This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state’s QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360,000 individuals, including pregnant women, children, parents/caretakers, adults, and individuals who are aged, blind, or disabled (ABD). The state had awarded contracts earlier this year, however, the contracts were rescinded as the state focused on their response to COVID-19.
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Webinar Replay: Exploring Medicare Advantage Plans as a New Business Strategy
This webinar was held on August 6, 2020.
The COVID-19 pandemic shined a spotlight on funding pressures on providers and systems that rely largely on fee-for-service payment. This, along with additional stressors brought on by the pandemic, has led many health systems and providers to consider revenue diversification and service expansion strategies. During this webinar, HMA Medicare Advantage experts addressed the option of using Medicare Advantage as a strategy to better manage care of patients and provide a steady stream of predictable revenues.
Learning Objectives:
- Evaluate the benefits and risks of exploring a Medicare Advantage business strategy.
- Understand the evolving national Medicare Advantage policy landscapes and competitive marketplace.
- Assess various Medicaid Advantage plan options and strategic business considerations.
- Find out about the unique market opportunities of Medicare Advantage Special Needs Plans.
- Learn what needs to be done for a successful Medicare Advantage launch or expansion in 2022.
HMA Speakers
Jon Blum, Managing Principal, Washington, DC
Mary Hsieh, Managing Principal, Atlanta, GA
Webinar Replay: Leveraging the Primary Care Team’s Strengths During Reopening: Part 3 – Payment and Documentation
This webinar was held on July 29, 2020.
In this webinar, HMA primary care experts discussed current payment flexibilities that allow physician practices to maintain revenues while operating in a virtual environment. Given the likelihood that many patients will continue to receive care virtually even after the pandemic, HMA experts explored mechanisms for alternative payment models that support virtual care and allow for efficient use of the care team. Speakers also shared necessary considerations for documentation to assure data capture and appropriate billing.
Learning Objectives
- Discuss current relaxation of regulations related to the National Emergency Declaration and CMS flexibility.
- Understand the use of alternative payment models to enhance revenue opportunities for practices providing virtual care.
- Understand the need for new templates and order sets to support virtual care.
- Discuss EHR optimization to improve care processes and capture data.
Speakers
Helen Duplessis, MD, Principal, Los Angeles, CA
Lisa Harrison, MS, MHS, PA-C, Senior Consultant, Denver, CO
Roxane Townsend, MD, Managing Principal, Raleigh, NC
Oklahoma Releases Medicaid Managed Care Request for Public Feedback
This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state’s Medicaid managed care program design before finalizing a request for proposals (RFP). The RFP, which is currently in development, is scheduled to drop in the fall and has an implementation date of October 2021. Individuals, program participants, providers, trade associations, companies, and other organizations are encouraged to submit responses by August 17, 2020.
HMA Announces Cancellation of 2020 Annual Conference
Health Management Associates has made the decision to cancel its October 2020 conference on Trends in Publicly Sponsored Healthcare, given continuing developments concerning COVID-19 and out of an abundance of caution for the safety of attendees, speakers, and staff. Full refunds will be made to registered attendees and sponsors.
Webinar Replay: Nursing Home Revenue Diversification and Care Options Series: Understanding the Impact of Nursing Home Compare Five-Star Quality Ratings
This webinar was held on July 24, 2020.
Even before COVID-19, nursing homes struggled with staffing shortages, inadequate reimbursement rates, and declining occupancy rates. The pandemic has amplified these challenges, forcing nursing homes to consider options for diversifying revenues and broadening services for both residents and individuals who qualify for institutional status but reside in the community. During this webinar (the second in a series), HMA quality experts will provide an overview of the Nursing Home Compare Five-Star Quality Rating System and its impact on nursing homes.
Learning Objectives
- Understand the components of the Nursing Home Compare Five-Star Quality Rating System.
- Find out how Nursing Home Compare ratings impact a nursing home’s business.
- Learn the strengths and limitations of Nursing Home Compare as a true measure of nursing home quality.
HMA Speakers
Doug Elwell, COO, Chicago, IL
Susan Tucker, Principal, Tallahassee, FL
Webinar Replay: Leveraging the Primary Care Team’s Strengths During Reopening: Part 2 – Adapting the Environment
This webinar was held on July 22, 2020.
Before reopening for in-person visits, primary care practices must address a wide variety of safety considerations, including infection control protocols; modifications to offices, waiting areas, and exam rooms; staffing and workflow issues; and other strategies that minimize the risk of exposure to COVID-19 for both patients and staff. During this 30-minute webinar, HMA primary care experts discussed best practices for successfully reopening primary care practices during the COVID-19 pandemic.
Learning Objectives
- Understand key clinical, physical office, and financial considerations for reopening primary care practices to in-person patient care.
- Learn about the availability of decision-support tools and resources to assist primary care practices with reopening.
- Find out about infection control protocols and other best practices to ensure the safety of patients and staff during reopening.
- Learn how the “new normal” of operating during the COVID-19 pandemic variously impacts clinicians, administrative staff, and leadership, including a look at new protocols and workflows.
Speakers
Karen Hill, PhD, ANP-C, MSN, RN, Senior Consultant, San Francisco, CA
Brittany LaBarreare, Senior Consultant, Austin, TX
Gail Mayeaux, Principal, Albany, NY
Deb Peartree, Senior Consultant, Albany, NY
Early Bird Registration Expires July 29 for HMA Conference, October 26-27 in Chicago
Be sure to register soon for HMA’s conference on What’s Next for Medicaid, Medicare, and Publicly Sponsored Healthcare: How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty, October 26-27, at the Fairmont Chicago, Millennium Park. The Early Bird registration rate of $1595 per person expires on July 29. After that, the rate is $1795.
Medicaid and Exchange Enrollment Update – March 2020
This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “March 2020 Medicaid and CHIP Applications, Eligibility Determination, and Enrollment Report,” published on June 22, 2020. Additionally, we review 2020 Exchange enrollment data from the “Health Insurance Exchanges 2020 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on April 2, 2020. Combined, these reports present a picture of Medicaid and Exchange enrollment in early 2020, leading up to the COVID-19 pandemic and representing 70.9 million Medicaid and CHIP enrollees and 11.4 million Exchange enrollees. Medicaid/CHIP and Exchange enrollment is expected to rise in 2020 according to a team of HMA Medicaid experts, health economists, and data analysts. Read the previous In Focus on HMA’s forecast model.