Communities across the country are seeing elevated numbers of adolescents in the Emergency Department due to suicide attempts, self-harm, anxiety, depression, substance use disorder (SUD), and overdose. While this youth mental health crisis predates COVID, it has been greatly exacerbated by the pandemic. According to the Centers for Disease Control and Prevention (CDC), in 2019, … Read More
This week, our In Focus section reviews the remaining Medicare payment and policy rules, finalized over the last several days by the Centers for Medicare & Medicaid Services (CMS), that will shape the landscape for the Medicare program in 2023 and beyond. These include the Physician Fee Schedule (PFS), the Hospital Outpatient Prospective Payment System … Read More
Flexible Services HMA will bring its experience and expertise to assist ACOs and Community Partners (CPs) in building the Flexible Services Program in a way that improves health outcomes for MassHealth members, maximizes the funds available for these services, and meets all MassHealth expectations and requirements. The Flexible Services Program represents a ground-breaking new addition … Read More
This webinar was held on April 26, 2016. More than three-quarters of Medicaid recipients report experiences of trauma and violence during their childhoods. These experiences may include verbal, physical or sexual abuse; living in poverty or violent surroundings, including war zones; or living with family members who struggle with substance abuse, mental illness or extreme … Read More
This article was authored by HMA Senior Consultant Annie Melia and Consultant Alona Nenko. This week, our In Focus section reviews two Medicaid managed care requests for proposals (RFPs) released on November 2, 2017. The Arizona Health Care Cost Containment System (AHCCCS) issued an RFP for the “Complete Care” program, which will integrate Medicaid managed … Read More
This week, our In Focus section reviews a rule proposed by the Centers for Medicare & Medicaid Services (CMS) on December 14, 2022, that would revise regulations governing Medicare Advantage (MA or Part C), the Medicare Prescription Drug Benefit (Part D), Medicare cost plans and Programs of All-Inclusive Care for the Elderly (PACE). Background The … Read More
This week, our In Focus section reviews a new Oklahoma law to implement Medicaid managed care by October 1, 2023. The law, signed by Governor Kevin Stitt on May 26, 2022, requires the state to issue a request for proposals and to award at least three Medicaid managed care contracts to health plans or provider-led … Read More
This week our In Focus section reviews the Illinois Healthcare Transformation 1115 Waiver Extension request, posted for review on May 12, 2023. In pursuing this waiver extension, Illinois joins a growing list of states taking advantage of new Centers for Medicare & Medicaid Services (CMS) policy flexibilities to address health-related social needs (HRSNs) through Medicaid and test … Read More
Community-Based Organization (CBO) Capacity Assessment Tool The Community-Based Organization (CBO) Capacity Assessment Tool is a powerful, web-based self-assessment. It yields both an individual report for each CBO and an aggregate “system of care” report, for multiple CBOs utilizing the tool within a targeted region. The resulting report will inform CBOs and healthcare organizations about the … Read More
This week, our In Focus section reviews a wide-ranging proposed rule issued by the Centers for Medicare & Medicaid Services (CMS) on November 6, 2023. The rule would update various policies governing Medicare Advantage (MA, or Part C), the Medicare Prescription Drug Benefit (Part D), Medicare cost plans and Programs of All-Inclusive Care for the Elderly. These proposed policy … Read More