This week, our In Focus comes to us from HMA Senior Consultant Narda Ipakchi. On March 11, 2019, the White House released President Trump’s budget for fiscal year (FY) 2020, which includes a number of legislative and administrative proposals related to Medicare that would reduce net Medicare spending by $811 billion over the next ten years. It is important to note that the legislative proposals included in the President’s budget are non-binding and serve as recommendations to Congress where they may or may not be advanced. Under a Democratic-majority House of Representatives, many of the legislative proposals outlined in the FY 2020 budget are unlikely to advance. Several of the policies, however, such as reductions to Medicare bad debt and implementing site neutral payment systems were also proposed by the previous administration. Administrative proposals are more likely to move forward, as the administration can implement these policies through its regulatory channels.
Government Programs & The Uninsured
HMA Colleagues Played Pivotal Role in Launching Forum for the Brooklyn Perinatal Network
HMA New York colleagues Heidi Arthur and Annalisa Baker played a pivotal role in launching a forum for the Brooklyn Perinatal Network on Jan. 11.
The forum, entitled, “A Community Response to Addressing Maternal Morbidity and Mortality,” was a collaboration between a network of community-based organizations (CBOs) making up the Brooklyn Coalition for the Health Equity for Women and Families Coalition Leadership Team.
Arkansas PASSE Program Readies for Full Risk Capitation
This week, our In Focus section reviews Arkansas’ Provider-led Arkansas Shared Savings Entity (PASSE) model, scheduled to transition to full risk capitation in March 2019. The PASSE program provides care coordination to improve the health of Medicaid members with behavioral health needs or developmental/intellectual disabilities.
Medicaid Managed Care Enrollment Update – Q4 2018
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 29 states.[1] Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. All 29 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2018. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):
HMA Conducts Multi-Layered Study to Address Alarming Youth Suicide Trends Across Colorado
On January 3, 2019, Colorado Attorney General Cynthia H. Coffman released the study, Community Conversations to Inform Youth Suicide Prevention. The multi-layered study, conducted by HMA, analyzes and characterizes the trends and patterns in the fatal and non-fatal suicidal behaviors among young people in the four Colorado counties with the highest rates of youth suicide: El Paso, La Plata, Mesa, and Pueblo. The purpose of the study was to determine the best strategies for addressing and preventing youth suicide in Colorado and to see where the state’s efforts and dollars can be used most effectively.
Exploring the Behavioral Health Independent Practice Association in an Era of Managed, Value-based Care
Editor’s Note: HMA Principals Karen Batia, David Bergman, Meggan Schilkie and Senior Consultants Meghan Manilla and Nicola Pinson contributed to this post.
Across the country, behavioral healthcare is stretched thin and access to specialty care is a challenge. As value-based payment makes its way to the forefront, more than ever government entities, providers, payers and community-based organizations are exploring new avenues to meet shifting priorities and the requirements that accompany them.
HMA Evaluation of Montana’s Tribal Systems of Care Grant
Editor’s Note: This post was authored by Principal Rebecca Kellenberg.
Montana Office of Public Instruction (OPI) contracted with HMA to serve as the independent evaluator of the Tribal Systems of Care grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). In this four-year role, HMA will assist in reporting on project evaluation data to show progress in meeting the goals and objectives of the grant as well as the fidelity, implementation, and impact of the project in the participating tribal communities.
Proposed Policy Changes Affecting Health Reimbursement Arrangements
This week, our In Focus section comes to us from HMA Senior Consultant Ryan Mooney (Austin), who reviewed the proposed rule on Health Reimbursement Arrangements (HRAs). On October 29, 2018, the U.S. Department of the Treasury, the Department of Labor, and the Department of Health and Human Services published a proposed rule (83 FR 54420), the purpose of which is to expand the use of HRAs. An HRA is an employer-supported account that helps employees pay for qualified medical expenses not covered by their health plans. The proposed rule is the latest component of the President’s Executive Order 13813, which directed the federal government to expand and facilitate access to association health plans, short-term and limited-duration insurance products, and HRAs.
A Deeper Look Into Highlights From the Kaiser/HMA 50-State Medicaid Director Survey
This week, our In Focus section reviews highlights and shares key takeaways from the 18th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 25, 2018, in two new reports: States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019 and Medicaid Enrollment & Spending Growth: FY 2018 & 2019. The reports were prepared by Kathleen Gifford, Eileen Ellis, Barbara Coulter Edwards, and Aimee Lashbrook from HMA, and by Elizabeth Hinton, Larisa Antonisse, and Robin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors.
Texas Medicaid and CHIP Managed Care Final Comprehensive Report
This week, our In Focus section comes to us from Senior Consultant Ryan Mooney, reviewing the Texas Medicaid and Children’s Health Insurance Program (CHIP) Evaluation report. The 85th Legislature of the State of Texas required the Texas Health and Human Services Commission (HHSC) to report on its findings for Rider 61, Evaluation of Medicaid Managed Care (the Report). HHSC recently published the Report, which includes the following:
- Rider 61(a) – A review of the current Medicaid and Children’s Health Insurance Program (CHIP) managed care delivery system and an assessment of the performance of managed care;
- Rider 61(b) – An assessment of Medicaid and CHIP managed care contract review and oversight;
- Rider 61(c) – A study of Medicaid Managed Care rate setting processes and methodologies in other states; and
- Rider 61(d) – An analysis of MCO administrative costs, including a survey of each MCO to determine the nature and scale of administrative resources devoted to the Texas Medicaid and CHIP programs and the identification of cost reduction opportunities.