2010: Year in Review - Medicaid Health Plans of America

M H P A ’ s a n n u a l r e p o r t2 0 1 0 : y e a r i n r e v i e wMembershipOur members demonstrate significant depth of specialized Medicaid managed care industryexperience. Our member companies represent 42 NCQA-Accredited Medicaid Health Plans —plans that have demonstrated levels of excellence in core systems and processes as well as qualitycare, service and efficiency.Membership CategoriesAs a member of MHPA, you will join with some of America’s leading health care professionals and helpvulnerable populations gain access to quality health care. MHPA has six levels of membership: (1) HealthPlan Members; (2) Partners; (3) Supporting Members; (4) Individual Members; (5) Student Members; and (6)State Health Plan Association Members.The health plan member category is open to organizations with a state license and/or contract to provideprepaid health services to publicly subsidized Medicaid managed care programs. As a health plan member,your voting rights are bestowed.Membership FactsMembership DetailsEach MHPA member healthplan has a seat on the Boardof Directors.MHPA member plans canhave representatives join anyof the MHPA committees.MHPA member planmembership is basedupon the number of planenrollees.Dues are sent no later than December 1st and are applicable to the following year.Payments are expected to be received by end of first quarter of the applicable year.MHPA CommitteesBoard of Directors – Each MHPA plan is a member ofthe MHPA Board of Directors.Executive Committee – Committee chairs aremembers of MHPA’s Executive Committee.Annual Meeting Committee – Involved in planning forMHPA Annual Meeting.Clinical Leadership Committee – Reviews andaddresses clinical and quality issues of interest to theindustry.Best Practices and Compliance Committee – Reviewsbest practices of industry and compliance issues ofindustry.Finance Committee – Reviews financial matterspertaining to MHPA.Government Affairs Committee – Reviews and makesrecommendations on government affairs issuesaffecting the Medicaid health plan industry.Health IT Committee – Reviews and addresses health information technology issues ofinterest to the industry.Marketing & Communications Committee – Reviews and makes recommendationsregarding marketing and communications issues for MHPA and the industry.Membership Committee – Addresses membership issues and concerns of MHPA.Nominations Committee – Makes nomination recommendations for MHPA.Strategic Planning Committee – Reviews and updates the MHPA Strategic Plan.| 8 | | 9 |

2010 Annual MeetingFlrom November 4-5, 2010, MHPA held itsmost successful Annual Meeting to datewith more than 350 senior-level healthplan executives and other industry attendeesconvening to learn, share knowledge andnetwork. The Annual Meeting not only set arecord number of registrants attending thisyearly event, but also attracted more sponsorsand exhibitors than ever before.For two days, a full slate of notable speakersand presenters graced our podiums. TheAnnual Meeting guest speaker lineup featureddistinguished keynote presenters such asCindy Mann, CMS Deputy Administrator andDirector of the Center for Medicaid, CHIP, Surveyand Certification; Charlie Cook, Publisher ofThe Cook Report; Dr. Mark McClellan, formerCMS Administrator; Ron Pollack, ExecutiveDirector of Families USA; and Sara Rosenbaum,Health Policy Chair at The George WashingtonUniversity Medical Center.This year’s 2011 Annual Meeting — MHPA’sseventh conference — will again be a mustattendindustry event for Medicaid healthplan executives. MHPA’s Annual Meetingprovides attendees with the latest informationon Medicaid policy, health care reform, bestpractices, cost containment, and discussesissues on the latest Medicaid trends.The 2011 Annual Meeting will be held onNovember 7-8 at the Hyatt Regency Capitol Hillin Washington, DC, and promises to provideattendees with the opportunity to networkwith leaders from the Medicaid health planindustry, as well as with other MHPA Membersand Partners.M H P A ’ s a n n u a l r e p o r t2 0 1 0 : y e a r i n r e v i e wHere are just a few comments from someof our 2010 Annual Meeting attendees:“The insight into PPACA waspresented in a well-rounded fashionand was very enlightening. ”– Dr. Mary Kay Stom, Senior Vice President,Health Care Management, and CMO,Health Partners of Philadelphia“ ”“The best one so far!– Len Kudgis, Director, Marketing &Communications, Horizon NJ HealthPresentations by Ron Pollack,Mark McClellan and Vernon Smithprovided an excellent synopsis ofthe… environment, challengesand opportunities facingMedicaid programs. Charlie Cook’spresentation was excellent andvery informative based upon recentpolitical changes. ”– Eugene Diebold, Controller,Health Partners of Philadelphia| 10 | | 11 |

2 0 1 0 : y e a r i n r e v i e w M H P A ’ s a n n u a l r e p o r tBest PracticesMedicaid Health Plansof America (MHPA)launched its new501(c)3 affiliate organization, theMHPA Center for Best Practicesin 2010. The Center for BestPractices (CBP) was created tosupport MHPA’s mission — toprovide efficient health careservices and improve quality and access to carefor Medicaid beneficiaries. The CBP serves as aconvener of Medicaid health plans on research,quality improvement, and dissemination of healthplan best practices in the domains of both clinicaland operational performance. The CBP providesleadership within MHPA for addressing the longstandingproblems of improving health outcomes ofthe medically underserved.The vision of the CBP is to convene health plansand other stakeholders to identify and implementbest practices strategies that will improve care forthe medically underserved and reduce health caredisparities. The MHPA Center for Best Practicesengages the senior leadership of MHPA’s memberplans– including CEOs, CFOs and Chief MedicalOfficers - to develop collaborative strategies thatimprove the health of plan members. Specifically,the CBP is developing programs, publications, andresearch initiatives that target health problems andidentify solutions based on data and best practiceinformation.Leadership: The Center was created by the MHPABoard of Directors in 2010, and its implementationis a key element of MHPA’s long term strategicvision. The Center is guided by a board of directorsrepresenting the senior leadership of Medicaidhealth plans. The Center for Best Practices Boardof Director comprises the current MHPA Board ofDirectors (see page 18 of this booklet) in additionto Jay Feldstein, DO, Regional President of theNortheast Region for AmeriHealth Mercy; and JohnSchaller, MD, MPH, Medical Director, CorporateMedical Management Dept., Aetna.2011 objectives of the CBP are to:Identify best practices in clinical andoperations areas of Medicaid healthplans;Analyze health plan and other data toimprove cost and quality management;Convene and support member plansin engaging in quality improvementinitiatives;Focus on improving quality andefficiency of health care services andreducing racial and ethnic disparities;Disseminate information and findings toabout Medicaid health plans and theirmembers to the health care community;Engage plans and stakeholders toimplement collaborative strategiesthat improve the health outcomes ofMedicaid/CHIP enrollees; andOffer education and information onstrategies to improve health outcomesof Medicaid/CHIP enrollees.Advisory Committee: In addition to a Board ofDirectors, the CBP solicits the input of key opinionleaders and stakeholders in the Medicaid and healthcare sectors. The first external Advisory Committeemeeting is slated for February, 2011. Confirmedrepresentatives include David M. Kendall, MD, ChiefScientific & Medical Officer for the American DiabetesAssociation; Ken Thorpe, PhD, Executive Directorof Partnership to Fight Chronic Diseases, and MarlaJ. Gold is the Dean of Drexel University’s School ofPublic Health, and a Professor of Health Managementand Policy are members.CBP ActivitiesBest Practice Awards Forum: The CBP will host its first annualone-day Best Practice Forum and Awards Program in May, 2011.The event will feature keynote speakers with sessions addressinginnovations in Medicaid programming and plan design to improvemember health outcomes and health plan operations.Data: In December 2011, the MHPA CBP announced an innovativepartnership with MedAssurant, an industry expert in health caredata mining and reporting. Through the agreement MedAssurantwill conduct analyses using its extensive Medicaid claims andmedical record data base to examine issues of importance to theMedicaid industry. These data reports will be used to identifybenchmark practices and to showcase Medicaid plan performance inhigh-priority clinical areas such as emergency room use, preventablehospitalizations, chronic condition management and maternity careoutcomes.Special Projects: Through the CBP, MHPA has secured externalfunding to carry out projects that help members to continuously improve the quality of care providedto Medicaid beneficiaries. Through an agreement with Merck, Inc. the MHPA CBP will be developing acompendium of best practices in childhood asthma management and hosting educational sessions. The CBP isalso in discussions with corporate and foundation funders regarding other clinical initiatives. Possible projectactivity will focus on helping members to more effectively prevent and manage obesity, addressing seriousmental illness and improving diabetes care. The CBP is also collaborating with the Association of Clinicians forthe Underserved in a program to create an asthma curriculum for clinicians.Partnership Opportunities: Center for Best Practices seeks strategic partnerships with organizations whosegoals are consistent with those of the Center. Through collaborations and partnerships, the Center is leadinghealth plan members in addressing crucial health care issues related to prevention, chronic care and complexcare management for underserved populations.Health Information TechnologyMlHPA formed its Health IT Advisory Committee in 2009 to focuson health information technology issues of importance to MHPAmembers. This committee meets to understand and addresssome of the major challenges to Medicaid health plans in implementinghealth information technology and compliance with changing privacy andcoding regulations. In 2010, the workgroup submitted comments on theproposed regulations for the Electronic Health Record Incentive Programauthorized in the American Recovery and Reinvestment Act. In additionto presentations on the meaningful use of health information technology,the Committee heard presentations on using health IT to: (1) improve health care quality for underservedpopulations; (2) improve quality and access through administrative and clinical transaction convergence; and(3) improve member communication and outreach.| 12 | | 13 |