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HMA Insights: Your source for healthcare news, ideas and analysis.

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.

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Brief & Report

Final HMA-authored reports on reproductive care access released

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A final report and series of five case studies, Beyond the Numbers: Access to Reproductive Health Care for Low-Income Women in Five Communities, have been released.

Working with the Kaiser Family Foundation (KFF),  a team of HMA colleagues, Managing Principal Sharon Silow-Carroll, Consultant Carrie Rosenzweig, Senior Consultant Diana Rodin, and Principal Rebecca Kellenberg, completed the project.

Through state policy reviews, site visits, interviews with local stakeholders, and focus groups with low income women, the team examined how national, state, and local policies, as well as cultural factors, shape access to contraceptive care, sexually transmitted infection prevention and treatment, obstetrical care, and abortion services.  The study focused on the on-the-ground experiences of women living in these communities and the reproductive health professionals caring for them.

The study identified themes that cut across all five “medically underserved” communities but play out in different ways depending on the local environment. The key factors influencing access include cultural and social determinants of health, healthcare coverage, provider supply and distribution, sex education, and abortion policies and environment.

In addition to an executive summary report, KFF has also published case study briefs that detail the findings in each of the five communities. The complete report is available here.

Blog

California Releases Medicaid Delivery System Waiver Proposal

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This week, our In Focus section reviews the California Advancing and Innovating Medi-Cal (CalAIM) proposal, issued by the California Department of Health Care Services (DHCS) on October 28, 2019. CalAIM would implement broad delivery system, program, and payment reform for the state’s Medicaid program. The proposal includes efforts to address social determinants of health and other policy priorities such as homelessness, lack of access to behavioral health care, children with complex medical conditions, justice-involved populations, and aging individuals. According to DHCS, the three key goals of the proposal are to:

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Brief & Report

Issue brief explores child care needs of families experiencing homelessness

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Recently, the HMA Community Strategies team of Managing Director Marci Eads, Principal Catherine Guerrero, Senior Associate Robyn Odendahl, Research Assistant Rathi Ramasamy and Principal Charles Robbins, contributed to a research project conducted in Los Angeles: Child Care Needs of Families Experiencing Homelessness.

Funded by the Child Care Resource Center, the study’s purpose was to understand the needs of families experiencing homelessness with children ages zero to five living in Los Angeles County Service Planning Areas 1 and 2 (San Fernando and Antelope Valleys). Through multiple sources of data including a literature review, publicly available data on homelessness in Los Angeles County, interviews with national and local experts and focus group with families experiencing homelessness, the research highlighted a need to develop and expand access to child care resources specifically designed for families experiencing homelessness.

 

Blog

New Medicare Benefit: Opioid Use Disorder Treatment

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This week, our In Focus section examines the new Medicare benefit for Opioid Use Disorder (OUD) treatment that includes counseling, as well as medication-assisted treatment (MAT) and related items and services. This benefit was established by Congress in the SUPPORT Act of 2018 and is now being implemented by the Centers for Medicare & Medicaid Services (CMS). Medicare beneficiaries, including those dually eligible for Medicare & Medicaid, are the fastest growing group of OUD patients. Beneficiaries may access one of two types of providers: Opioid Treatment Programs (OTPs) (i.e., methadone clinics), or physicians + other health professionals. Providers offering these services will receive a bundled payment, either weekly or monthly depending on the type of provider, that can repeat as long as a patient needs treatment. Based on early guidance, Medicare Advantage (MA) plans have already created 2020 benefit packages that provide a level of access to OTP services that is “consistent with prevailing community patterns of care.”  Now that the new benefit is final, MA will need to cover both OTP & Physician OUD treatment for 2021.

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Blog

HMA Colleagues Lead Health Reproductive Care Access Study

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Health Management Associates (HMA), working with the Kaiser Family Foundation, recently conducted research and completed five case studies to identify distinct challenges that low-income women face in obtaining reproductive healthcare in five diverse communities, and the key factors contributing to them.

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Blog

Indiana Releases Hoosier Care Connect Managed Care RFP

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This week, our In Focus section reviews the Indiana Hoosier Care Connect request for proposals (RFP), issued by the Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) on October 18, 2019. Hoosier Care Connect is the state’s Medicaid managed care program for approximately 90,000 aged, blind, and disabled (ABD) Medicaid beneficiaries. Implementation is expected April 1, 2021, with contracts worth $1.4 billion annually.

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Blog

2020 Medicare Advantage, Part D Landscape Files and Quality Performance Data

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This week, our In Focus reviews the Medicare Advantage (MA) and Part D landscape files and quality performance data for the 2020 plan year from the Centers for Medicare & Medicaid Services (CMS). Data on MA and Part D offerings include premiums and benefit design, as well as Star Ratings for each MA contract. This year’s release signals continued growth for the MA program in 2020. The total number of MA plans increased by 403 offerings to 3,144, up from 2,741 in 2019, the highest number since inception of the program. Notably, growth appears to be occurring in parts of the country with existing market saturation, as many MA organizations are offering new plans in states with MA enrollment levels of 30 percent or higher. There is also significant growth in the number of Dual Eligible Special Needs Plans (D-SNPs) offered by MA organizations, particularly among top MA sponsors Humana and CVS (Aetna).

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Blog

Highlights from 19th annual Kaiser/HMA 50-State Medicaid Director Survey

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This week, our In Focus section reviews highlights and shares key takeaways from the 19th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 18, 2019, in two new reports: A View from the States: Key Medicaid Policy Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2019 and 2020 and Medicaid Enrollment & Spending Growth: FY 2019 & 2020. The report was prepared by Kathleen Giff­ord and Aimee Lashbrook from HMA; Eileen Ellis and Mike Nardone; and by Elizabeth Hinton, Robin Rudowitz, Maria Diaz, and Marina Tian from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors.

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Brief & Report

Annual 50-state Medicaid director survey released: states report expansion and enhancement

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Results of the 19th annual Medicaid Budget Survey were released Oct. 18, 2019 and examine changes taking place in Medicaid in all 50 states and the District of Columbia. The Kaiser Family Foundation (KFF) and HMA conducted the annual survey in partnership with the National Association of Medicaid Directors.

Key findings of the survey include:

  • Multiple states reported expansions or enhancements to provider rates and benefits.
  • Several states implemented, adopted, or continued to debate the ACA Medicaid expansion.
  • A growing number of states continued to pursue work requirements and other policies promoted by the Trump administration that could restrict eligibility.
  • States are implementing Medicaid initiatives to address social determinants of health, control prescription drug spending, improve birth outcomes and reduce infant mortality, and address the opioid epidemic.

The report was prepared by Kathleen Giff­ord and Aimee Lashbrook, Eileen Ellis and Mike Nardone, and by Elizabeth Hinton, Robin Rudowitz, Maria Diaz, and Marina Tian.

Blog

Pennsylvania Releases HealthChoices Physical Health RFA

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This week, our In Focus section reviews the Pennsylvania HealthChoices Physical Health Medicaid managed care request for applications (RFA), issued by the Pennsylvania Department of Human Services on October 15, 2019. Medicaid managed care organizations (MCOs) will serve the five HealthChoices zones covering all 67 counties: Southeast, Southwest, Lehigh-Capital, Northwest, and Northeast. Contracts are worth nearly $13 billion.

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Blog

Utah Releases Medicaid Expansion Fall Back Plan Waiver Amendment

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This week, our In Focus section reviews the Utah Medicaid Section 1115 Demonstration Waiver amendment Fallback Plan, released for public comment on September 27, 2019. The Fallback Plan would raise Utah’s Medicaid expansion income limit to 138 percent of the federal poverty level (FPL)[1]. Voters in the state passed full Medicaid expansion through a ballot initiative in 2018, however, the state only enacted partial expansion through a waiver. The Fallback Plan looks to fully expand Medicaid, while also implementing certain provisions, including work requirements and premiums.

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