Public Health

Nursing Home Report Highlights Benefits of Single Resident Rooms

The COVID-19 pandemic highlighted nursing home safety and infection control as critical public health issues. A new report authored by HMA colleagues found compelling evidence that single rooms in nursing homes have numerous benefits for both public health and residents’ experience. The authors conclude that transitioning from multi-resident rooms to single rooms should be a component of person-centered nursing home reform. The report calls on stakeholders to come to the table to discuss options and strategies for long-term care redesign and transformation. 

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Highlights from Kaiser/HMA 50-State Medicaid Director Survey COVID-19 Update for FY 2021 and FY 2022

This week, our In Focus section shares key takeaways from the Kaiser Family Foundation (KFF) and Health Management Associates (HMA) mini-survey of Medicaid directors in all 50 states and the District of Columbia titled, Medicaid Spending and Enrollment Trends Amid the COVID-19 Pandemic – Updated for FY 2021 & Looking Ahead to FY 2022. The survey, released on March 12, 2021, is an update to the 20th annual Medicaid Budget Survey conducted by KFF and HMA. The brief is authored by Elizabeth Hinton , Lina Stolyar , and Robin Rudowitz from KFF with survey assistance and dissemination from HMA Principal Kathy Gifford and Consultant Anh Pham.

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California Releases Revised CalAIM Proposal

This week, our In Focus section summarizes the revised California Advancing and Innovating Medi-Cal (CalAIM) proposal, released on February 17, 2021. Medi-Cal, the state’s Medicaid program, covers over 12 million individuals, with over 11 million in managed care. CalAIM seeks to standardize and streamline the Medi-Cal program and address health disparities and social determinants of health for high-risk, high-cost Medi-Cal members through broad-based delivery system, program, and payment reform. CalAIM was originally scheduled to begin its tiered implementation in January 2021, but due to COVID-19 has been delayed until January 2022. The revised proposal incorporates additional stakeholder input, learnings from the workgroup meetings, and ongoing policy development.

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New Report Supports State Medicaid Programs to Advance Health Justice

Rates of illness and death due to the COVID-19 pandemic have disproportionally impacted Americans who are Black, African American, Latinx, Native American, Asian, and other people of color as well as people with disabilities and those subsisting on poverty-level income. In response to this, AcademyHealth, in partnership with the Disability Policy Consortium (DPC), a Massachusetts-based cross-disability advocacy and action research organization, released a new report: Advancing Health Justice Using Medicaid Data: Key Lessons from Minnesota for the Nation. This report provides information on the importance of investing in data analysis to advance health justice in Medicaid populations. It further highlights the importance of partnering with communities most impacted by injustices that cause inequities in health outcomes.

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CMS Releases New Tools

Two new tools have been released by the Centers for Medicare & Medicaid Services (CMS) to help states and territories plan to transition back to regular operations after the COVID-19 public health emergency (PHE) ends.

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The Centers for Medicare & Medicaid Services Innovation Center’s Geographic Direct Contracting Model Opportunity

This week, our In Focus section reviews a new model – Geographic Direct Contracting – introduced by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. The model will test whether a geographic-based approach to care delivery and value-based care can improve health and reduce costs for Medicare beneficiaries enrolled in the traditional fee-for-service program across an entire region. This model represents one of the most transformational models released by the Innovation Center.  During the 6-year Geographic Direct Contracting model performance period the traditional Medicare program will be replaced by the Direct Contracting program in the 10 selected regions.

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The Future of Quality Reporting: Understanding Digital Quality Measurement Practices

In the wake of the COVID-19 pandemic, the need for greater health information technology interoperability, “digital” measures of healthcare quality and performance, and advanced value-based care systems has grown. In January 2021, the National Committee for Quality Assurance (NCQA) publicly released its vision for healthcare quality measurement to the Biden-Harris Department of Health and Human Services (HHS) transition team. The paper, “The Future of Healthcare Quality,”  focuses on four core areas, with three of them being specific to the evolution of a digital quality ecosystem:

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Drivers and Barriers to Adoption of Flexible Medicare Advantage Supplemental Benefits

This week’s In Focus highlights a recent HMA publication examining the drivers and barriers to Medicare Advantage plan adoption of newly available supplemental benefits intended to address unmet health and social needs. Unlike Traditional Medicare, Medicare Advantage plans, which provide coverage for 40 percent of all Medicare beneficiaries, may offer enrollees supplemental benefits which are not covered by the Medicare program. Until recently, the Medicare program has required that supplemental benefits be limited to those that are medical in nature. However, in recent years, Congress and CMS —through four different legislative and regulatory authorities — granted new flexibilities for Medicare Advantage plans to offer non-medical benefits that address social needs. Medicare Advantage plans may also now tailor supplemental benefits and make them available only to certain subpopulations based on chronic disease or health status.

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Report Examines Medicare Advantage Supplemental Benefits

The experts at Health Management Associates (HMA) have released Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access. The white paper examines the factors contributing to a Medicare Advantage plan’s decision to offer or not offer newly available supplemental benefits and opportunities and challenges with adoption and implementation. Newly available supplemental benefits are intended to address unmet health and social needs.

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HMA Expert Provides Medicaid Funding Insights

HMA Managing Principal Anne Winter joined the “Our American States” podcast, produced by the National Conference of State Legislatures, to discuss emerging gene therapies and the high costs associated with them. The episode, The Fiscal Challenge of Emerging Gene Therapies, originally aired Jan. 11, 2021.

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