Insights

HMA Insights: Your source for healthcare news, ideas and analysis.

HMA Insights – including our new podcast – puts the vast depth of HMA’s expertise at your fingertips, helping you stay informed about the latest healthcare trends and topics. Below, you can easily search based on your topic of interest to find useful information from our podcast, blogs, webinars, case studies, reports and more.

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Webinar

Webinar Replay: Medicaid in an Era of Health and Delivery System Reform

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On Nov. 7, 2014, HMA hosted the webinar, “Medicaid in an Era of Health and Delivery System Reform.”

HMA Managing Principals Vern Smith, Kathy Gifford and Eileen Ellis talked about the findings from the Kaiser Family Foundation’s (KFF) 14th annual 50-state Medicaid budget survey, which they co-authored along with KFF’s Robin Rudowitz and Laura Snyder. The survey was conducted with the cooperation of the National Association of Medicaid Directors.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Webinar

Webinar Replay: Managed Care and Individuals with Intellectual and Developmental Disabilities: Innovative Approaches to Care Coordination

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On Nov. 4, 2014 HMA hosted a webinar by Principal Shane Spotts, “Managed Care and Individuals with Intellectual and Developmental Disabilities: Innovative Approaches to Care Coordination.”

Shane is a leading expert on trends in managed care and I/DD. During the webinar he provided an overview of the most recent initiatives and strategies, including an assessment of what’s working and why.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Brief & Report

KCMU Issue Brief Profiles Newer Programs in Medicaid Health Homes

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HMA Managing Principal Mike Nardone and Julia Paradise authored the recently released issue brief, “Medicaid Health Homes: A Profile of Newer Programs” for the Kaiser Commission on Medicaid and the Uninsured (KCMU).

The Affordable Care Act (ACA) established a new state option in the Medicaid program to implement “health homes” for individuals with chronic conditions, giving states a new tool to develop models of care designed to improve care coordination and reduce costs for high-need populations. In August 2012, the KCMU issued a brief examining the first six health home programs. This update profiles health home programs in the nine states that have taken up the option in the intervening two years – Alabama, Idaho, Maine, Maryland, Ohio, South Dakota, Washington, Wisconsin, and Vermont.

States have implemented health home programs in a variety of ways, reflecting different targeting priorities, underlying delivery and payment systems, and visions of delivery system reform, as well as other state-level factors. This issue brief identified both themes and diversity in the more recent health home programs in a number areas, including geographic scope, target population, health home providers, payment, fee for service versus managed care, and HIT.

Webinar

Webinar Replay: The Value Proposition of Medicare ACOs

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On June 18, 2014 HMA’s Healthcare Transformation Institute, formally the Accountable Care Institute, presented “Medicare Accountable Care Organizations: The Value Proposition,” the third in a three-part webinar series.

HMA Principal Dr. Art Jones, MD, a pioneer in the accountable care movement, explored the financial considerations for establishing a Medicare ACO.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Brief & Report

Kaiser Releases Medicaid, CHIP Enrollment Snapshot Reports

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On June 3, the Kaiser Commission on Medicaid and the Uninsured released its “Medicaid Enrollment Snapshot: December 2013” issue brief.

Authored by Kaiser’s Laura Snyder and Robin Rudowitz and HMA’s Eileen Ellis and Dennis Roberts, the report indicates that as of December 2013, nearly 55.4 million people were enrolled in Medicaid. That’s an increase of 585,000 enrollees from the prior year, but the slowest growth since before the Great Recession.

The report examines changes in monthly Medicaid enrollment from December 2012 to December 2013 and the factors that influenced those changes in a variety of ways. Factors of particular note include:

  • Continued improvement in economic conditions resulted in slower Medicaid enrollment growth.
  • Early expansion of Medicaid in some states, as well as successful outreach and enrollment efforts for new Marketplaces pushed enrollment up in some states.
  • Problems implementing new enrollment systems for the Federally Facilitated Marketplace (FFM) and State Based Marketplaces (SBM) put downward pressure on Medicaid enrollment growth.

Click here to access the report.

The Commission also released its “CHIP Enrollment Snapshot: December 2013” issue brief.

Authored by HMA’s Vern Smith and Kaiser’s Laura Snyder and Robin Rudowitz, the report shows nearly 5.8 million children were enrolled in the Children’s Health Insurance Program (CHIP) in December 2013. That represents a 3.1 percent increase from 2012.

This report examines changes in monthly CHIP enrollment between December 2012 and December 2013. Some findings of interest include:

  • Continued improvement in economic conditions likely resulted in both some growth as children shifted from Medicaid to CHIP and some declines as family incomes continued to increase above CHIP eligibility levels.
  • Successful outreach and enrollment efforts for new Marketplaces likely pushed enrollment up in some states.
  • Problems implementing new enrollment systems for the Federally Facilitated Marketplace (FFM) and State Based Marketplaces (SBM) likely put downward pressure on CHIP enrollment growth.

Click here to access the report.

Webinar

Webinar Replay: ACOs and Effective Care Management

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On May 28, 2014 HMA’s Healthcare Transformation Institute, formally the Accountable Care Institute, presented “The Medicare ACO: Effective Care Management and its Anticipated Impact,” the second in a three-part webinar series.

HMA Principals Lynne Fagnani, Dr. Art Jones, MD, and Nancy Jaeckels offered lessons learned from the latest Medicare demonstrations and talked about the importance of effective care management and its return on investment. Webinar highlights include characteristics of successful programs, population management and workflow, and building blocks for care management success.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

The third and final webinar in the series will focus on Finances of the Medicare ACO and is slated for 2 p.m. EDT June 18.

Webinar

Webinar Replay: Lessons Learned from ACA Early Implementation: Exchanges, Medicaid Expansion and System Transformation

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On April 30, 2014 HMA leveraged the vast expertise of our national consulting team to explore the early takeaways from ACA implementation and offer insights about what we can expect to see as implementation continues.

The HMA Expert Roundtable “Lessons Learned from ACA Early Implementation: Exchanges, Medicaid Expansion and System Transformation” featured:

  • Moderator Vern Smith, Managing Principal, Lansing
  • Panelist Barbara Markham Smith, Principal, Washington, D.C.
  • Panelist Kathy Gifford, Managing Principal, Indianapolis
  • Panelist Dr. Art Jones, MD, Principal, Chicago

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Brief & Report

HMA-authored report for SAMHSA-HRSA looks at health homes

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The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) engaged Health Management Associates (HMA) to outline key areas of a recently enacted provision of the Affordable Care Act that permits Medicaid coverage of health homes, a service delivery model supporting care coordination and related supports for individuals with chronic conditions, including those with mental and substance use conditions.

HMA’s team of Managing Principal Jennifer N. Edwards and Principals Katharine V. Lyon, Juan Montanez, and Alicia D. Smith created “Financing and Policy Considerations for Medicaid Health Homes for Individuals with Behavioral Health Conditions: A Discussion of Selected States’ Approaches.”

This report has three purposes:

  • To describe the overarching policy considerations for states and potential providers of health home services
  • To discuss the roles of quality measurement and health information technology (HIT)
  • To explore options and considerations for developing reimbursement methodologies and establishing payment rates.

The report provides an overview of health home service design and Medicaid State Plan Amendment development. It outlines the processes that may be necessary for state governments to work with SAMHSA and CMS in order to receive consultation and obtain approval for Medicaid health home services. HMA authors also offer observations and recommendations for states interested in implementing the benefit.

Released this week, the report was developed for the SAMHSA-HRSA Center for Integrated Health Solutions with funds under grant number 1UR1SMO60319-01 from SAMHSA-HRSA, U.S. Department of Health and Human Services. The CIHS promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings.

Brief & Report

Issue brief examines Medicaid outreach, enrollment strategies

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A continuum of coverage options take effect under the Affordable Care Act (ACA) in 2014. In advance of this milestone, the Kaiser Family Foundation is offering a series of issue briefs that profile Medicaid outreach and enrollment strategies to inform efforts to implement the ACA.

HMA Principal Jennifer Edwards and Consultant Diana Rodin worked with Samantha Artiga, of the  Kaiser Family Foundation, to produce the recently released “Profiles of Medicaid Outreach and Enrollment Strategies: Helping Families Maintain Coverage in Michigan.” It is the second installment in the “Gearing up for 2014” series which highlights lessons learned from Medicaid and CHIP outreach and enrollment strategies . This brief profiles a new initiative of the Michigan Primary Care Association (MPCA) to facilitate coverage renewals through a systematic, technology-based reminder system coupled with one-on-one assistance.

The inaugural issue brief profiled a successful initiative among health centers in Utah to provide one-on-one Medicaid enrollment assistance.

Brief & Report

New report details state dual integration efforts

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In the fall of 2012, Health Management Associates Senior Consultant Jenna Walls and colleagues from the AARP Public Policy Institute, and the National Association of States United for Aging and Disabilities (NASUAD) surveyed all 50 states and the District of Columbia to develop a comprehensive picture of emerging dual integration initiatives for older adults and adults with physical disabilities.

The research shows that two-thirds of all states will integrate Medicaid and Medicare services for dual eligibles over the next two years, most with statewide initiatives designed to target all full-benefit duals and span most types of long-term care services and supports. In addition, the report discovered that most states are turning to risk-based managed care models to deliver these integrated services to duals.

 

Webinar

Webinar Replay: The Economics of the Medicaid Expansion

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On November 30, 2012, HMA hosted a webinar by leading independent Medicaid policy and financing experts Jack Meyer, Vern Smith, and Kathy Gifford.  They offered an objective perspective on the direct and indirect fiscal considerations of the Medicaid expansion under the Affordable Care Act (ACA).

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Webinar

Webinar Replay: Medicaid Game Changer – Health Information Technology

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New legislation has created new expectations for Medicaid to speed adoption and meaningful use of a range of technology services and deliver a 21st century customer service experience.  Watch this webinar to learn from HMA’s Renee’ Bostick how health information technology is a “game changer,” transforming Medicaid to improve health and the delivery of care and to lower per capita costs.