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.
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.
This week, our In Focus section is led by Matt Powers, a Principal in our Chicago office, who worked with HMA colleagues to summarize the factors that non-expansion states weigh when considering whether or not to expand Medicaid under the Affordable Care Act. Including the states where Medicaid expansion ballot initiatives passed, 37 states have chosen Medicaid expansion or are moving toward Medicaid expansion. More than 12 million newly eligible individuals are insured by state Medicaid programs through the expansion. Comments on recent ACA Court Ruling:
Editor’s Note: This post was authored by Principal Rebecca Kellenberg.
Montana Office of Public Instruction (OPI) contracted with HMA to serve as the independent evaluator of the Tribal Systems of Care grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). In this four-year role, HMA will assist in reporting on project evaluation data to show progress in meeting the goals and objectives of the grant as well as the fidelity, implementation, and impact of the project in the participating tribal communities.
This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “September 2018 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on November 30, 2018. Additionally, we review 2018 Exchange enrollment data from the “Health Insurance Marketplaces 2018 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on April 3, 2018. Combined, these reports present a picture of Medicaid and Exchange enrollment in 2018, representing 73 million Medicaid and CHIP enrollees and nearly 12 million Exchange enrollees.
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.
This week, our In Focus section reviews highlights and shares key takeaways from the 18th annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 25, 2018, in two new reports: States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019 and Medicaid Enrollment & Spending Growth: FY 2018 & 2019. The reports were prepared by Kathleen Gifford, Eileen Ellis, Barbara Coulter Edwards, and Aimee Lashbrook from HMA, and by Elizabeth Hinton, Larisa Antonisse, and Robin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors.
This week, our In Focus section comes to us from Senior Consultant Ryan Mooney, reviewing the Texas Medicaid and Children’s Health Insurance Program (CHIP) Evaluation report. The 85th Legislature of the State of Texas required the Texas Health and Human Services Commission (HHSC) to report on its findings for Rider 61, Evaluation of Medicaid Managed Care (the Report). HHSC recently published the Report, which includes the following:
This week, our In Focus section provides a recap of the third annual HMA Conference, The Rapidly Changing World of Medicaid: Opportunities and Pitfalls for Payers, Providers and States, held this Monday, October 1, and Tuesday, October 2, in Chicago, Illinois. More than 450 leading executives representing managed care organizations, providers, state and federal government, community-based organizations, and other stakeholders in the health care field gathered to address the opportunities and challenges facing health plans, states, and providers as they strive to provide the best possible care to Medicaid beneficiaries and other vulnerable populations at a time of significant uncertainty and change. Conference participants heard from keynote speakers, engaged in panel discussions and connected during informal networking opportunities. Below is a summary of highlights from this year’s conference.
This week, our In Focus section reviews Medicare-Medicaid integration opportunities through Dual Eligible Special Needs Plans (D-SNPs). States are motivated to expand their capacity to address the needs of dually eligible beneficiaries through integrated care. They are increasingly requiring health plans that operate Medicaid managed long-term services and supports (MLTSS) programs to become Medicare Advantage (MA) D-SNPs. A few states require D-SNPs to be Medicaid MLTSS health plans.[1]