Scale Without Headcount: Analyze how AI ecosystems mitigate funding pressures by expanding clinical capacity through automated, intelligent workflows.
Foster Member Dignity: Discover how digital coaching empowers members and improves data accuracy by reducing the “chilling effect” of traditional clinical settings.
Close Care Gaps: Identify strategies for integrating multi-condition platforms to move the needle on HEDIS, quality ratings, and avoidable ER visits.

Presenters:
Keith Reynolds
Chief Operating Officer
Welldoc
Priya Jaisinghani, MD
Endocrinologist and Clinical Assistant Professor
NYU Langone

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Seeing What Data Hasn’t Shown Us Before: The Next Chapter of Specialized SDoH
2026-04-15 14:00 - 15:00
Wednesday, April 15, 2026
2:00 PM ET
As member needs grow more complex, traditional SDoH models no longer tell the full story. This webinar introduces a more expansive, data informed approach that helps health plans better assess risk, prioritize investments, and quantify the economic impact tied to social interventions. We will specifically focus on the value of specialized SDoH for maternity and NICU case management – where advocacy breaks down barriers and builds member trust. It’s a new lens on an old challenge – with tangible implications for your organization, your members, and the communities you serve.
Learning Objectives:
By the end of this webinar, participants will be able to:
1. Differentiate traditional SDoH intervention approaches from specialized SDoH intervention models
Understand how generalized SDoH screening can overlook critical risk drivers—and how specialized advocacy models uncover deeper, actionable insights for high- risk Medicaid populations, particularly related to maternity and NICU populations.
2. Identify how advanced SDoH data improves risk stratification and investment prioritization
Learn how integrating social, life- based, and clinical context enables health plans to more accurately assess member risk, target interventions, and allocate resources where they will have the greatest impact.
3. Explain clinical and broad economic value of specialized SDoH interventions in maternity and NICU case management
Examine how trusted engagement, advocacy, and facilitation can reduce avoidable utilization, improve outcomes, and generate measurable return on investment for Medicaid programs.
Webinar Leaders

Janna Lacatell | Facilitator
Madeline Szabo, RN, BSN | Clinical Leader
Sara Teppema, FCA, MAAA, FSA | Actuarial & Data Science Leader

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Modernizing Medicaid Redetermination Engagement in the HR.1 Era
2026-05-20 13:00 - 14:00
With HR.1 introducing twice-annual redeterminations and work requirements, Medicaid plans face rising complexity, tighter timelines, and increased enrollment volatility. Yet the primary risk isn’t eligibility—it’s communication. During the unwinding period, nearly 71% of disenrollments were procedural, driven by missed notices, confusion, and administrative barriers.
In this session, experts from Santa Clara Family Health Plan and Ushur share how Medicaid plans are reducing preventable, procedural disenrollment through proactive, digital-first engagement.
Learn how health plans are:

Engaging hard-to-reach members earlier and more effectively throughout the redetermination process
Guiding action with simplified, timely two-way digital communication
Scaling outreach with automation while maintaining compliance
Reducing missed deadlines through proactive outbound and inbound support
Amplifying member outreach within procedural disenrollment grace period

Speaker:
Chelsea Byom, Vice President, Marketing, Communications & Outreach at Santa Clara Family Health Plan
Yvonne Daugherty, Global Head of Industries, Ushur

Register Now
