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2023 Strategy Session: Member Redetermination, CAHPS, and Social Needs

2023 Strategy Session: Member Redetermination, CAHPS, and Social Needs

Mildred Menos

Director of Member Advocacy and Community Outreach
Transformation,
Horizon BCBS of New Jersey

Mildred has been with Horizon Blue Cross Shield of New Jersey for five years and serves as Director of Member Advocacy and Community Outreach Transformation for the Medicaid membership. In this role, she and her team advocate for and roll out initiatives, programming and health education that address the rapidly expanding nature of healthcare and the societal factors that influence it.

In the past year, Mildred has overseen the development and launch of Horizon’s first mobile application for Medicaid members and worked across lines of business to introduce access to doula services to members on the State Exchange, a first for New Jersey.

Before joining Horizon, Mildred served as the Director of Project Management for the Life Raft Group, where her passion for patient advocacy began. She has served as a Patient Advocacy Fellow with the Drug Information Association and received Seton Hall University’s Young Alumni Impact Award in recognition of her work with the rare disease community.

Mildred is an active member of the Medicaid Health Plans of America, serving on its Board of Directors and Chairing its Communications Committee. She holds an MBA from the University of Pittsburgh, an MA from Columbia University and a BA from Seton Hall University.

Steve Wigginton

CEO, Icario

Steve is responsible for the company’s overall strategy, growth, and operations. Previously the CEO of NovuHealth, Steve became the CEO of Icario in 2020 following NovuHealth’s merger with Revel. Steve has a 25-year track record of driving growth, culture, and innovation in healthcare and is passionate about creating a better experience for members, patients, and providers.

Steve came to Icario from Sutter Health | Aetna, a 50/50 joint venture between Aetna, a CVS Health company, and Sutter Health, a not-for-profit integrated health delivery system in northern California. There, he served as the joint venture’s first CEO, responsible for launching an innovative health insurance business, delivering best-in-class clinical care, and driving breakthrough consumer and member experiences.

Before that, Steve served as CEO of Valence Health, where he led and grew the business following its acquisition by Evolent Health, doubling revenues and scaling operations internationally. Before the Valence acquisition, Steve was the chief development officer at Evolent Health, responsible for driving growth, partnerships, and the brand.

Additional leadership roles in technology-driven care management, physician practice management, and healthcare supply chain businesses round out Steve’s experience.

Steve holds a bachelor’s and master’s degree in business administration from Indiana University, Kelley School of Business. Steve is an avid cyclist, traveler, and concertgoer in his free time. He and his wife, an award-winning OB/Gyn, have four beautiful children.

Mikal Sutton

Managing Director,
Medicaid Policy,
BCBS Association

Mikal leads federal and regulatory Medicaid and CHIP strategy for BCBSA and develops policy positions and strategies to ensure BCBSA can effectively influence Medicaid and CHIP policy on a national level and assist Plans with local strategies.

She serves as an advisor to provide executive-level counsel to BCBSA officers as well as producing proactive policy positions and strategies to raise the visibility of BCBSA and BCBS Plan initiatives with key policymakers and other influential individuals and organizations (e.g., state organizations, trade associations, provider and consumer organizations, think takes, policy forums, researchers).

2023 Strategy Session: Member Redetermination, CAHPS, and Social Needs

As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member’s health. This panel will offer insights on the trends to watch as we enter 2023.

Topics include:

  1. The new reality health plans and members will face once the PHE ends and how getting ahead will avoid significant membership losses
  2. CMS’ increased weight on CAHPS surveys will lead to more focus on member satisfaction
  3. New Social Need Screening and Intervention (SNS-E) requirement means that plans will need to get more serious about members’ social needs by 2025

Mildred Menos

Director of Member Advocacy and Community Outreach
Transformation,
Horizon BCBS of New Jersey

Steve Wigginton

CEO, Icario

Mikal Sutton

Managing Director,
Medicaid Policy,
BCBS Association

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