The ACA marketplace keeps changing. HMA will help you keep thriving.
The HMA ACA Marketplace team can support your organization in all aspects of health coverage access and affordability initiatives in the individual, small, and large group fully insured markets. When policy changes, enrollment shifts, or rising costs necessitate new strategies to succeed, you can count on our experts to help you adapt and thrive.
Our experienced team includes former:
- State-based and federal marketplace leaders
- Insurance commissioners
- State Medicaid directors
- Other senior government officials
- Payer executives
- Provider leaders
This firsthand, in-depth knowledge allows us to skillfully guide you through the complexities of strategy, operations, and compliance in the ACA Marketplace.
Meet some of our ACA Marketplace experts.
Our services: How we help Marketplace stakeholders succeed.
Our multidisciplinary approach allows us to guide clients with a range of different roles and objectives in the ACA Marketplace, including:
In their current and former roles, our team members have assisted 18 different states with Marketplace initiatives. If your state is moving (or considering a move) from Healthcare.gov to a state-based or hybrid model, HMA can help with:
- Hybrid and state marketplace assessments for states and foundations
- Design and implementation of state-based marketplaces
- Marketplace policy development and regulatory compliance
- Vendor procurement and oversight support
- Design and assessment of eligibility, enrollment, and customer service solutions
Whether you’re in the initial exploration phase or are ready to implement new initiatives, HMA can assist with:
- Development, submission, and administration of 1332 State Innovation Waivers
- Creation of new state programs, such as premium and cost-sharing subsidies, public option plans, and undocumented immigrant coverage options
- Establishment and updates of Qualified Health Plan (QHP) certification and contract standards
- Operational assessments of state business processes and IT needs
HMA can assist with initiatives and strategies to address Medicaid marketplace churn. Our services include:
- Coverage transition gap assessments and solutions, including lessons learned from the Medicaid Public Health Emergency unwind
- Development and implementation of Medicaid and marketplace eligibility integration and/or coordination initiatives
- Alignment and mapping of benefits across Medicaid and marketplace coverage
- Program budget assessments and Medicaid funding maximization
HMA supports initiatives that promote equity and affordability of coverage. We can help you with:
- Enhanced rate and benefit review
- Affordability studies
- Payment/cost containment reform initiatives (rate/cost caps, reference pricing, transparency boards, etc.)
- Essential Health Benefits (EHB) policy support
- No Surprises Act (NSA) enforcement
- Mental Health Parity and Addiction Equity Act (MHPAEA) enforcement
HMA also assists federal and state regulators, nonprofit organizations and foundations, benefit vendors, and other relevant entities.
Stakeholders in the ACA Marketplace may also be interested in:
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