Texas Covered Clinical Leadership Forum

The Texas Covered Clinical Leadership Forum is a redesigned, invitation-only working session for clinical leaders across Texas health plans, including medical, pharmacy, dental, vision, and behavioral health.

The forum focuses on peer discussion, practical problem-solving, and collaboration around shared clinical challenges. The format includes a structured day with clinical and educational sessions and time reserved for health plan–only discussion.

đź”’ Attendance is restricted to health plan clinical leaders and approved event sponsors.

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Stephen F. Austin, Capitol Ballroom B

701 Congress Ave., Austin, TX

Apr 28, 2026

9:15 am - 3:30 pm

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Agenda

9:15 am

Opening Remarks + Announcements

9:30 am

High-Value Care Starts Here: Integrating Lifestyle Medicine into the Modern Care Model

Chronic disease is the defining challenge of modern healthcare, and managing it with medications alone is neither clinically sufficient nor financially sustainable. This keynote makes the case for lifestyle medicine as the foundation of high-value care, showing how health plans and clinical leaders can move beyond symptom management to root-cause interventions that reduce utilization, improve outcomes, and align with emerging federal care models. Drawing on real-world implementation data and the latest in reimbursement innovation, this session offers a practical roadmap for integrating lifestyle medicine into care delivery not as a wellness add-on, but as a core clinical strategy.

Speaker: Padmaja Patel, MD, FACLM, DipABLM, CPE

10:15 am

A Roadmap to Prior Authorization Modernization: Strategic Approaches Across Medicare, Medicaid, and Commercial Lines

As health plans face mounting pressure to modernize prior authorization across all lines of business, understanding the distinct compliance requirements, operational challenges, and strategic opportunities for each market segment has never been more critical. This session provides a comprehensive roadmap for how leading health plans are approaching prior authorization modernization across Medicare, Medicaid, and commercial populations, from regulatory compliance to operational excellence.

Speaker: Michael Lunzer, CEO, Itiliti Health

11:00 am

Current Treatment of CLL with Focus on Future Therapies

This session provides a comparative look at BTK inhibitors in CLL, with a focus on zanubrutinib.  Drawing from Phase 2 and 3 trials, the discussion will highlight recent updates on safety, efficacy, and patient tolerance trends across the BTKi class. On the horizon, next-generation BCL2 inhibitors and BTK CDACs hope to offer deeper responses and extended survival in mono/combo treatment approaches in both 1L and R/R settings.  Attendees will gain insight into clinical and economic factors shaping oncology treatment decisions today.

Speaker: Kirk S. Culotta, PharmD, Senior Director, Medical Value & Outcomes, BeOne Medicines USA, Inc.

11:45 am

Improving Birth Outcomes Nationwide: Pomelo’s Virtual Care Model and Peer-Reviewed Impact

12:10 pm

Shield Healthcare Diabetes Management Pilot: An Endocrinologist-Led CGM Virtual Diabetes Program

Shield Healthcare is expanding beyond CGM fulfillment to offer plans an endocrinology-led virtual diabetes program that delivers measurable value for their high-risk, insulin-treated members. Shield HealthCare deploys CGM and our team of diabetes educators monitors and reviews CGM data based on clinical need, proactively reaches out to high or rising risk members, supports diabetes care gap closure, and delivers protocol-driven therapy. The result is improved glycemic control, fewer avoidable acute events, and lower diabetes-related spend with stronger quality performance.

Speaker: Eric Morrow, Director of Business Development, Shield HealthCare

12:30 pm

Lunch + Peer Networking

1-3:30 pm

Closed Door Collaborative Session: Improving Health Plan and Primary Care Alignment in Texas

This collaborative work session will bring together TAHP clinical leaders and primary care stakeholders to discuss practical ways to improve how health plans and physician practices collaborate in Texas. The focus is on identifying realistic opportunities to improve communication, streamline workflows, and reduce unnecessary administrative burden while maintaining appropriate clinical standards, quality, and accountability. The goal is to leave with a small set of pragmatic ideas for continued collaboration and operational improvement.

  • Facilitator: Ken Janda, Principal of Wild Blue Health Solutions
  • Participants: Texas Primary Care Consortium (TPCC) and Key Stakeholders
Speakers

Padmaja Patel, MD

President, American College of Lifestyle Medicine

Kirk Culotta, PharmD

Senior Director, Medical Value & Outcomes, BeOne Medicines

Michael Lunzer

Founder and CEO, Itiliti Health

Eric Morrow

Director of Business Development, Shield HealthCare

Become a Sponsor

If you are interested in sponsoring one of our upcoming forums or other events please complete the request to sponsor form. Please make sure to include the event of interest.

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