This week, our In Focus section reviews two recent Medicare developments from the Centers for Medicare & Medicaid Services (CMS). On September 24, 2020, CMS released the Medicare Advantage (MA) and Part D landscape files for the 2021 plan year. These files include information on MA and Part D offerings, including plan types and premiums. Earlier this month, CMS also released a final rule implementing two new mandatory payment models addressing radiation oncology and end-stage renal disease (ESRD).
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Leaders in justice and child welfare systems explain how HMA-developed MAT training can keep families together
Focused on ongoing support and solutions for those living with opioid use disorder (OUD), Health Management Associates (HMA) has developed a robust web-based training program about addiction and its treatment in the criminal justice and child welfare systems, including access to, and continued use of, medications for addiction treatment (MAT).
CMS considers expanding Medicaid APMs to control spending growth
On September 15, 2020, the Centers for Medicare & Medicaid Services (CMS) released State Medicaid Director (SMD) letter #20-004 regarding value-based care (VBC) opportunities in Medicaid. [1] In the letter, CMS lays out a road map for state Medicaid agencies to adopt value-based payment (VBP). The SMD describes how states can use existing – or obtain new – authorities to adopt VBP. It lists examples of successful VBP designs in other states and identifies key enabling factors from its examination of lessons learned over the last ten years of investments in VBC activities.
HMA to lead Integrated Care Technical Assistance Program in the District of Columbia
The District of Columbia’s Department of Health Care Finance (DHCF) has engaged Health Management Associates (HMA) to spearhead a multi-year training and coaching effort across the District. The five-year project will support Medicaid providers’ efforts to deliver whole person care by integrating physical and behavioral health in order to better manage the complex needs of Medicaid beneficiaries.
Webinar Replay: Medicare, Medicaid and the ACA’s Evolution After the 2020 Presidential Election
This webinar was held on September 30, 2020.
The upcoming federal elections portend tremendous change for federal health care programs, in particular Medicare, Medicaid and the Affordable Care Act. If there is a change in administration and Congressional control, stakeholders should expect rapid implementation of new policy agendas and regulatory frameworks. New presidents generally pursue aggressive policy and regulatory agendas to fulfill campaign promises and quickly secure their policy objectives. Second-term presidents seek to solidify and extend their policy legacies. Health care stakeholders should begin to prepare for potential changes now to ensure that their organizations are best positioned for 2021 and beyond.
Through a new collaboration between Health Management Associates (HMA) and Dentons global law firm, a former presidential candidate and governor, presidential transition team veterans, former federal government administrators, and health policy experts outlined the different health care platforms of the Biden and Trump campaigns. The webinar explored:
- The major differences in policy positions and how a Trump or Biden Administration will administer the Medicare, Medicaid and Affordable Care Act (ACA) programs.
- How the current COVID-19 pandemic, economic downturn, and a potential Supreme Court decision will shape these agendas.
- The process for presidential transitions and how new governing and regulatory agendas are established.
During this webinar, the first in a series hosted by HMA and Dentons, presenters discussed the implications of the upcoming elections and their potential impact on federal health program policies and regulatory agendas.
Speakers
Governor Howard Dean (VT), Former Presidential Candidate & Senior Advisor, Dentons’ Public Policy and Regulation Practice
Kathleen Nolan, Regional Vice President, HMA
Jonathan Blum, Vice President, Federal Policy & Managing Director, Medicare, HMA
Bruce Fried, Partner, Dentons’ Health Care Practice
Missouri Pharmacy and Clinical Services Management Solution RFI; Kentucky Pharmacy Benefit Manager RFP
This week, our In Focus sections reviews the Missouri HealthNet Pharmacy and Clinical Services Management Solution request for information (RFI) and the Kentucky Medicaid Managed Care Organization (MCO) Pharmacy Benefit Manager request for proposals (RFP).
Webinar Replay – Health Performance Accelerator Webinar Series: Strategies to Integrate Health and Human Services Systems
This webinar was held on September 22, 2020.
State and local governments face a common set of challenges to implementing well-coordinated, fully-integrated health and human services (HHS) programs. From multiple information systems that cannot exchange data to overlapping funding streams and workflows, fragmented and siloed HHS systems create inefficiencies which jeopardize the health and wellbeing of the populations which they seek to serve. During this webinar, experts from HMA and HealthEC shared recommendations that states and localities can adopt to achieve greater coordination of HHS programs.
Learning Objectives:
- Learn about practices being employed across the country to improve coordination of health and human services, including the critical role of improved information management and systems in enabling service coordination.
- Learn how HMA can support state and local government agencies on HHS coordination/ integration initiatives.
- Find out how IT solutions such as HealthEC’s can dramatically improve processes such as data aggregation, synthesis, transformation and validation that enable HHS agencies to have greater visibility into the needs of individual residents and tailor interventions that more effectively address those needs.
Speakers
Laura Zaremba, MA, Principal, HMA
Sita Kapoor, HealthEC, Chief Information Officer
Webinar Replay: Expert Guidance and Support for Effective and Equitable COVID-19 Vaccination
This webinar was held on September 18, 2020.
As the COVID-19 pandemic continues to sweep across the country and new “hotspots” emerge daily, multiple research labs are working at an extraordinary pace to develop a viable vaccine. However, prior to the release of a vaccine, or more likely multiple vaccines, the public health and health care delivery systems must be ready. We need protocols for vaccine storage and handling for different vaccine types, as well as measured plans for rapid and efficient vaccine distribution and administration. Myriad factors must be considered to ensure safe and effective transport, storage, management, distribution, and tracking of millions of vaccine doses. Many states, cities, counties, and local communities are struggling to keep up with current public health needs, including contact tracing, preparation for a seasonal flu campaign and ensuring that school-aged children do not fall behind on important immunizations.
In this webinar, HMA experts presented practical guidelines and tools to help public health professionals, health plans, community organizations, and others plan for effectively distributing and managing COVID-19 vaccine(s) in their jurisdictions. Presenters also touched on issues ranging from physical infrastructure needs for vaccine storage and distribution to meeting tracking requirements, and the importance of using an equity lens across all aspects of vaccine campaign planning.
Learning Objectives:
- Gain a comprehensive understanding of what is needed to prepare for managing a COVID-19 vaccine from acquisition to distribution.
- Explore tools designed to help identify the number of vaccinators needed and the costs to meet desired coverage levels.
- Learn practical insights for planning and preparing for a mass vaccination event on a local level
- Understand how to ensure an equity lens is used when determining priority populations for distribution
- Identify the roles of various stakeholders participating in vaccine delivery
HMA Speakers
Michelle Parra, PhD, Principal, Los Angeles, and former director of the Vaccine Preventable Disease Control Program for the Los Angeles County Department of Public Health
Greg Vachon, MD, MPH, Principal, Chicago, Board Certified in Internal Medicine with expertise in digital health solutions and information technology for integration and population health management
Margaret Kirkegaard, MD, MPH, Principal, Chicago, Board Certified in Family Medicine with expertise in practice transformation and population-based health care delivery for vulnerable and underserved groups.