Navigating Complex Systems: Care and Policies for Dual-Eligible Beneficiaries

December 12, 2023
1:00 pm-

2:30 pm

Virtual Event

Event Description

This webinar provided an overview of dually eligible populations and discussed key programs and coverage arrangements that coordinate care for beneficiaries. Panelists also identified policy considerations for managing the cost and quality of care for dual eligibles. 

Learning Goals

  • Comprehend what it is like to navigate as a dually eligible individual, including what works and what doesn’t from a first-person perspective.
  • Describe the heterogeneity of dually eligible populations and how people become dually eligible: including definitions, demographics, and paths to eligibility.
  • Understand how dual-eligible programs are financed, administered, and delivered. 
  • Understand commonly-held policy goals and a brief introduction to policy efforts on dual eligibility. 

This webinar was sponsored by The SCAN Foundation, the Association for Community Affiliated Plans, Santa Clara Family Health Plan, and Health Plan of San Mateo.


Allison Hamblin, MSPH

President and CEO, Center for Health Care Strategies
Allison Hamblin, MSPH, is president and CEO at the Center for Health Care Strategies (CHCS), a nationally recognized nonprofit policy resource center devoted to improving outcomes for people enrolled in Medicaid. In this role, she is responsible for the overall strategy and management of the organization, which is supported by the nation’s leading health care philanthropies, corporate community benefit programs, states, and the federal government. She oversees CHCS’ national portfolio, including Medicaid leadership and capacity building activities; delivery system and payment reform efforts to promote accountable care and improve population health; and projects focused on advancing effective care models for people with complex medical, behavioral health and social needs. Prior to her appointment as CEO in 2019, Allison served as senior vice president responsible for program development and organizational oversight. Over 15 years at CHCS, Allison has worked directly with state Medicaid, federal, health plan, and provider stakeholders across the nation to develop and test new solutions for enhancing care delivery for populations with complex health and social needs. In particular, she has substantial expertise in the areas of physical and behavioral health integration; alternative payment and delivery models for people with complex needs; innovative financing strategies to support social service investments; and return on investment. Before joining CHCS in 2006, Allison worked at Apax Partners, Inc. and Goldman, Sachs & Co., where she provided venture capital and investment banking services to companies in the health care and technology industries. She holds a master’s degree in public health from the University of North Carolina at Chapel Hill and a bachelor’s degree in biology from Duke University.

Tim Engelhardt, MHS

Director, Federal Coordinated Health Care Office
Tim Engelhardt directs the CMS Medicare-Medicaid Coordination Office. The office was created in the Affordable Care Act to improve services for individuals dually eligible for Medicaid and Medicare. Prior to joining CMS in 2010, Tim was a consultant with The Lewin Group, and he previously served as the Deputy Director for Long Term Care Financing at the Maryland Department of Health and Mental Hygiene. Tim received a BA in Sociology from the University of Notre Dame and an MHS from the Johns Hopkins School of Public Health.

Thomas Betlach, MPA

Partner, Speire Healthcare Strategies
Tom Betlach served as the Arizona Medicaid Director for almost 10 years where he reported directly to the Governor. In 2019, Tom completed 27 years of state service in Arizona, working for five different Governors in three different cabinet positions. He is a nationally recognized thought leader on Medicaid and healthcare policy, known for his expertise in serving complex populations, delivery system transformation, value-based purchasing, managed care and cost containment. Tom joined Speire Healthcare Strategies in 2019 as a partner to advise government and private sector clients on health policy and strategic initiatives. Tom served as both Vice President and President of the National Association of Medicaid Directors and on the NRI and NASMHPD Boards. Tom currently serves as a Board member for NCQA, Circle the City, Mutual Insurance Company of Arizona and Oakwood Creative Care.

Dennis Heaphy, D.Min., M.Div., M.Ed., MPH

Policy Analyst/Researcher, Disability Policy Consortium
Dennis, a person with a disability is a qualitative researcher and policy analyst at the Massachusetts Disability Policy Consortium (DPC). DPC is a Massachusetts-based disability rights advocacy organization committed to the civil and social rights of persons with disabilities. Dennis, a member of One Care, was actively engaged in the managed care program’s development and works closely with MassHealth and other advocates on the new Disability Special Needs Plans development. (D-SNP) transition. Much of his work focuses on pressing for increased accountability of health insurance companies to advancing health equity through the operationalization of independent living philosophy and recovery model in care plan development and coordination. His previous work experience includes the Americans with Disabilities Act Project Coordinator for the Massachusetts Department of Public Health. Dennis serves on several state-level health policy committees and community nonprofit boards. Dennis is a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). He holds a DMin, MDiv, MEd, and MPH.

Presentation: Speaker Slides

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