Blog

Navigating CMS’ Proposed Medicaid Managed Care Regulations

This week’s HMA Weekly Roundup features an In Focus article from HMA Senior Consultants Amber Swartzell and Stephanie Baume (Indiana), who reviewed the Centers for Medicare & Medicaid Services (CMS) proposed Medicaid managed care regulations. On November 8, 2018, CMS released a proposed rule that would update several sections of the Medicaid and Children’s Health Insurance Program (CHIP) managed care rules, which were most recently amended in 2016. This much anticipated proposal, scheduled to appear in the Federal Register on November 14, 2018, focuses on “promoting flexibility, strengthening accountability, and maintaining and enhancing program integrity.” The key provisions of the proposed regulations are summarized below.

Read More

Kentucky Becomes First State to Enact Community Engagement & Employment Requirements for Medicaid Members

This article was written by Senior Consultants Amanda Schipp and Lora Saunders of HMA Medicaid Market Solutions (HMA MMS). HMA MMS helped the Commonwealth of Kentucky secure a groundbreaking Medicaid Section 1115 Waiver. Below is a summary of what the waiver entails.

On January 12, 2018, Kentucky’s section 1115 Medicaid Demonstration Waiver was approved by the Centers for Medicare and Medicaid Services (CMS). The demonstration includes two significant components: an expansion of substance use disorder (SUD) services, including a waiver of the Institution for Mental Disease (IMD) exclusion, and the creation of a new Medicaid program for able-bodied adults, known as Kentucky HEALTH (Helping to Engage and Achieve Long Term Health). The demonstration contains several groundbreaking policies never previously approved by CMS, most notably, a requirement for non-exempt Medicaid enrollees to work or participate in approved work-related activities, such as education, training, or volunteering as a condition of Medicaid eligibility. This approval paves the way for the nine other states that also have pending waivers requesting similar work requirements.[1]

Read More

Relationship-Centered Care: Empathy and Healing

This blog post was authored by HMA clinicians
Margaret Kirkegaard, MD, MPH, and Jeffrey Ring, PhD.

Patient: I am anxious about my results, Doctor.

Doctor: Let’s take a look … Yes, you do indeed have cancer. I will refer you to the surgeon for an evaluation as fast as possible. You must have questions.

Patient: (Silent, in shock)

Doctor: OK, well hang out here for a few minutes, and our medical assistant will bring you contact information for the surgeon. We are backed up with patients today, so this may take a short while.

This brief exchange illustrates missed opportunities for healthcare clinicians to provide empathic relationship-centered care.

Read More

HMA Completes Acquisition of SVC

SVC, founded by CMS Administrator Seema Verma, is now part of Health Management Associates (HMA). The acquisition, announced March 13 by HMA founder Jay Rosen, was finalized late Friday, March 31. SVC now becomes HMA Medicaid Market Solutions (HMA MMS), a subsidiary of HMA.

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 from childhood to death. It sought to track what factors in life — such as faith, marriage, pets and exercise — increased longevity. The most significant finding was that strong social networks mattered the most. The quality of social connections was more significant than the quantity.[1] In an interview with National Public Radio, lead researcher Howard Friedman notes, “We saw that over and above the number of connections and the frequency of interactions that when those connections involved helping other people, reaching out, being actively engaged to do things for others, that was an added bonus on top of what we already see as quite beneficial from the social contacts themselves.”[2]

Read More

Health Management Associates to Acquire Firm Founded by Seema Verma

Below is the news release HMA issued March 13th.

WASHINGTON, D.C. – Today, Jay Rosen, founder and president of Health Management Associates (HMA), announced the signing of an agreement by which HMA will acquire SVC, a consulting firm which is owned by Seema Verma, founder and president, and recently confirmed Administrator of the Centers for Medicare & Medicaid Services (CMS).

SVC will become HMA Medicaid Market Solutions, a new subsidiary of HMA.

Read More

Is your organization ready to become an integrated delivery system?

For providers, transitioning from volume- to value-based care is no easy task. You are likely facing a growing number of pressures that are becoming increasingly difficult to manage. These could include community/political pressures, primary care shortages, medical staff competition, and incentives to measure and manage care quality and total costs and address non-clinical aspects of health. Additional demands include risk sharing arrangements, audits, and pitches from vendors. Aligning your facilities, programs and services into a fully integrated delivery system can seem like a daunting task. But HMA can help.

Read More