HMA Weekly Roundup

HMA Welcomes New Colleagues:

Deborah Witham, LMSW, JD
Principal
Washington, D.C.

Debbi Witham is a seasoned executive with experience delivering high quality, mission driven healthcare. During her career, she has focused on behavioral health, including mental health and substance use disorders (SUD), integration of primary and behavioral health services, services for people living with HIV/AIDS, and housing and social services.

She joins HMA after serving as managing director of public policy and opioid treatment programs with CARF International where she oversaw federal policy for all accreditation areas, tracked and monitored policy issues that impact service delivery for accredited services and provided education to policymakers on quality issues. In addition, she oversaw development of standards for opioid treatment programs and served as the liaison to the Substance Abuse Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT).

Skilled in program design and development, Debbi has worked to create and improve programs aimed at improving access and care in behavioral health and housing systems, including large scale projects aimed at delivery system reform, workforce development and preparing systems for value-based payment.

Debbi is also an experienced compliance, accreditation, and quality improvement expert, leading corporate compliance, and quality improvement programs to build structured strategic plans, implement internal audit procedures, prepare for – and succeed with – accreditations, and develop countermeasures to manage risk exposure, ensure compliance, and improve outcomes. Prior to moving to CARF in a full-time managing director role, Debbi served as a CARF surveyor for the opioid treatment program accreditation area.

She is a licensed social worker with experience delivering services across the lifespan and earned a Juris Doctor from New York Law School. She received her Master of Social Work and a bachelor’s degree, also in social work, from the University of Pittsburgh.

Dina Besirevic, RN, RAC-CT, RAC-CTA, CDONA
Senior Consultant
Chicago, IL

With an extensive background in managed care, Medicare, Medicaid Case Mix, and healthcare policy, and a focus on financial performance, Dina Besirevic is a seasoned healthcare and clinical reimbursement expert.

She joins HMA after serving Villa Healthcare in increasingly senior roles including divisional director of clinical reimbursement. In that role, she increased revenue and Medicare Patient Driven Payment Method (PDPM) use as well as Medicaid Case Mix rates in a number of states over multiple years. She provided leadership across facilities in three states and coordinated efforts around continuing improvement in PDPM. In addition, she provided continuing education to staff and streamlined processes which led to to improved quality measures and outcomes for resident.

During her career, Dina has worked to optimize reimbursement by performing consistent, focused data mining, and implementing change based on those findings. She is also adept at creating and maintaining relationships with healthcare executives and external business partners in order to enhance quality and performance.

Dina is a registered nurse and holds certifications in restorative nursing, resident assessment coordinator-certified advanced nursing, and director of nursing administration. Her clinical experience includes providing hands-on oversight to rehabilitation center operations and restorative nursing programs as well as serving as a charge nurse.

She earned an associate’s degree in science and nursing from Harry S. Truman College in Chicago.

Autumn Carparelli
Senior Consultant
Denver, CO

A skilled data expert, Autumn Carparelli has the know-how and experience to analyze big data in order to understand populations and programs and to improve efficiency, accessibility, and affordability of healthcare. Autumn has experience using datasets from a wide range of sources including Medicare, Medicaid, local and state health departments, and electronic medical records (EMR).

She joins HMA after a position as a population health data scientist with St. Peter’s Health where she led a team of subject matter experts in upgrades and improvements to a clinical decision support tool. In this role, she also mined EMR data to produce visualizations and reports analyzing program cost projections, value-based contract outcomes, and operational and clinical decision support. While there, she also provided useful data to providers so they could better understand the needs and outcomes of their patient population.

Earlier in her career, Autumn gained experience with claims data focused on member care management programs and tribal health with Montana Medicaid. She also has experience with Medicare claims data, using this dataset to glean insights about utilization and quality outcomes.

Autumn’s technical skills include building dashboards and queries to explore trends, developing maps and infographics, and replying to requests from member care management programs, hospitals and health systems, Medicaid agencies, CMS, and other stakeholders.

Autumn earned a Master of Public Health in epidemiology from the University of Nebraska Medical Center and a bachelor’s degree in pre-medicine and environmental studies from the University of Nebraska, Lincoln.

Ruth Danielzuk, MA, MBA, BS, CPHQ
Senior Consultant
Phoenix, AZ

Driven by collaboration across the healthcare landscape, Ruth Danielzuk is a seasoned quality and innovation expert with experience managing programs and projects while optimizing patient safety and improving healthcare quality outcomes.

Before joining HMA, she served as director of risk performance improvement with Acadia Health Care where she led infection control strategies and provided analysis to aide prevention and mitigation factors during the COVID-19 pandemic. She also oversaw, and successfully completed, The Joint Commission survey for preparedness management earning accreditation with a focus on Net Promoter Score goals and best practices in a behavioral health setting.

Ruth has driven performance and quality improvement efforts by developing and implementing hospital and health center innovations, leading to cost savings and cost avoidance while implementing and enforcing best practices to reduce harm to patients. She has led quality improvement teams and achieved Patient Center Medical Home certifications while enhancing patient outcomes and reducing costs through care coordination.

She earned a Master of Business Administration from Saint Thomas University, a Master of Arts in psychology from Bethel University, and a bachelor’s degree in public health, family social science and child psychology from the University of Minnesota.

Ruth is a Certified Professional in Healthcare Quality and a Lean Certified Green Belt. She also completed the Telluride Certificate of Achievement Patient Safety Academy for Emerging Leaders in Patient Safety.

Katie Sherman
Senior Consultant
Austin, TX

An experienced behavioral health professional, Katie Sherman has served in clinical and administrative roles with public, private, and governmental organizations within the behavioral health, substance use disorder (SUD), healthcare integration and operational management spaces.

She joins HMA after serving as vice president of international drug policy with The Levenson Foundation where she developed models of care to increase revenue streams and improve access to quality behavioral health and harm reduction services. She also identified and executed funding opportunities for services in addition to consulting and collaborating with partners on changes in international drug policy law and their impacts.

An expert in SUD and medication assisted treatment (MAT), Katie previously had statewide oversight of MAT services in the state of Texas. In this role, she developed policy, oversaw procurement and contracting services as well as capacity growth and quality management for providers and populations with opioid use disorders.

Katie has experience utilizing data and metrics to evaluate and improve programs and assess service delivery, target audience outcomes and financial operations.  She has provided project oversight, cross agency coordination, strategic development, and process improvement to agencies and organizations while securing grant funding, meeting federal CMS and state agency regulations, and improving care and workflows to partners and stakeholders.

In her spare time, Katie harnesses her passion for MAT advocacy by co-facilitating trainings to empower peer support services in Medication Assisted Recovery.

New This Week On HMA Information Services (HMAIS):

Medicaid Data

• Mississippi Medicaid Managed Care Enrollment is Down 8.3%, Apr-22 Data
• Missouri SNP Membership at 73,076, Mar-22 Data
• Nebraska Medicaid Managed Care Enrollment Is Up 1.5%, Jan-22 Data
• South Carolina Dual Demo Enrollment is Down 5.4%, Nov-21 Data
• South Carolina Medicaid Managed Care Enrollment is Up 9.4%, Nov-21 Data
• Texas Dual Demo Enrollment is 35,525, Feb-22 Data
• Texas Medicaid Managed Care Enrollment is Up 2%, Feb-22 Data
• Utah Medicaid Managed Care Enrollment is Up 14.8%, Nov-21 Data
• Virginia Medicaid Managed Care Enrollment is Up 11.5%, Oct-21 Data
• Virginia Medicaid MLTSS Enrollment is Up 6.1%, Oct-21 Data

Public Documents:                                                                                                         

Medicaid RFPs, RFIs, and Contracts:

• Colorado Healthcare Billing, Data Collection, Reporting, and Analysis RFP, May-22
• Minnesota Medicaid Managed Care Plan Financials, 2017-21
• Minnesota Medicaid Managed Care Model Contracts, 2022
• Minnesota Medicaid Managed Care Organization (MCO) Contracts, 2022
• Tennessee Dual Eligibles LTSS Program Planning Assistance RFI, May-22

Medicaid Program Reports, Data and Updates:

• California Medi-Cal Managed Care External Quality Review Reports, 2013-21
• Illinois Medicaid Annual Reports, 2013-21
• Illinois Medical Programs External Quality Review Annual Reports, FY 2012-21
• Iowa Medical Assistance Advisory Council Meeting Materials, 2016-22
• Louisiana Medicaid Quality Committee Meeting Materials, May-22
• Michigan Dental Health Plans External Quality Review Technical Reports, 2020-21
• Michigan Medicaid Health Plan External Quality Review Reports, FY 2014-21
• Minnesota DHS EQR Annual Technical Reports, 2016-20
• New Jersey Medical Assistance Advisory Council Meeting Materials, Apr-22
• Texas Coordinated Statewide Behavioral Health Expenditure Proposals, FY 2020-22
• Texas Housing Choice Plan Report, May-22
• Texas Quarterly Reports from the HHS Ombudsman Managed Care Assistance Team, FY 2019-22

A subscription to HMA Information Services puts a world of Medicaid information at your fingertips, dramatically simplifying market research for strategic planning in healthcare services. An HMAIS subscription includes:

• State-by-state overviews and analysis of latest data for enrollment, market share, financial performance, utilization metrics and RFPs
• Downloadable ready-to-use charts and graphs
• Excel data packages
• RFP calendar

If you’re interested in becoming an HMAIS subscriber, contact Carl Mercurio.