Blog

HMA Experts Aid Delivery System Transformation Efforts

Editor’s Note: This post was authored by Managing Principal Roxane Townsend, MD, and Senior Consultant Jeannine Hinton, LCSW, MHA.

HMA recently completed efforts to help the State of Louisiana and Louisiana State University (LSU) enter into a cooperative endeavor agreement with Ochsner LSU Health System of North Louisiana, a private nonprofit corporation.

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Exploring the Behavioral Health Independent Practice Association in an Era of Managed, Value-based Care

Editor’s Note: HMA Principals Karen Batia, David Bergman, Meggan Schilkie and Senior Consultants Meghan Manilla and Nicola Pinson contributed to this post. 

Across the country, behavioral healthcare is stretched thin and access to specialty care is a challenge. As value-based payment makes its way to the forefront, more than ever government entities, providers, payers and community-based organizations are exploring new avenues to meet shifting priorities and the requirements that accompany them.

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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.

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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]

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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.

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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.

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