Healthcare Delivery Development & Redesign

North Carolina Prepaid Health Plans Policy Paper

This week, our In Focus section reviews the North Carolina Department of Health and Human Services (DHHS) Medicaid Managed Care Proposed Policy Paper released on May 16, 2018, Prepaid Health Plans in North Carolina Medicaid Managed Care, ahead of a competitive procurement for the new Medicaid managed care program expected to be released in spring or summer 2018. North Carolina will be contracting with statewide Medicaid managed care organizations (Commercial Plans, CPs) as well as regional provider-led managed care entities (Provider-Led Entities, PLEs) to serve 1.9 million Medicaid beneficiaries beginning in 2019. All plans are considered by the state to be Prepaid Health Plans (PHPs). The policy paper provides additional detail on the characteristics and requirements that apply to CPs and PLEs. To read HMA’s previous analysis of “North Carolina’s Proposed Program Design for Medicaid Managed Care,” click here.

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Electronic Visit Verification: Implications for States, Providers, and Medicaid Participants

This week, our In Focus, written by HMA Principal Jen Burnett in collaboration with the National Association of States United for Aging and Disabilities (NASUAD), summarizes key considerations and policy decisions contained in Electronic Visit Verification: Implications for States, Providers, and Medicaid Participants for state consideration as they work to implement electronic visit verification (EVV) systems in accordance with the mandate included in the December 2016 21st Century Cures Act (the CURES Act).

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Roles and Responsibilities in a Value Based Payment World

This week, our In Focus section, written by HMA Principal Denise Soffel, reviews New York’s Medicaid Redesign Team Structural Roadmap: Roles and Responsibilities in a Value Based Payment World, released by the state’s Department of Health on March 19, 2018.

New York is committed to the transformation of its health care delivery system. Its Delivery System Reform Incentive Payment (DSRIP) program envisions a significant shift to community-based care, a more integrated delivery system, and a shift to value-based payment. A new document, released in draft form for public comment, lays out an ambitious objective: “New York seeks to make health care a team sport. The State seeks to forever banish the traditional silos that made care navigation for patients difficult and in some cases impossible.” (p. 13)

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HMA Principal Designs Workshop to Enhance Delivery of Patient-Centered Care

This blog post was written by HMA Principal Jeffrey M. Ring, Ph.D.

There are many great things to do up in California’s majestic Sierras.  The air is fresh and crisp, the water runs clear and the trees stretch up to dizzying heights.

The health care practitioners of Avenal/Aria Community Health in Central California decided to head to the Sierras for a weekend retreat coordinated with Health Net, and an opportunity to learn together about enhancing the delivery of patient-centered care.  I designed an interactive, experiential workshop  that aimed to facilitate team-building, an exploration of the foundations of communication (including empathy, trust and non-verbal communication), and the skills of Motivational Interviewing which has been empirically demonstrated to be more successful in generating patient behavior change than giving advice.

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HMA PCMH Experts Create 2017 Readiness Assessment Tool

This blog post was written by HMA Senior Consultant Meghan Kirkpatrick Manilla.

HMA’s Healthcare Transformation Institute (HTI) provides a venue to develop and share new innovations, experiences, and best practices across the country related to the development of community-specific integrated delivery systems, new financial strategies to incentivize value, and innovative partnerships between providers and payers to ensure quality care for its populations. Through the HTI, HMA has invested in the continued development of new approaches, tools, and resources to enhance the provision of healthcare services, with a focus on publicly-supported populations.

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Highlights from Kaiser/HMA 50-State Medicaid Director Survey

This week, our In Focus section reviews highlights and shares key takeaways from the 17th annual Medicaid Budget Survey conducted by Health Management Associates (HMA) and the Kaiser Family Foundation (KFF). Survey results were released on October 19, 2017, in three new reports: “Medicaid Enrollment & Spending Growth: FY 2017 & 2018,” Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018,” and “Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2017 and 2018.” The reports were prepared by Kathleen Giff­ord, Eileen Ellis, Barbara Coulter Edwards, and Aimee Lashbrook from HMA, and by Elizabeth Hinton, Larisa Antonisse, Allison Valentine, and Robin Rudowitz from the Kaiser Family Foundation. HMA’s Dennis Roberts also contributed. The survey was conducted in collaboration with the National Association of Medicaid Directors.

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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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Save the Date for HMA’s 2017 Conference on Trends in Publicly Sponsored Healthcare

The Future of Medicaid is Here: Implications for Payers, Providers and States

Sept. 11-12, 2017
Chicago, IL

Health Management Associates (HMA) is proud to announce its 2nd conference on Trends in Publicly Sponsored Healthcare, Sept. 11-12, 2017, in Chicago. The theme of this year’s event is The Future of Medicaid is Here: Implications for Payers, Providers and States and features as keynote speakers some of the nation’s most innovative healthcare leaders.

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