Blog

Section 1332 State Innovation Waivers

This week, our In Focus, written by HMA Principals Nora Leibowitz and Donna Laverdiere, reviews Section 1332 State Innovation Waivers.

What Are Section 1332 Waivers and How Can They Be Used?

Section 1332 of the Affordable Care Act allows states to apply for State Innovation Waivers to pursue innovative ways of offering high-quality, affordable health coverage to state residents. This authority allows states to seek waivers of provisions related to these elements of the Affordable Care Act:

Read More

How Interagency, Cross-Sector Collaboration Can Improve Care for CSHCN: Lessons from Six State Initiatives

Families and care providers know that children and youth with special health care needs (CYSHCN) are best served through a coordinated approach across the myriad programs, agencies, and levels of government that touch them. However, states face structural, operational, financial, regulatory, and cultural challenges to breaking down traditional silos to achieve interagency, cross-sector collaboration.

Read More

CMS Renews Healthy Indiana Plan Through 2021

HMA Medicaid Market Solutions helped the State of Indiana secure approval for an extension of its Medicaid Section 1115 Waiver, the Healthy Indiana Plan. Below is a summary of what the renewal entails. 

On February 1, 2018, Indiana received approval from the Centers for Medicare and Medicaid Services (CMS) to continue its long-standing Healthy Indiana Plan (HIP) with a three-year renewal. This CMS approval maintains the core of the HIP program and incorporates additional features, including expansion of the current Gateway to Work initiative to add required community engagement for non-exempt HIP members beginning in 2019. Also new is a substance use disorder component that will be available to all Indiana Medicaid members, including those enrolled in HIP.

Read More

Health Management Associates Acquires California Firm Care Integration Partners

Today, Jay Rosen, founder and president of Health Management Associates (HMA), announced the acquisition of California healthcare consulting firm Care Integration Partners (CIP).

Formerly known as Jen Clancy Consulting, CIP specializes in advancing the integration of behavioral health and primary care by working directly with health plans.

“For over a decade HMA has been helping clients to integrate behavioral health and primary care, and transform how practices function,” said Rosen. “CIP’s unique approach nicely complements our experience and expertise in these areas.”

CIP’s work has focused on achieving the Quadruple Aim of better population health outcomes, improved experience for patients, improved experience for healthcare teams, and reduced healthcare costs for individuals with complex behavioral health and medical conditions. HMA has worked closely with CIP and client Inland Empire Health Plan for over two years with impressive preliminary results.

“When it comes to helping clients develop and implement innovations to integrate behavioral health and primary care, HMA leads the way,” said Jennifer Clancy, CIP founder. “I know their experts will continue producing cutting edge practice transformation work and advance efforts to achieve the Quadruple Aim as CIP has worked so diligently to do.”

In addition to further broadening HMA’s nationally recognized care integration and practice transformation expertise, the acquisition of CIP also expands the firm’s reach along the West Coast, where it has five offices, three in California.

Founded in 1985, HMA is an independent, national research and consulting firm specializing in publicly funded healthcare reform, policy, programs, and financing. Clients include government, public and private providers, health systems, health plans, institutional investors, foundations and associations. With 21 offices and nearly 200 multidisciplinary consultants coast to coast, HMA’s expertise, services, and team is always within client reach.

Texas Receives 1115 Waiver Renewal

This week, our In Focus section reviews Texas’ 1115 Medicaid waiver renewal. After more than a year of negotiations, on December 21st the Texas Health and Human Services Commission (HHSC) received CMS approval to extend the state’s 1115 waiver.[1] The Texas Healthcare Transformation and Quality Improvement Program waiver was initially approved by CMS as a five-year demonstration waiver that began December 2011 and ended September 2016 and included $29 billion in funding.  The waiver authorized the expansion of Medicaid managed care while preserving federal hospital funding historically received as supplemental payments. The waiver created two new funding pools:  the Uncompensated Care (UC) payment pool and the Delivery System Reform Incentive Payment (DSRIP) pool.

Read More

CMS approves Kentucky Medicaid Waiver

The Centers for Medicare & Medicaid Services (CMS) has approved the “Kentucky Helping to Engage and Achieve Long Term Health” 1115 Medicaid Waiver, a five-year waiver that includes a “community engagement” or work requirement as a condition of eligibility for non-disabled adult Medicaid beneficiaries ages 19-64.

The decision from CMS represents the first approval of a Medicaid waiver that includes a work requirement as a condition of eligibility. Kentucky developed the waiver in collaboration with HMA Medicaid Market Solutions (HMA MMS).

Kentucky defines “community engagement activities” as 80 hours per month of employment, education, job skills training, and community service. Exempted groups include pregnant women, the medically frail, and full-time students. The waiver also includes “consumer-driven tools” that provide incentives for healthy behavior.

Come back to the HMA blog Monday to read more about Kentucky HEALTH.

Read the full text of the press release issued by the Kentucky Governor’s Office here.

Read the Kentucky HEALTH Demonstration Approval here.

HMA Principal Designs Workshop to Enhance Delivery of Patient-Centered Care

This blog post was written by HMA Principal Jeffrey M. Ring, Ph.D.

There are many great things to do up in California’s majestic Sierras.  The air is fresh and crisp, the water runs clear and the trees stretch up to dizzying heights.

The health care practitioners of Avenal/Aria Community Health in Central California decided to head to the Sierras for a weekend retreat coordinated with Health Net, and an opportunity to learn together about enhancing the delivery of patient-centered care.  I designed an interactive, experiential workshop  that aimed to facilitate team-building, an exploration of the foundations of communication (including empathy, trust and non-verbal communication), and the skills of Motivational Interviewing which has been empirically demonstrated to be more successful in generating patient behavior change than giving advice.

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 to ensure quality care for its populations. Through the HTI, HMA has invested in the continued development of new approaches, tools, and resources to enhance the provision of healthcare services, with a focus on publicly-supported populations.

Read More

Arizona, Kansas Medicaid Managed Care RFPs Reviewed

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 care for physical and behavioral health as well as replace the state’s long-standing Acute Care Medicaid managed care program. It will cover approximately 1.5 million Medicaid members. Meanwhile, the Kansas Department of Health and Environment and Department for Aging and Disability Services issued an RFP for KanCare 2.0 Medicaid and Children’s Health Insurance Program (CHIP) Capitated Managed Care, which will serve approximately 403,000 members.

Read More