This week, our In Focus highlights a recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, revisits questions raised in a previous HMA report and offers potential answers to guide progress and changes for demonstrations within the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (CMMI) or the Innovation Center.
Government Programs & The Uninsured
2022 Star Ratings, An Historical Year
This week, our In Focus provides an analysis of 2022 Medicare Advantage (MA) Star Ratings, including a look at how regulatory changes during the COVID-19 pandemic resulted in a record number of Medicare plans receiving historically high scores. HMA Managing Director Anthony Davis and Principal Sarah Owens rely on data from the Centers for Medicare & Medicaid Services (CMS) to take a deep dive into ratings for nearly 500 Medicare plans serving 26.8 million members.
New Jersey outlines five-year vision in latest 1115 waiver renewal draft
This week, our In Focus reviews the the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) draft proposal for the renewal of its 1115 Comprehensive Demonstration Waiver, released on September 10, 2021. The waiver was initially approved and implemented in October 2012. This demonstration is in its second five-year period and is slated to expire on June 30, 2022.
Texas releases STAR Health draft RFP, seeks input on STAR+PLUS, STAR Kids ACO
This week, our In Focus reviews the Texas Health and Human Services Commission (HHSC) draft request for proposals (RFP) for Texas STAR Health, the state’s Medicaid managed care program for foster care kids. The state is also seeking public input for the STAR+PLUS and STAR Kids Accountable Care Organization (ACO) programs, in anticipation of the reprocurement of these Medicaid managed care programs.
Medicaid non-emergency transportation benefit: trends and innovations from stakeholders
This week, our In Focus section reviews key takeaways from the report, Medicaid Non-Emergency Transportation Benefit: Stakeholder Perspectives on Trends and Innovations, prepared by Health Management Associates (HMA) for the Medicaid and CHIP Payment and Access Commission (MACPAC).
Arizona Releases Competitive Contract Expansion (CCE) RFP
This week, our In Focus section reviews the Arizona Health Care Cost Containment System (AHCCCS) Competitive Contract Expansion (CCE) request for proposals (RFP), released on August 4, 2021. The procurement will expand the current AHCCCS Complete Care (ACC) Medicaid contracts to include responsibilities as an ACC Contractor (health plan) with a Regional Behavioral Health Agreement (ACC-RBHA). At least one incumbent Medicaid ACC Contractor will be selected in each of the state’s three Geographic Service Areas (GSAs). The responsibilities will include management of:
Senate infrastructure bill impacts U.S. healthcare system, Leavitt Partners analysis shows
President Biden and Senator Majority Leader Schumer have been pursuing a two-track strategy to advance major policy objectives in 2021. The first track, the bipartisan “Infrastructure Investment and Jobs Act,” passed the Senate 69-30. Attention now turns to the House, where Speaker Pelosi has indicated she will not consider the bill until the Senate passes a Democratic-only reconciliation bill – which is the second track in Democrats’ policy strategy. While the Senate vote reflects a major bipartisan milestone, the bill still faces a trip through the House of Representatives before it gets to President Biden’s desk.
Vermont proposes risk-bearing, state-run Medicaid managed care entity
This week our In Focus section reviews Vermont’s Global Commitment to Health Section 1115 waiver renewal application. In the proposed five-year demonstration extension, Vermont seeks to move the Medicaid population to a new a risk-bearing public, state-run managed care organization (MCO). Under the arrangement, the Department of Vermont Health Access (DVHA) would transition into the new entity and accept capitated risk for the state’s Medicaid population, covering physical and mental health, pharmacy services, substance use disorder (SUD) services, and long-term services and supports (LTSS) beginning January 1, 2022.
Medicare-Medicaid integration: key elements and policy recommendations for dual eligible care programs
This week, our In Focus section releases a new brief from Health Management Associates, Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals. The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Narda Ipakchi.[1]
Minnesota releases Integrated Health Partnerships program RFP
This week, our In Focus section reviews the Minnesota Integrated Health Partnerships (IHP) Program request for proposals (RFP) released by the Minnesota Department of Human Services (DHS), Health Care Administration on July 6, 2021. Minnesota will contract with provider organizations to serve as IHPs and provide health care services to Medical Assistance and MinnesotaCare enrollees under alternative payment arrangements.