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.
HMA has published a white paper identifying the appropriate, and inappropriate, uses of risk corridors in the context of Medicaid managed care capitation rate setting. The paper is timely due to the widespread use of risk corridors by states during the COVID-19 public health emergency (PHE) and the potential continuation of those risk corridors after the PHE ends.
Download the Executive Summary here.
This webinar was held on May 19, 2021.
Member experience measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey play a growing role in the quality rankings of Medicaid and Medicare health plans, with the difference between high and low plan scores often amounting to a few percentage points. During this webinar, HMA quality expert David Wedemeyer delved into how Medicaid and Medicare plans can improve their CAHPS scores and thereby benefit from incentive payments tied to high quality performance.
Learning Objectives
Speaker
David Wedemeyer, BSN, Principal, Los Angeles, CA
This webinar was held on May 13, 2021.
This was the second webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.
Behavioral health professionals who have cared for their own family members have firsthand knowledge of the effects of depression, schizophrenia, and substance use disorder on individuals and families. While the experience informs their work in many positive ways, it can also make them susceptible to strong emotional reactions that may cloud their judgment. During this webinar, HMA clinical psychologist, consultant, and family caregiving expert Barry Jacobs explored strategies that behavioral health professionals can employ to manage their emotions in professional situations, ensuring the most effective and constructive interactions with family members and treatment teams as well as the best possible outcomes for patients.
Learning Objectives
Speaker
Barry Jacobs, Psy.D., Principal, Philadelphia
This webinar was held on April 28, 2021.
This is the first webinar in the series “Exploring the Landscape of Behavioral Healthcare,” a series on the growing impact of behavioral healthcare on clinical outcomes and cost.
Behavioral health providers continue to struggle to increase COVID-19 vaccine acceptance among staff and patients, especially in communities of color. During this webinar, HMA behavioral health experts discussed strategies for increasing vaccine acceptance among behavioral health providers and clients. Speakers also addressed how disparities in COVID-19 infection rates impact behavioral healthcare.
Speakers
Laquisha Grant, MPA, Senior Consultant
Deb Peartree, RN, MS, Senior Consultant
This week, our In Focus section examines differences in Medicare Advantage (MA) churn rates among select provider-sponsored plans (PSPs) and non-PSPs. Enrollee churn rates, or rates at which enrollees switch plans, may be an indicator of enrollee satisfaction. In the years studied, PSP organizations had lower average churn rates compared to non-PSP organizations.
This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for individuals dually eligible for Medicare and Medicaid (dual eligibles) in nine states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Rhode Island, South Carolina, and Texas. Each of these states has begun either voluntary or passive enrollment of dual eligibles into fully integrated plans providing both Medicaid and Medicare benefits (“Medicare-Medicaid Plans,” or “MMPs”) under three-way contracts between the state, the Centers for Medicare & Medicaid Services (CMS), and the MMP. As of February 2021, approximately 392,000 dual eligibles were enrolled in an MMP. Enrollment rose 5.7 percent from February of the previous year.
This week, our In Focus reviews the fiscal year (FY) 2022 skilled nursing facility (SNF) proposed payment rule, released by the Centers for Medicare & Medicaid Services (CMS) on April 8, 2021. If the proposals contained in the rule are foreshadowing, SNFs will continue to face financial pressures coming out of the public health emergency. This payment update, combined with other policy proposals, is likely to lead to the smallest payment update since the Medicare Access and CHIP Reauthorization Act of 2015 set a 1 percent increase in FY 2018. The rule proposes a net payment update of 1.3 percent after accounting for forecast error and the multifactor productivity adjustment. In addition to the payment update, CMS proposes changes to the SNF Quality Reporting Program (QRP), and the SNF Value-Based Program (VBP) for FY 2022. Notably, CMS proposes an eventual payment correction to achieve a budget neutral implementation of the Patient-Driven Payment Model (PDPM) that could result in a 5 percent rate reduction.
This week, our In Focus reviews federal enacted and proposed investments in home and community-based services (HCBS). HCBS are critically important for millions of Americans with disabilities and older adults, assisting them to remain in their homes and participate in their communities. People with disabilities and older adults have also been disproportionately affected by COVID-19, yet little federal funding has been directed to HCBS during the public health emergency. This changed on March 11, 2021, when the American Rescue Plan Act (ARPA) was signed into law, with both Medicaid and non-Medicaid HCBS funding included. Additionally, the Administration has recently proposed further HCBS investments in both The American Jobs Plan and the President’s 2022 Discretionary Request.
