This week, our In Focus reviews the Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020. The new proposed rule does not contain as many major changes as the 2019 rule, but there are requests for comment on potentially important rulemaking starting in 2021 and guidance on important policy, such as:
This week, our In Focus summarizes the findings of an HMA Information Services (HMAIS) analysis of Medicaid managed care rates in 2018 versus 2017. The analysis represents HMAIS’ first attempt at what will be an annual tracking of Medicaid managed care rate increases, which we will expand upon and refine over time with input from our readers and the Medicaid community. Complete results, including spreadsheets showing underlying analysis, will be made available to HMAIS subscribers. For information on how to subscribe, contact Carl Mercurio.
On January 3, 2019, Colorado Attorney General Cynthia H. Coffman released the study, Community Conversations to Inform Youth Suicide Prevention. The multi-layered study, conducted by HMA, analyzes and characterizes the trends and patterns in the fatal and non-fatal suicidal behaviors among young people in the four Colorado counties with the highest rates of youth suicide: El Paso, La Plata, Mesa, and Pueblo. The purpose of the study was to determine the best strategies for addressing and preventing youth suicide in Colorado and to see where the state’s efforts and dollars can be used most effectively.
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:
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 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 highlights HMA Medicaid Market Solutions’ (MMS) efforts to support state flexibility in designing and implementing Section 1115 Demonstration Waivers promoting member engagement and personal responsibility. Over the coming weeks, HMA MMS will present a series of articles providing in-depth analyses of the many facets of these new Medicaid models. This week, we examine important issues and considerations for implementing Medicaid consumer empowerment, community engagement, and work requirements.