Clinical Services

HMA Consultants Tapped as Authors for Book About Oregon Healthcare Reforms

Health Reform Policy to Practice – Oregon’s Path to a Sustainable Health System: A Study in Innovation published by Elsevier Academic Press in August, provides a real-world example of an innovative, successful, and comprehensive Medicaid program redesign conducted by the State of Oregon. HMA colleagues Tina Edlund, Jeanene Smith, Cathy Kaufmann, and Lori Coyner were actively involved in Oregon’s healthcare reform efforts and have authored chapters on the development of Oregon’s metrics and incentive program, its patient-centered primary care medical home program, and its comprehensive system of supports for delivery system transformation.

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Medicaid Managed Care Enrollment Update – Q3 2017

This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states.[1] Many state Medicaid agencies elect to post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 27 states have released monthly Medicaid managed care enrollment data through the third quarter (Q3) of 2017. This report reflects the most recent data posted.

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HMA Authors Report on Digitally Driven Integrated Primary Care and Behavioral Health

This week, our In Focus section highlights an article, Digitally Driven Integrated Primary Care and Behavioral Health: How Technology Can Expand Access to Effective Treatment, published in the Current Psychiatry Report, was co-authored by HMA Principals Lori Raney, MD and David Bergman, MPA, as well as John Torous, MD, and Michael Hasselberg, M.S., Ph.D. Together, they addressed how technology solutions can be utilized for more widespread implementation of effective integrated primary care and behavior health.  

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Highlights from HMA Conference on Future of Medicaid

Last week, our In Focus section provided a recap of the second annual HMA Conference, The Future of Medicaid is Here: Implications for Payers, Providers, and States, held Monday, September 11, and Tuesday, September 12, in Chicago, Illinois. More than 300 leading executives from health plans, providers, state and federal government, community-based organizations, and others in the health care field gathered to address the challenges and opportunities for organizations serving Medicaid and other vulnerable populations given the priorities of the new Administration and Congress.

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New Mexico Issues Centennial Care 2.0 Medicaid Managed Care RFP

This week, our In Focus section reviews the request for proposals (RFP) released by the New Mexico Human Services Department (HSD) to reprocure contracts for the state’s Medicaid managed care program in its second phase, Centennial Care 2.0. Centennial Care provides integrated Medicaid managed care coverage, including long-term services and supports (LTSS) and behavioral health, to nearly 700,000 Medicaid beneficiaries in the state, with annual spending of roughly $4.5 billion.

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Chronicle of a Death Foretold: ACA Repeal and Replace Stalls in Senate

This In Focus article, authored by HMA Managing Principal Greg Nersessian, CFA  and Research Assistant Anh Pham, was originally published in the August 2, 2017 HMA Weekly Roundup.

In deference to Miracle Max, after last week’s failed votes on “Repeal and Replace,” “Straight Repeal,” and “Skinny Repeal,” the GOP’s efforts to undo the Affordable Care Act (ACA) through budget reconciliation appear to be at least “mostly dead.” While it is possible strictly partisan discussions will reaccelerate at some point, it appears that Congress is, for the first time, considering bipartisan proposals for shoring up the underwriting challenges in the individual market. In light of this change in direction, we are using this week’s In Focus section to chronicle the events that transpired over the last five months leading to last week’s historic vote. Our objective here is to create a reference piece for our readers so that the next time Congress revisits major healthcare legislation we can look back on the strategies and approaches that led to last week’s result.  Many times over the last eight months, we have reflected on the key dynamics surrounding the passage of the ACA in 2010 as a guide for what factors to watch in the efforts to repeal the ACA – budget reconciliation issues, Congressional Budget Office (CBO) scoring, key proposals to win over recalcitrant legislators, the President’s role in pushing the agenda – but our memories were not always up to the task. So in the spirit of having a reference document for future reflection, we record below the key events associated with this effort.

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Register Now: 30-plus Speakers Slated for HMA Conference

The Future of Medicaid is Here: Implications for Payers, Providers and States is a two-day event organized by Health Management Associates (HMA). Confirmed speakers include industry executives from Medicaid plans across the nation as well as Medicaid directors from California, Florida, Kansas, Hawaii, Michigan, Tennessee, Texas, and Washington.

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It Takes a Community to Divert Populations with Behavioral Health Needs from Jail

This blog post was authored by HMA Principal Bren Manaugh, LCSW-S, CPHQ and Senior Consultant Laquisha Grant, MPA.

We have all seen the headlines about jails and prisons becoming the largest de facto mental healthcare providers in the country. Nationally, 14 to 17 percent of inmates have a serious mental illness, 53 to 68 percent have a substance use disorder[1], and up to 72 percent of jail inmates have both a mental illness and substance use disorder. The overrepresentation of individuals with mental illness and substance use disorder did not happen overnight — and it is not a result of one system or issue.

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