This week, our In Focus section reviews highlights and major findings from the study, Beyond the Numbers: Access to Reproductive Health Care for Low-Income Women in Five Communities, conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). The report, published in November 2019, was prepared by Sharon Silow-Carroll, Carrie Rosenzweig, Diana Rodin, and Rebecca Kellenberg from Health Management Associates; and by Usha Ranji, Michelle Long, and Alina Salganicoff from KFF.
Government Programs & The Uninsured
Indiana Releases Hoosier Care Connect Managed Care RFP
This week, our In Focus section reviews the Indiana Hoosier Care Connect request for proposals (RFP), issued by the Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) on October 18, 2019. Hoosier Care Connect is the state’s Medicaid managed care program for approximately 90,000 aged, blind, and disabled (ABD) Medicaid beneficiaries. Implementation is expected April 1, 2021, with contracts worth $1.4 billion annually.
Highlights from Kaiser/HMA 50-State Medicaid Director Survey
This week, our In Focus section reviews highlights and shares key takeaways from the 19th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 18, 2019, in two new reports: A View from the States: Key Medicaid Policy Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2019 and 2020 and Medicaid Enrollment & Spending Growth: FY 2019 & 2020. The report was prepared by Kathleen Gifford and Aimee Lashbrook from HMA; Eileen Ellis and Mike Nardone; and by Elizabeth Hinton, Robin Rudowitz, Maria Diaz, and Marina Tian from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors.
The Future of the ACA: Implications of 5th Circuit Decision in Texas v. United States
This week, our In Focus section reviews Texas v. United States., the most recent legal challenge to the Affordable Care Act (ACA). In July 2019, the United States Court of Appeals for the 5th Circuit heard oral arguments in the case and is reviewing the decision of United States District Court for the Northern District of Texas (District Court). The District Court ruled that the “individual mandate” provision of the ACA is unconstitutional as a result of the 2017 Tax Cuts and Jobs Act (TCJA) zeroing out of the tax penalty for not having health insurance and, consequently, that the entire ACA should be struck down as a result. As the nation awaits the 5th Circuit panel’s decision, this article discusses background, next steps in the court process, and the potential far-reaching implications of this case.
Highlights from this Week’s HMA Conference on The Next Wave of Medicaid Growth and Opportunity
This week, our In Focus section provides a recap of the fourth annual HMA Conference, The Next Wave of Medicaid Growth and Opportunity: How Payers, Providers, and States are Positioning Themselves for Success, held this Monday, September 9, and Tuesday, September 10, in Chicago, Illinois. Nearly 500 leading executives representing managed care organizations, providers, state and federal government, community-based organizations, and other stakeholders in the health care field gathered to address the challenges and opportunities for organizations serving Medicaid and other vulnerable populations. Conference participants heard from keynote speakers, engaged in panel discussions, and connected during informal networking opportunities. Below is a summary of highlights from this year’s conference.
Strategies to Support Postpartum Visits for Women in Medicaid
This week, our In Focus section comes from HMA Community Strategies (HMACS) Senior Associate Diana Rodin and HMA Managing Principal Sharon Silow-Carroll who authored a recent article in the Journal of Women’s Health drawing on data from the recently completed five-year evaluation of the Strong Start for Mothers and Newborns II Initiative to identify promising approaches to support women in Medicaid to attend postpartum visits. Nationally, less than 60 percent of women enrolled in Medicaid or the State Children’s Health Insurance Program attend a scheduled postpartum medical visit, and some states have much lower rates.[1],[2]
HMA Colleagues Author Journal Article on Strategies to Support Postpartum Visits for Women in Medicaid
HMA Community Strategies (HMACS) Senior Associate Diana Rodin and HMA Managing Principal Sharon Silow-Carroll have authored an article drawing on data from the recently completed five-year evaluation of the Strong Start for Mothers and Newborns II Initiative to identify promising approaches to support women in Medicaid to attend postpartum visits.
CMS Medicare Fee-For-Service FY 2020 Proposed Rules Part 2: Physician Fee Schedule and Home Health
This week, our In Focus section reviews the new Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service FY 2020 proposed rules: the Physician Fee Schedule (PFS), released on July 2019, and Home Health prospective payment system, released on July 11, 2019. For the hospital outpatient department (HOPD) and ambulatory surgical center (ASC) prospective payment systems (PPS) and the End-Stage Renal Disease (ESRD) PPS proposed rules, please see last week’s In Focus here.
National Jail-Based Opioid Treatment Program Expands
A successful approach to expanding access to jail-based opioid treatment, that began in California, will grow to 16 additional counties across the country. Health Management Associates (HMA), a leading healthcare consulting firm, developed the program blueprint which was successfully deployed in 29 California counties and resulted in better access to Medication Assisted Treatment (MAT) for those in the criminal justice system.
HMA Summary of CMS Innovation Models Pertaining to Radiation Oncology, Kidney Care, and End-Stage Renal Disease
This week, our In Focus section reviews the four new payment models addressing radiation oncology, kidney care, and end-stage renal disease released by the Centers for Medicare & Medicaid Services (CMS), through the Center for Medicare and Medicaid Innovation (CMMI) on July 10, 2019. Two of the models would be mandatory in randomly selected geographies and were published as proposed rules: the End-Stage Renal Disease Treatment Choices (ETC) and Radiation Oncology (RO) models. For these two proposed models, stakeholders have until what will likely be mid-September 2019 (60 days following publication of the forthcoming publication of the proposed rules in the federal register) to submit comments to CMS. The other two models are voluntary demonstrations: the Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC) models. This is the first time this administration has proposed a mandatory model since the hip fracture and cardiac bundled payment models, which were cancelled in 2017. For these two models stakeholders will not have the opportunity to submit comments.