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Session 4 | November 4, 2026

Overview

In support of DHCS’ goal to expand access to Dual Eligible Special Needs Plans (D-SNPs) for the 1.7 million Californians who are eligible for both Medicare and Medi-Cal, many local plans newly launched D-SNPs, making access to care more integrated and seamless, and simpler to navigate. Individuals who qualify for Medicare and Medi-Cal often have more complex health and social needs, requiring a greater level of coordination across the systems of care with which they engage. Coupled with an increasingly challenging political, regulatory and competitive environment, local plans must pursue and employ strategic, operational and tactical practices and approaches that will sustain and strengthen their D-SNPs.

Join us for our quarterly virtual learning series where local plan leaders, subject matter experts and external partners will share strategic and operational best practices and recommendations to better serve and care for dual eligible members. Developed with support from the California Health Care Foundation and The SCAN Foundation, the series will increase your knowledge and understanding of priority issues, such as quality and Stars performance, risk adjustment and financial sustainability, member experience and growth strategies, and more.

The learning series will run through December 2026.

Session 4 Agenda

Session 4: Integration with CalAIM and LTSS    
November 4, 2026 | 10:00 a.m. – 12:00 p.m., Pacific Time
Gale Carino, Director of Integrated Care and Katie Niño, LCSW, Associate Director of Integrated Care, Health Plan of San Mateo
*Additional speakers to be announced

• Challenges in supporting members and providers as individuals transition from the MCP to EAE D-SNPs with respect to ECM/CICM and Community Supports
• Role of the D-SNP in coordinating internally and with external agencies to manage across LTSS, including carved-in services and key carved-out services
• Lessons learned that can inform refinements to care coordination workflows, provider partnerships and member communications as D-SNP integration with CalAIM and MLTSS continues to evolve
• Local plan strategies and practices for integrating CalAIM and MLTSS

Who Should Attend:
This session may be most valuable for local health plan staff leading or supporting D-SNP integration with Medi-Cal, including CalAIM and LTSS/MLTSS operations. Recommended attendees include D-SNP product leads, ECM/Community Supports directors and staff, teams that coordinate with LTSS and HCBS services (i.e., IHSS, CBAS, MSSP, SNF/LTC), care management and UM, provider network/contracting, data/analytics, compliance and quality staff.

Previous Agendas

Session 1: Quality & Stars Performance
February 18, 2026
Michael Blatt, Pharm. D., Director of Clinical Pharmacy & Patient Safety, Inland Empire Health Plan; Kailey Collier, Director of Quality Performance and Magdee Hugais, Director of Quality Improvement, Kern Health Systems; Kelli Glynn, MPH, Director III of Quality Initiatives, CalOptima Health

• Implications of the proposed changes to Star measures from the CY 2027 Medicare Advantage and Part D Proposed Rule
• Practical approaches for identifying and prioritizing quality measures
• Key considerations for building an effective Stars strategy that prioritizes improving performance and member experience
• Perspectives from local plans at different stages of D-SNP implementation

Session 2: Risk Adjustment Considerations
July 13, 2026
Melissa Hugo, Medicare Risk Adjustment Director, San Francisco Health Plan, Teresa Mason, Partner, Epstein Becker & Green, P.C., Katie-Elyse Turner, Director of Financial Planning & Analysis, Health Plan of San Mateo

• Examining CMS’ risk adjustment payment methodology
• Hierarchical Condition Category coding essentials
• Current federal enforcement priorities
• What comprises a successful compliant risk adjustment program
• Perspectives and best practices from experienced local plans

Session 3: Member Experience & Growth and Retention Strategies
August 19, 2026
Jack Dailey, Director of Health Policy/Coordinator of Health Consumer Alliance, Legal Aid Society of San Diego; Gunilla Bergensten, Director of Marketing and Communications and Chau Le, Senior Director, Product and Growth Operations, San Francisco Health Plan; Jocelyn Barnes, Manager, Community Engagement, Thien Ly, Director, Medicare Outreach, and Cha See, Director, Community Engagement, Santa Clara Family Health Plan

• Role of and services provided by the Medicare and Medi-Cal Ombudsperson Program (MMOP)
• Engaging members and caregivers in designing, participating and assessing their care systems
• Strategies and promising practices for bringing member voices and perspectives into plan governance
• Local plan strategies and approaches for membership growth and retention

Issue Brief

A culmination of the two-year LHPC Institute D-SNP Learning Collaborative, the Advancing Integrated Care for Dual Eligible Californians: Insights from California’s Local Health Plans issue brief summarizes notable learnings from D-SNP implementation, including key operational and policy challenges, and shares recommendations for stronger coordination between state and federal agencies, and local health plans and providers, all with the goal of improving care for dual eligible members.

Read the Issue Brief

Learning Series Faculty

Jocelyn Barnes
Manager, Community Engagement
Santa Clara Family Health Plan

Gunilla Bergensten
Director of Marketing and Communications
San Francisco Health Plan

Gale Carino
Director of Integrated Care
Health Plan of San Mateo

Michael Blatt, Pharm. D.
Director of Clinical Pharmacy & Patient Safety
Inland Empire Health Plan

Athena Chapman
President
Chapman Consulting LLC

Kailey Collier
Director of Quality Performance
Kern Health Systems

Jack Dailey
Director of Health Policy/Coordinator of Health Consumer Alliance
Legal Aid Society of San Diego

Kelli Glynn, MPH
Director III of Quality Initiatives
CalOptima Health

Magdee Hugais
Director of Quality Improvement
Kern Health Systems

Melissa Hugo
Medicare Risk Adjustment Director
San Francisco Health Plan

Chau Le
Senior Director, Product and Growth Operations
San Francisco Health Plan

Thien Ly
Director, Medicare Outreach
Santa Clara Family Health Plan

Teresa Mason
Partner
Epstein Becker & Green, P.C.​

Katie Niño, LCSW
Associate Director of Integrated Care
Health Plan of San Mateo

Cha See
Director, Community Engagement
Santa Clara Family Health Plan

Rebecca Sullivan
Director of Government Affairs, CalAIM & MLTSS
Local Health Plans of California

Katie-Elyse Turner
Director of Financial Planning & Analysis
Health Plan of San Mateo

Registration

This learning series is developed with support from the California Health Care Foundation and The SCAN Foundation. Participation in the series is complimentary; however, registration is required.

Register for the webinar

The series will accommodate up to 300 participants per session. Registration will close after the deadline or once the seat limit has been reached. Registration closes Oct. 30 at 5:00 p.m. 

Participating in the Webinar: You will only need a computer with an updated web browser (Google Chrome, Microsoft Edge, Mozilla Firefox or Safari are recommended). Participants may opt to listen to the webinar via telephone or device.