This week, our In Focus highlights a recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, revisits questions raised in a previous HMA report and offers potential answers to guide progress and changes for demonstrations within the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (CMMI) or the Innovation Center.
1875 Results found.
Accreditation Association for Ambulatory Healthcare
A health plan with a newly awarded contract was entering a new market to provide long-term services and supports (LTSS) and was seeking required, nationally recognized accreditation in order to comply with the state contract requirements. The client was working against a short three-month timeline and needed document review, report analysis, policy and procedure development, and assistance preparing for the review and evaluation process to secure accreditation.
Download the read the approach and results.
Identification of states for possible market expansion via de novo start-up or acquisition
HMA was engaged to evaluate a set of ten states for possible market expansion via either a de novo start-up or acquisition.
Download the read the approach and results.
Evaluation of investment in multi-state personal care services provider for LTSS qualifiers
The client was evaluating an investment opportunity in a multi-state personal care services (PCS) provider for elderly and disabled Medicaid beneficiaries that qualify for long term services and supports (LTSS). HMA was asked to evaluate the market environment for personal care services providers in 13 states to determine the stability of the regulatory environment and the outlook for Medicaid funding. The timeline for this due diligence engagement was five weeks.
Download to read the approach and results.
Study examines Austin LGBTQIA+ community, quality of life
A new report summarizing the ShoutOut Austin Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA+) Quality of Life Study, has been released. The report summarizes research conducted by HMA Community Strategies (HMACS) which included town hall meetings, surveys, stakeholder interviews, and focus group responses from a diverse group of community members.
2022 Star Ratings, An Historical Year
This week, our In Focus provides an analysis of 2022 Medicare Advantage (MA) Star Ratings, including a look at how regulatory changes during the COVID-19 pandemic resulted in a record number of Medicare plans receiving historically high scores. HMA Managing Director Anthony Davis and Principal Sarah Owens rely on data from the Centers for Medicare & Medicaid Services (CMS) to take a deep dive into ratings for nearly 500 Medicare plans serving 26.8 million members.
HMA brief examines options for CMMI to refine approach for testing Medicare program improvements
A recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, revisits questions raised in a previous HMA report and offers potential answers to guide progress and changes for demonstrations within the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (CMMI) or the Innovation Center.
The brief examines options for how CMMI could refine their approach to testing ideas for improving the Medicare program. HMA colleagues Jennifer Podulka, Yamini Narayan, and Lynea Holmes wrote the brief which was supported by Arnold Ventures.
HMA’s earlier brief examined the progress the Innovation Center has made in learning from Medicare-focused models during its first decade and raised questions to guide policymakers as they plan for the next phase of the Innovation Center’s work. In the new report, the team returns to those questions and offers potential answers.
The brief outlines seven pairs of competing goals and offers four recommendations that may, in part, help to balance these competing goals, as they are designed to increase the transparency of Innovation Center efforts and improve the likelihood that more models succeed in decreasing spending or improving quality. The recommendations include:
- The Department of Health and Human Services (HHS) should establish a National Healthcare Transformation Strategy
- CMMI should articulate a vision for how different models work together
- CMMI should tailor models to test ideas that address the largest areas of spending growth and key areas of quality concerns, including
- Include Part D in models
- Include Part C in models
- Promote primary care as a counterbalance to excessive low-value care
- Address social determinants of health and other drivers of quality and access disparities
- Congress and HHS should revisit the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
Strategic approaches to utilize ARPA funds to support older adults issue brief authored by HMA
A new issue brief, authored by Madeline Shea and Aaron Tripp, provides an overview of key provisions of the American Rescue Plan Act (ARPA) of 2021 which offer the potential to make communities better places to grow older. ARPA provides an opportunity for states to build sustainable, person-centered systems and infrastructure for older Americans. These provisions aim to allow older Americans to age in their home and communities.
The provisions examined in the issue brief include addressing both long-standing and emerging needs of older adults for state government officials, including staff of Medicaid, aging, and housing and community development agencies; state legislators and their staff; and advisors to governors.
The ARPA funds are now available to states and local governments and will allow the development of better systems for older Americans. Key areas of opportunity outlined in the brief include
- Building integrated data systems
- Expanding affordable housing with services
- Enhancing quality measurement and value-based purchasing models
- Developing workforce recruitment and retention strategies
- Ensuring access to internet services and assistive technology
- Aligning Medicaid and Medicare services and payments
- Creating ongoing structures to engage stakeholders in designing innovative and integrative approaches to meet community needs and monitoring their effectiveness over time
Medicaid Managed Care Enrollment Update – Q2 2021
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 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 33 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2020. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):