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Revisiting Congressman Tom Price’s ACA Repeal Legislation

This week, we revisited 2015 legislation introduced by Georgia Congressman Tom Price, who was announced this week as President-elect Donald Trump’s nominee for Secretary of the U.S. Department of Health & Human Services (HHS). Representative Price’s 2015 bill, H.R. 2300, known as the “Empowering Patients First Act,” included a full repeal of the Affordable Care … Read More

Loneliness is Lethal: Five Strategies to Improve Health Outcomes by Improving Social Connectedness

This blog post was authored by HMA clinicians Margaret Kirkegaard, MD, MPH, and Jeffrey Ring, PhD While most people would agree that social relationships improve day-to-day quality of life, do social connections actually provide a health benefit? The answer is a resounding yes! In 1921, a remarkable study began tracking the lives of 1,500 Americans … Read More

Community-Based Care and Social Determinants of Health

Community-Based Care and Social Determinants of Health HMA bring experience and expertise in system transformation, care delivery, value-based payment models, and operations to help ACOs and Community Partners (CPs) address the social determinants of health (SDOH). We understand the diversity of the MassHealth membership and the importance of cultural sensitivity in addressing SDOH. We also … Read More

California Releases Revised CalAIM Proposal

This week, our In Focus section summarizes the revised California Advancing and Innovating Medi-Cal (CalAIM) proposal, released on February 17, 2021. Medi-Cal, the state’s Medicaid program, covers over 12 million individuals, with over 11 million in managed care. CalAIM seeks to standardize and streamline the Medi-Cal program and address health disparities and social determinants of … Read More

Financial impact summary of the 2024 Medicare Advantage Advance Notice

This week, our In Focus section highlights a Wakely, an HMA Company, summary and analysis of the 2024 Medicare Advantage Advance Notice, prepared for America’s Health Insurance Plans (AHIP). The Centers for Medicare & Medicaid Services (CMS) released the contract year (CY) 2024 Advance Notice with an accompanying fact sheet on February 1, 2023. AHIP has retained … Read More

Value-Based Payment (VBP) – Is your organization ready?

Utilization of value-based payment (VBP) strategies continues to expand, with states and health plans recognizing the benefits of rewarding outcomes over volume. This includes population based VBP initiatives intended to address disparities. Health Management Associates (HMA) is at the center of these initiatives, supporting payers with development and implementation, as well as supporting providers through … Read More

New HMA report analyzes the expanded landscape of value-based entities and market growth opportunities

This week, our In Focus section highlights a new report released on January 25, 2024, Analyzing the Expanded Landscape of Value-Based Entities: Implications and Opportunities of Enablers for the CMS Innovation Center and the Broader Value Movement. The analysis explores the growing ecosystem of new entities designed to assume accountability for the total cost and quality of care … Read More

Analysis of Key Medicare Proposals in the President’s FY 2020 Budget

This week, our In Focus comes to us from HMA Senior Consultant Narda Ipakchi. On March 11, 2019, the White House released President Trump’s budget for fiscal year (FY) 2020, which includes a number of legislative and administrative proposals related to Medicare that would reduce net Medicare spending by $811 billion over the next ten years. It … Read More

November 15, 2023

In Focus: CMS Proposes Significant Changes to Medicare Advantage and Medicare Prescription Drug Benefit Programs for 2025 HMA Report Shows First-of-Its-Kind Actual Comparisons of State-by-State Medicaid Disenrollments vs. ProjectionsMedicaid Eligibility Redeterminations News: Arkansas, Idaho, Florida, Iowa, Kentucky, Maine, Maryland, Mississippi, Nevada, Texas, Washington Idaho Legislative Task Force Agrees State Should Stick with Medicaid Value Care Organizations Indiana Submits 1915c Waiver Request to Transition Medicaid LTSS to Managed CareIowa to Award Medicaid Dental Services Contracts to Delta Dental of Iowa, DentaQuest USACareSource Names Chad Moore Kansas Market PresidentMissouri Extends Medicaid Postpartum Coverage to 12 MonthsSouth Dakota Enrolls Less than 20 Percent of Eligible Medicaid Expansion PopulationTennessee Releases RFP for TennCare Select Prepaid Inpatient Health Plan for ChildrenStates Expect Medicaid Enrollment Decrease, Spending Increase in Fiscal 2024, KFF Medicaid Director Survey FindsFourteen Insurers to Exit Medicare Advantage Markets in 2024, KFF Data ShowCentene Names Susan Smith as Chief Operating Officer

September 13, 2023

In Focus: New Hampshire Releases Medicaid Managed Care RFPRedeterminations News: Arizona, Arkansas, Idaho, West VirginiaCalifornia Medicaid Director Jacey Cooper Is Leaving to Join CMSDistrict of Columbia Receives Approval for Community-Based Mobile Crisis Services SPAFlorida Renews Medicaid Utilization Management Contract with Acentra HealthHawaii Receives $4 Million Project LAUNCH Federal Grant to Improve Children’s Behavioral Health Michigan Expects Medicaid Community Health Worker Benefit to Impact 50,000 Residents If Approved BCBS-NC Names Angela Boykin CEO of Medicaid Plan Oregon to Seek Federal Approval for Basic Health Plan Pennsylvania to Review Rates for Providers Serving Individuals with Intellectual Disabilities, Autism CMS to Lower Cost of 34 Prescription Drugs Beginning October 1 Walmart May Buy Majority Stake in ChenMed