This week, our In Focus section examines the operational impacts of federal Medicare Advantage policy changes in response to the COVID-19 pandemic. On January 31, 2020, the Secretary of Health and Human Services declared a public health emergency. This was followed by a national emergency declared by President Trump on March 13, 2020. These declarations provide the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) authority to waive certain Medicare and Medicaid regulatory requirements to help health plans, providers, and other stakeholders respond to immediate needs of their members and communities. These waiver flexibilities, when combined with other legislative and regulatory changes issued by Congress and CMS have resulted in over 200 policy changes to Medicare alone. Many of these affect Medicare Advantage sponsors and have direct implications to current and future operations of plan responsibilities. We examine eight categories of requirements and flexibilities that have significant business relevance and exposure for Medicare Advantage plan sponsors:
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Optimizing buprenorphine prescribing capacity in jails and prisons
This week, our In Focus section discusses an issue brief prepared by Health Management Associates (HMA), Optimizing Capacity for Prescribing Buprenorphine in Jails and Prisons, authored by HMA Principals Shannon Robinson, MD and Donna Strugar-Fritsch, BSN, MPA, CCHP.
Webinar Alert – The Tsunami of need is coming: Integrated care in the era of COVID-19
HMA is cohosting a webinar with the College for Behavioral Health Leadership.
Thursday, June 25, 2020
Webinar | 12:00pm – 12:45pm PST / 3:00pm – 3:45pm EST
Discussion with Panelists | 12:45pm – 1:30pm PST / 3:45pm – 4:30pm EST
Webinar alert: Evidence-based treatment of opioid use disorder in correctional settings
HMA is cohosting a webinar with the National Commission on Correctional Health Care.
Opioid use disorder is a chronic brain disease with effective, evidence-based treatments, and is a condition protected by the Americans with Disabilities Act. Prisons and jails are expected, by national health care and justice organizations and by communities, to treat incarcerated persons with OUD in accordance with evidence-based practices. This webinar reviews the most current evidence-based care for opioid withdrawal and OUD treatment and provides clinicians with strategies to move correctional health practices into compliance with national and community standards.
Webinar Replay: Federal COVID-19 Response: Medicare Advantage Policy Changes and Impacts
This webinar was held on June 11, 2020.
In response to the rapid spread of the COVID-19 virus, Congress and the Centers for Medicare & Medicaid Services (CMS) have made significant policy changes to Medicare Advantage regulations, allowing for expanded benefits and other flexibilities designed to better serve the Medicare population.
During this webinar, HMA experts addressed the impact of these changes, including a look at policies affecting cost sharing, telehealth, Star Ratings, prescription drugs, provider funding, appeals, and Special Needs Plans (SNP). Speakers also addressed the likelihood that these policies remain in place even after the COVID-19 emergency ends.
Learning Objectives:
- Learn about changes in federal Medicare Advantage policies in response to COVID-19.
- Understand how Medicare Advantage plans, including Special Needs Plans, are adjusting to the new rules, including the impact on benefit design, care delivery, payment models, and quality.
- Identify operational implications of Medicare Advantage policy changes to ensure continued delivery of high-quality care to beneficiaries.
HMA Speakers:
- Julie Faulhaber, MBA, Principal, Chicago
- Mary Hsieh, PharmD, MPH, Managing Principal, Atlanta
- Narda Ipakchi, MBA, Senior Consultant, Washington, DC
- Sarah Owens, Principal, Philadelphia
- Danielle Pavliv, MPH, PMP, Senior Consultant, Atlanta
HMA framework examines behavioral health crisis diversion facilities
This week, our In Focus section provides a model framework examining an option for care for individuals with behavioral health needs who often find themselves involved with law enforcement or in hospital emergency rooms during times of crisis. The framework – Crisis Diversion Facilities – was released by Health Management Associates, led by HMA Principal Bren Manaugh and supported by Arnold Ventures as part of a larger opioid and mental health response initiative.
2020 Medicare Advantage Supplemental Benefit Flexibilities: Adoption of and Access to Newly Expanded Supplemental Benefits
An HMA-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.
The new flexibilities for MA plans include innovative supplemental benefits offered through expansion of primarily health-related benefits, benefits offered non-uniformly, Value-Based Insurance Design (VBID), and Special Supplemental Benefits for the Chronically Ill (SSBCI).
The brief’s key finding is that enrollment in plans offering these flexibilities is relatively low and varies across geographic areas with 19% of all MA enrollees enrolled in a plan that offered at least one expanded supplemental benefit. HMA will conduct additional analyses including interviews with key stakeholders to inform the policy community on the opportunities and challenges with the adoption and implementation of new supplemental benefits.
This brief was produced by HMA Managing Principals Jonathan Blum and Mary Hsieh, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi under a grant from Arnold Ventures.
Exploring flexibilities in Medicare Advantage supplemental benefits: HMA brief on access, adoption, and impacts
An HMA-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.
The new flexibilities for MA plans include innovative supplemental benefits offered through expansion of primarily health-related benefits, benefits offered non-uniformly, Value-Based Insurance Design (VBID), and Special Supplemental Benefits for the Chronically Ill (SSBCI).
The brief’s key finding is that enrollment in plans offering these flexibilities is relatively low and varies across geographic areas with 19% of all MA enrollees enrolled in a plan that offered at least one expanded supplemental benefit. HMA will conduct additional analyses including interviews with key stakeholders to inform the policy community on the opportunities and challenges with the adoption and implementation of new supplemental benefits.
This brief was produced by HMA Managing Principals Jonathan Blum and Mary Hsieh, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi under a grant from Arnold Ventures.