This workshop provides an overview of the major provisions and anticipated impacts of the Patient Protection and Affordable Care Act (ACA) related to Medicare, Medicaid, and Health Insurance Marketplaces. A basic overview of the Medicare and Medicaid programs and the private health insurance marketplaces is provided, leading into a detailed discussion of the ACA Medicaid expansion, creation and implementation of the ACA health insurance marketplaces, and ACA provisions reforming elements of Medicare. Topics to be addressed include:

• Medicaid expansion and health workforce concerns
• Impact on vulnerable populations in states where no Medicaid expansion is taking place
• ACA provisions related to Medicare targeting quality and efficiency on the delivery of health care
• Explanation of the ACA health insurance marketplace rules for providing qualified
health plans that cover essential health benefits
• Subsidies provided for eligible individuals to purchase insurance through the marketplace

Congressman Waxman plans to retire at the end of 2014. He has worked tirelessly, in office for 20 terms, for health care reform. Few people have a better idea of what the future holds for health care than him. As he exits office he will honestly, and openly share what the future holds for Medicaid, Medicare, the health insurance exchanges, and health reform. In this Keynote Address, hear from a veteran of the Hill on exactly where health care is headed including:

• How much money will be appropriated toward Medicare, Medicaid, and government sponsored care?
• What regulations are on the horizon?
• What does a changing political environment mean for health care in America?
• Where can you expect to see cuts, increases in funding, and the most dramatic changes to the health care system?

We can change a health plan, we can change a hospital, and we can change an entire health care system; but if we don’t change how people take care of themselves and engage in health care, we will never change the health of America.

• Hear an overview of current successful health programs — Reducing obesity, heart disease, etc.
• Learn about policies the government plans to put in place that will impact health care
• Discuss strategies to change the culture of health in America

In this session, hear from multiple states that are a part of the duals demonstration and how they are approaching their alignments in different ways. Hear from a state that is working on an FFS model, a state working on a capitated model, and a state working on both models. By the end of this session, understand:

• The challenges the demonstrations are facing and how they are managing to overcome those challenges
• The successes and opportunities they are experiencing
• What the industry should prepare for when it comes to handling duals

The National Governors Association Center for Best Practices has been working with several states to develop the infrastructure to deliver high-quality and comprehensive services for complex populations, sometimes known as “super-utilizers.” In this session, hear the themes, challenges, and progress made in the work on this topic in several states. Understand present learnings in the area of stakeholder engagement, data analytics, regulatory issues, and care delivery/payment reform.

• Identify what populations are driving cost the most
• Learn which programs plans will use to reduce costs and maximize care
• Explore unique strategies for working with provider networks and risk sharing
• Discuss what opportunities and challenges expansion
  has presented

Plans face many new challenges in health care. They must do more with less in every part of their business. Finding opportunities amongst the challenges has become their business. In this session, hear a presentation from each industry expert, and then engage in a facilitated Q&A; with encouraged audience participation.

• Hear how plans are managing their business in a time of expansion and reform
• Discover how plans are managing their providers through innovative new approaches
• Learn how plan leaders see the future of Medicare, Medicaid, Duals, and the health insurance exchanges and how they believe it will impact their business and the business of health care

Many states have experienced difficulties launching the exchanges. Others have been successful. Understanding the challenges and learning from the successes help all of the state and federal exchanges improve their operations in the long run. In this high-level overview, hear four state perspectives on:

• Current operational challenges and successes
• Network adequacy
• Funding the state exchanges
• New products for the exchanges

Medicaid is rapidly changing in states that are expanding, and in the states that have chosen not to expand. In this Keynote Panel Discussion, Medicaid Directors from a variety of states discuss the changing environment and initiatives being implemented to ensure sustainable success.

• Discuss how states are handling expansion and what progress has been made in 2014
• Learn the methods states are using to handle managed care, quality/access initiatives
• Realize how the directors plan to create sustainability in their programs

When it comes to Medicaid and the exchanges, the churn dilemma is on many states’ minds. This session explores the intricacies of the churn and strategies to manage the ‘in between.’

• Discuss how best to manage the churn
• Understand what strategies will be employed by states and health plans
• Hear how the proposed solutions will affect your business

In this session, hear a case study from an expanding state and a case study from a state that has chosen an alternative form of expansion.

• Hear details surrounding these unique visions of reform
• Learn how these forms of expansion have been implemented and challenges have been overcome
• Determine what resources states need to continue reform/expansion

During these interactive roundtable discussions, attendees have the opportunity to engage in informal discussions with the meeting’s expert speaking faculty and diverse network of peers participating in the meeting. Learn from state experts, industry leaders, and one another on the issues that you care about most. Participate in a variety of roundtable discussions to network, exchange ideas, identify new opportunities, and develop solutions to common obstacles.