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.
Long-Term Services and Supports
Annual Survey Finds Medicaid Enrollment Growth Slowing, Uptick in Spending Growth
Medicaid enrollment continues to slow in FY 2017 and FY 2018; however, states project an uptick in spending in FY 2018. This is just one finding in the 17th annual 50-state Medicaid Budget Survey conducted by The Kaiser Family Foundation and in collaboration with Health Management Associates (HMA) and the National Association of Medicaid Directors.
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.
Review of Medicaid Managed Care Procurement Landscape in 2017
This week, our In Focus section reviews the Medicaid managed care procurement landscape for 2017, including those requests for proposals (RFPs) and other procurement vehicles that were awarded, are currently out to bid, or are expected to be released before the end of the calendar year. By year’s end, we anticipate there will have been at least 16 procurements awarded or issued this year across 13 states, covering more than 13 million Medicaid or CHIP members, and accounting for more than $76 billion in annual spending when fully implemented.
Graham-Cassidy Affordable Care Act (ACA) Repeal-And-Replace Bill
This week, our In Focus section reviews the bill put forward last week by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) to repeal and replace the Affordable Care Act (ACA). General consensus, the HMA Roundup included, viewed ACA repeal-and-replace efforts as largely defeated at the end of July, with the Senate’s failure to pass the Better Care Reconciliation Act. There is, however, an emerging view, which was shared by several speakers at last week’s HMA conference, that the Graham-Cassidy bill has a real chance of passing the Senate ahead of the September 30 deadline, at which point the reconciliation process expires and a bill would require 60 votes to pass the Senate. Below, we highlight key provisions of the Graham-Cassidy bill that impact federal funding to states, state Medicaid programs, and the Exchange and individual insurance markets, including both a block grant program targeted at higher-income and Medicaid expansion populations and a Medicaid per capita cap funding structure.
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.
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.
HMA Conference to Feature Insights from Health Plan CEOs, State Medicaid Directors
Dates: September 11-12, 2017
Location: Renaissance Chicago Downtown Hotel
Waivers, block grants and per capita caps, member premiums and copays, health savings accounts, expansion, and new benefit design and funding models will take center stage as 35 speakers from leading health plans, states and providers join Health Management Associates for the high-level, two-day conference The Future of Medicaid is Here: Implications for Payers, Providers and States.
HMA’s Raney, Lasky Edit Book that Serves as Guide for Implementing Integrated Care
Integrated Care: A Guide for Effective Implementation is co-edited by HMA’s Lori Raney, MD and Gina Lasky, PhD, MAPL and Collaborative Care Consulting’s Clare Scott, LCSW. The book provides a detailed, thoughtful, and experience-based guide to effective implementation of integrated behavioral healthcare. Using evidence and on the ground experience, the authors share practical and actionable advice for a complex model of care.
Alabama, Ohio Provide Details on Medicaid MLTSS Program Designs
This week, we reviewed two proposed statewide Medicaid managed long-term services and supports (MLTSS) program designs. Alabama is currently accepting public comments on a plan to implement provider-driven Integrated Care Networks (ICNs) to provide MLTSS statewide to roughly 25,000 beneficiaries who are residing in nursing facilities or receiving home and community based services (HCBS) through three of the state’s Medicaid HCBS waiver programs. Meanwhile, Ohio Governor John Kasich proposed in his upcoming state budget to implement a statewide MLTSS program for more than 100,000 beneficiaries in the state. We review both states’ plans for MLTSS, including market sizes, implementation timing, and existing Medicaid managed care plans in the states.