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Kyle Edrington

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Kyle Edrington founded Edrington Health Consulting where he was responsible for the design, development, and communication of client engagements. Edrington joined the HMA family of companies in 2021. He provides a skillset unique to other actuarial consultants leveraging experience as an analyst, consultant, and lead strategist. His technical background and real-world application bring a unique … Read More

July 3, 2024

In Focus: Unwinding Recent Supreme Court Rulings: Impact on Healthcare and BeyondIdaho Releases Medicaid Dual, MLTSS Programs RFPIllinois Receives Federal Approval for Section 1115 Healthcare Transformation DemonstrationIllinois Advisory Council Begins Hearings on Medicaid Financing for Sickle Cell Disease TherapiesMinnesota Rural Hospitals Form Clinically Integrated NetworkNew York Medicaid Seeks Approval to Provide Continuous Medicaid, CHIP Coverage for ChildrenOregon Launches OHP Bridge to Expand Adult Medicaid CoverageNorth Carolina Seeks Federal Approval to Help Relieve $4 Billion Medical DebtTexas Faces Lawsuit Over Medicaid STAR, CHIP Contract AwardsMore News HereFive States Receive Federal Approval to Provide Reentry Services for Incarcerated Individuals Prior to ReleaseCMS Proposes 1.7 Percent Cut to Medicare Home Health Provider RatesOptum Drops Out of Bid to Purchase Steward Health Care Physician GroupElara Caring Acquires Caregivers Home HealthMore News Here

Vermont Publicizes Draft All-Payer Model Waiver

This week, we reviewed the draft waiver agreement between the Centers for Medicare & Medicaid Services (CMS) and the Governor of Vermont, the Green Mountain Care Board (GMCB), and the Vermont Agency of Human Services (AHS) to form an all-payer accountable care organization (ACO) model in Vermont. The agreement, if approved by all parties, would … Read More

HMA PCMH Experts Create 2017 Readiness Assessment Tool

This blog post was written by HMA Senior Consultant Meghan Kirkpatrick Manilla. HMA’s Healthcare Transformation Institute (HTI) provides a venue to develop and share new innovations, experiences, and best practices across the country related to the development of community-specific integrated delivery systems, new financial strategies to incentivize value, and innovative partnerships between providers and payers … Read More

MLTSS Implementation Plans in North Carolina and New Hampshire

This week, our In Focus reviews two recently released papers outlining North Carolina’s and New Hampshire’s plans to implement Medicaid managed care long-term services and supports (MLTSS). The North Carolina Department of Health and Human Services released “North Carolina’s Vision for Long-term Services and Supports under Managed Care” on April 5, 2018, and is accepting … Read More

North Carolina Prepaid Health Plans Policy Paper

This week, our In Focus section reviews the North Carolina Department of Health and Human Services (DHHS) Medicaid Managed Care Proposed Policy Paper released on May 16, 2018, Prepaid Health Plans in North Carolina Medicaid Managed Care, ahead of a competitive procurement for the new Medicaid managed care program expected to be released in spring … Read More

Highlights From This Week’s HMA Conference On The Rapidly Changing World Of Medicaid

This week, our In Focus section provides a recap of the third annual HMA Conference, The Rapidly Changing World of Medicaid: Opportunities and Pitfalls for Payers, Providers and States, held this Monday, October 1, and Tuesday, October 2, in Chicago, Illinois. More than 450 leading executives representing managed care organizations, providers, state and federal government, … Read More

Louisiana Releases Medicaid MCO RFP

This week, our In Focus reviews the Louisiana Medicaid managed care organizations (MCOs) request for proposals (RFP), released by the Louisiana Department of Health (LDH) on February 25, 2019. Selected MCOs will manage health care services for more than 1.5 million Medicaid enrollees statewide, starting January 2020.