Public Health

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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Annual Survey Finds Medicaid Enrollment Growth Slowing, Uptick in Spending Growth

Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

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.

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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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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.

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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.

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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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Medicaid and Exchange Enrollment Update – May 2017

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 “May 2017 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on July 21, 2017. Additionally, we review 2017 Exchange enrollment data from the “Health Insurance Marketplaces 2017 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on March 15, 2017. Combined, these reports present a picture of Medicaid and Exchange enrollment in the first half of 2017, representing nearly 75 million Medicaid and CHIP enrollees and more than 12 million Exchange enrollees.

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North Carolina Outlines Proposed Design for Medicaid Managed Care

This week, our In Focus section reviews “North Carolina’s Proposed Program Design for Medicaid Managed Care,” a draft proposal published this week for public comment, which provides a detailed overview of the planned statewide Medicaid managed care program to be launched in 2019. By 2023, North Carolina estimates it will have transitioned roughly 1.8 million Medicaid beneficiaries in the state to managed care. North Carolina’s Department of Health and Human Services (DHHS) is encouraging public comment on the program design proposal through September 8, 2017, ahead of a planned request for information (RFI) release later this year.

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