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What does passage of the “debt ceiling” bill mean for the healthcare workforce?

On May 31, the House passed H.R. 3746 – the Fiscal Responsibility Act of 2023, otherwise known as the “debt ceiling” bill, which increased the federal debt limit, established new discretionary spending limits, rescinded unused funds, and expanded work requirements for federal programs. It was passed by the Senate on June 1 and will soon be signed into law. What does all this have to do with healthcare workforce? Well, part of the rescindment plan comes from $28 billion in unused pandemic funding, with a substantial portion of those funds that were allocated for healthcare workforce efforts. This includes funds set to be used for mental health and substance use disorder training, grants to improve mental health and burnout in the healthcare workforce, and additional educational and training grants for promoting future workforce. Overall, part of $28 billion specifically includes removal of $1.7 billion from the Centers for Disease Control and Prevention (CDC) and $13.4 billion from the Department of Health and Human Services (DHHS), including $10.4 billion from public health and social services emergency funds.

Washington DC Capitol dome detail with waving american flag

So, what does this mean for the healthcare workforce? It means healthcare organizations will need to continue to optimize their current and future workforce plans, without additional funding that could provide some relief.

At Health Management Associates (HMA), our healthcare workforce experts have not only partnered with health system leaders to identify real-world solutions, we have directly experienced the same challenges, because our team includes physicians, nurses, advanced practice providers, and former health system operations and financial executives who share the same lived experiences.

HMA offers a number of workforce solutions to healthcare communities across the spectrum. We cannot fill all your staffing gaps tomorrow, however, we can give you an innovative, model-of-care plan designed to lower costs, increase revenue, and position organizations for long-term financial success and operational sustainability.

With HMA’s Delivery System Optimization Team, organizations will benefit from:

An experienced team of health system leaders, bedside clinicians, and workforce subject matter experts with real-world experience and modern health care delivery solutions

A thorough quantitative and qualitative assessment including:
- Workforce capacity, needs, and gap analysis.
- Leadership and governance structure evaluation.
- Key regulatory and policy gap analysis.
- Compensation and benefits review.
- Clinical and/or non-clinical workflow evaluation.
- Provider billing practices and quality metric capture.
- Provider and staff utilization analysis.

What organizations receive is:

A customized, comprehensive phased implementation plan that:
- Improves cash flow and maximizes revenue.
- Reduces turnover, increases retention, and improves health system culture.
- Optimizes the ‘Model of Care’ delivery while still maintaining quality and safety.
- Provides solutions for long-term financial success and operational sustainability.
- Offers on-going executive and leader coaching services to help provide support through the change management process.

Today’s healthcare workforce challenges are unwavering, especially given the recent passage of the “debt ceiling” bill. From significant workforce shortages, to rising costs and competition, to decreasing employee engagement and burnout, today’s health systems face tremendous challenges. But by understanding workforce and health system needs and identifying gaps and inefficiencies, employers can fully utilize the employees they have to their highest potential and deliver care more effectively and efficiently. Here at HMA, our delivery system optimization team can help health care communities struggling with workforce challenges do just that.

Contact our healthcare delivery system experts, who can partner with your organization to design a custom workforce solution for you.

Roxane Townsend MD, Managing Director, Delivery Systems
Melinda Estep, Managing Director, Delivery Systems
Jennifer M. Orozco, DMSc, PA-C, DFAAPA, Principal, Delivery Systems

Opportunities for state regulators to shape policy and regulation of treatment for substance abuse disorder

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Health Management Associates (HMA) is offering a 3-part series of webinars looking at the effect of proposed regulations on delivery of opioid treatment services to the population facing addiction issues. In this third and final webinar, HMA consultants will highlight opportunities for state regulators to shape policy and regulation of SUD treatment.

New federal regulations encourage significant changes to how opioid treatment is provided, with the goal of expanding access and improving patient-centered care. State regulators will need to adapt their regulatory practices and work closely with Medicaid agencies and treatment providers so the new regulations can achieve their intended goals. This webinar will discuss how State Opioid Treatment Authorities (SOTAs), licensing entities, and state Medicaid agencies will need to work together to craft updated regulations, facility licensing, and reimbursement practices that advance person-centered care.

Learning Objectives:

New Regulatory Requirements – Overview of state rules around opioid treatment vs the new requirements.
How to Improve SUD Treatment Access – Specific recommendations on statutory and regulatory changes that could lead to more patient centered treatment options.
States Leading the Way – Examples from states that are leading the way to expand access and reduce stigma.

Other webinars in this series:

Watch the replay of Part 1 on Opioid Treatment Providers

Watch the replay of Part 2 on Opioid State Payers Aligning Incentives for Treatment

May 2023

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May 31, 2023

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Health Management Associates selected as CalAIM Technical Assistance vendor

One of only two firms selected in all seven domains out of 46 vendors.

The California Department of Health Care Services (DHCS) has developed a multi-year initiative whose goal is to improve health outcomes and health care quality through broad delivery, payment, and program reforms known as California Advancing and Innovating Medi-Cal (CalAIM). This includes the introduction of new programs and changes to existing programs that will occur over the span of five years. CalAIM further expands upon prior initiatives, such as Whole Person Care, the Health Homes Program, and the Coordinated Care Initiative, and strives to integrate California’s delivery systems to better facilitate the overall Medi-Cal program.

With the rollout of these programs and the vast requirements associated with them, DHCS and California’s Medi-Cal managed care health plans are now tasked with the challenge of implementing CalAIM and enabling the participation of community providers and partners in these opportunities. To support these partners, DHCS developed a funding initiative, known as Providing Access and Transforming Health (PATH) to aid in strengthening capacity and infrastructure of Community Based Organizations, public hospitals, county agencies, and others to stand up CalAIM. This five-year, $1.85 billion initiative includes the creation of a virtual Technical Assistance (TA) Vendor Marketplace that organizations can use to request resources and support from approved vendors through services that are fully paid for by the State.

Health Management Associates (HMA) is recognized as a valued partner to Payers, Community Based Organizations, public hospitals, and county agencies and has deep expertise in CalAIM policy, operations and implementation. Recognized for our extensive capabilities in the field, HMA is one of only two firms out of 46 vendors that received State approval to serve as a technical assistance vendor on the PATH Technical Assistance (TA) Marketplace for all seven domains:

Domain 1: Building Data Capacity: Data Collection, Management, Sharing, and Use
Domain 2: Community Supports: Strengthening Services that Address the Social Drivers of Health
Domain 3: Engaging in CalAIM Through Medi-Cal Managed Care
Domain 4: Enhanced Care Management (ECM): Strengthening Care for ECM Population of Focus
Domain 5: Promoting Health Equity
Domain 6: Supporting Cross-Sector Partnerships
Domain 7: Workforce

HMA also has expertise in and hands-on experience with addressing the unique challenges experienced by providers and partner agencies serving rural communities. Please visit the PATH Technical Assistance (TA) Marketplace to access TA resources that can help strengthen capacity to provide high quality Enhanced Care Management (ECM) and Community Supports services for Medi-Cal members.

Connecting community partners to improve transitions of care

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HMA’s webinar series, 1115 Medicaid Justice Demonstration Waivers: Bridging Healthcare, will focus on helping stakeholders optimize the continuity of care for persons in carceral settings and during their transition back to the community.

Part 3 will focus on optimizing key partnerships before, during and after transition from a carceral setting into the community to ensure the best outcomes for individuals eligible for 1115 approved waiver services.

Learning Objectives:

Health Assessments and Transition Planning: Understand the health and resource needs of returning citizens (health, behavioral health and social issues).
Collaboration with Community Providers: Identify key partners and formalize collaborations to strengthen the quality of transitions care and support provided to individuals transitioning to the community.
Insurance Enrollment Strategies: Develop Medicaid enrollment strategies that apply to your state and local framework.

Other webinars in this series:

Watch a replay of Part 1: Medicaid Authority and Opportunity to Build New Programs for Justice-Involved Individuals
Watch a replay of Part 2: 1115 Justice Waivers to Improve Carceral Healthcare Delivery Information
Part 4: 1115 Justice Waivers and Medication Assisted Treatment (MAT) – July 13 at 2pm ET
Part 5: 1115 Justice Waivers and Special Populations: Meeting the Needs of Justice-Impacted

Youth mental health access: school-based intervention strategies

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The youth behavioral health crisis has resulted in a cascade of federal funding, advisories, and overall opportunities to improve resources to help kids. This webinar will present the Dialectical Behavioral Therapy (DBT) STEPS for Adolescents model, which is a low cost, high impact approach that empowers schools to intervene and support well-being and resiliency before students are in crisis, self-harming, or suicidal. Attendees will learn how to fund and implement this approach to promoting mental wellness as a strategy to reduce the burden on clinical resources designed to treat mental illness.

Whether you are a plan looking to develop value added services, a provider looking to better integrate with schools, or a school team looking for new approaches, this discussion will offer information about available funding, highlight research demonstrating evidence for the model, and offer Q&A with one of the developers of the DBT model. Attendees will receive links to a training calendar and overview of DBT.

Learning Objectives

Credentialing Not Required – Why DBT is a preferred model to address the youth BH crisis.
Ease of Implementation – How DBT has been adapted for current school personnel to deliver.
Financing Options – How to finance implementation of DBT.

Featured Speakers

James J. Mazza, Ph.D., Co-Developer for DBT Steps-A and Professor School Psychology Program, University of Washington

HMA annual conference on innovations in publicly sponsored healthcare

Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth

Pre-Conference Workshop: October 29, 2023
Conference: October 30−31, 2023
Location: Fairmont Chicago, Millennium Park

Health Management Associates has announced the preliminary lineup of speakers for its sixth annual conference, Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth.

Hundreds of executives from health plans, providers, state and federal government, investment firms, and community-based organizations will convene to enjoy top-notch content, make new connections, and garner fresh ideas and best practices.

A pre-conference workshop, Behavioral Health at the Intersection of General Health and Human Services, will take place Sunday, October 29.

Confirmed speakers to date include (in alphabetical order):

Jacey Cooper, State Medicaid Director, Chief Deputy Director, California Department of Health Care Services
Kelly Cunningham, Administrator, Division of Medical Programs, Illinois Department of Healthcare and Family Services
Karen Dale, Chief Diversity, Equity, and Inclusion Officer, AmeriHealth Caritas
Mitchell Evans, Market Vice-President, Policy & Strategy, Medicaid & Dual Eligibles, Humana
Peter Lee, Health Care Policy Catalyst and former Executive Director, Covered California
John Lovelace, President, Government Programs, Individual Advantage, UPMC Health Plan
Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation
Anne Rote, President, Medicaid, Health Care Service Corp.
Drew Snyder, Executive Director, Mississippi Division of Medicaid
Tim Spilker, CEO, UnitedHealthcare Community & State
Stacie Weeks, Administrator/Medicaid Director, Division of Health Care Financing and Policy, Nevada Department of Health and Human Services
Lisa Wright, President and CEO, Community Health Choice

Publicly sponsored programs like Medicare, Medicaid, and the Marketplaces are leading the charge in driving value, equity, and growth in the U.S. healthcare system. This year’s event will highlight the innovations, initiatives, emerging models, and growth strategies designed to drive improved patient outcomes, increased affordability, and expanded access.

Conference Agenda

Early bird registration ends July 31. Questions may be directed to Carl Mercurio at cmercurio@healthmanagement.com. Group rates, government discounts, and sponsorships are available.

May 24, 2023

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New experts join HMA in April 2023

HMA is pleased to welcome new experts to our family of companies in April 2023.

Jed Abell – Consulting Actuary
Wakely

Jed Abell is a professional health insurance actuary with over 20 years of experience focusing on Medicare Advantage, Part D, and commercial employer group plans.

Surah Alsawaf – Senior Consultant
HMA

Surah Alsawaf is a senior consultant with experience in creating and implementing regulatory strategies and workflows, conducting reviews and audits, and leading cross-functional teams to complete complex deliverables.

Elrycc Berkman – Consulting Actuary
Edrington

Elrycc Berkman is experienced in Medicaid managed care rate development including managed long-term services and supports (MLTSS) and program of all-inclusive care for the elderly (PACE) rate development.

Monica Bonds – Associate Principal
HMA

Monica Bonds is an experienced managed care professional with over 15 years of experience working in large and diverse organizations.

Yucheng Feng – Senior Consulting Actuary
Wakely

Yucheng Feng has over 15 years of experience providing actuarial support for Medicare Advantage clients, including bid preparation, reserve, actuarial analytics and providing strategic recommendations. Read more about Yucheng.

Melanie Hobbs – Associate Principal
HMA

Melanie Hobbs is an accomplished healthcare executive, consultant, and thought leader specializing in Medicare, Medicaid, and Special Needs Plans (SNPs).

Daniel Katzman – Consulting Actuary
Wakely

Daniel Katzman is experienced in Medicare Advantage bid pricing and modeling as well as claims trend analytics and affordability/cost-savings analysis. Read more about Daniel.

Supriya Laknidhi – Principal
HMA

Supriya Laknidhi has over 20 years of experience in the healthcare industry and a proven track record in driving growth and innovation for companies.

Donald Larsen – Principal
HMA

Dr. Donald Larsen is a C-suite physician executive with over 30 years of experience spanning complex academic medical centers, community health systems, acute care hospitals, and research institutes.

Ryan McEntee – Senior Consultant
Wakely

Ryan McEntee is an experienced managed care executive specializing in strategic leadership within Medicare Advantage plans. Read more about Ryan.

Nicole Oishi – Principal
HMA

Nicole Oishi has over 30 years of experience in senior leadership roles as a healthcare clinician and executive.

Opportunities for state payers to improve & align incentives for treatment of substance use disorder

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Health Management Associates (HMA) is proud to offer a 3-part series of webinars looking at the effect of proposed regulations on delivery of opioid treatment services to the population facing addiction issues. In this second webinar, HMA consultants will highlight Opportunities for State Payers to Improve & Align Incentives so that providers can expand access to treatment enabled by new federal regulations that encourage patient-centered care.

Patients seeking SUD treatment stand to truly benefit from the changes presented in the forthcoming SAMHSA regulations. However, payers need to restructure the reimbursement model to incentivize person-centered care and allow opioid treatment providers to remain fiscally viable without putting undue burden on patients. The change in regulations present a unique opportunity to advance value-based payment models in the SUD treatment system and expand access to treatment that meets patients where they are.

Learning Objectives:

How Payers Can Benefit – Understanding the opportunity for payers to close important gaps in current approaches to SUD treatment.
Innovation Inspiration – Learning from other programs to better deliver whole person care.
Tackling Challenges – Identifying the likely obstacles and how they can be overcome.

Featured Speaker:

Chris Regal, Director, Clinical Innovation, America’s Health Insurance Plans

Watch the replay of Part 1 of our Opioid Treatment Providers webinar series.

Stayed tuned for information on part 3 of our Opioid Treatment Providers series: Opportunities for State Regulators to Shape Policy and Regulation of Treatment for Substance Abuse Disorder

Child and family wellbeing: May is National Foster Care Month

This is part of an ongoing series highlighting efforts in Human Services and Family Wellbeing.

During the month of May, National Foster Care Month provides an opportunity to raise awareness on issues related to foster care and to celebrate those who are dedicated to serving our children, youth, and families. Yet it is important to note that unfortunately issues surrounding children and youth experiencing foster care are not limited to one month a year. As noted in our recent child well-being blog, Child welfare services face challenges every day to prevent, treat, and reduce risk of maltreatment, neglect, trauma, housing instability, and violence in communities. All these issues contribute to the significant number of children and youth who enter or remain in the foster care system. These issues are year-round and decades in the making. They need to be seen as a priority for public health and community wellbeing and not just the jurisdiction and responsibility of child welfare agencies.

To positively impact the number of children and youth experiencing foster care, there are some strategies that can be implemented now to promote change:

We must meaningfully elevate the voices of those with lived experience to help us design systems that meet their needs. For foster care, working to hear and understand the voices of youth based on how they have experienced foster care will help create opportunities to improve the system from those most impacted. Further, the meaningful elevation of these voices helps to ensure their input is not contributing towards tokenism and re-traumatization.
Multi-system involvement is important. We can work together to enhance access, increase prevention-oriented services, improve community health, and well-being, and achieve better outcomes using an equity lens, but proposed system reforms cannot be successful without shared ownership within the community and across government agencies. This requires building a responsive and integrated system of care approach to allow communities to seek solutions with the necessary support of the highest leadership within their organizations.
Continue to find ways to assure that mandated reporters and staff who work within child welfare understand that poverty is not neglect, and poverty alone should not be a reason children and youth are removed from their home(s).
System redesign is needed. From front end reporting and assessment, to working with court systems, to building up networks of caring service providers, each component of the current child welfare system and human services partners can strive to find areas needing improvement and collectively change the experiences for children and youth engaged in the child welfare system.
Focus on mental health. This year’s theme from the Children’s Bureau for national foster care month is “Strengthening Minds, Uplifting Families” and is dedicated to supporting children and youth mental and behavioral health as the largest unmet need related to foster care. According to the Children’s Bureau, Up to 80 percent of children experiencing foster care have significant mental health issues, compared with approximately 18 to 22 percent of the general population.[1]

HMA can help public sector and community partners align themselves to improve and develop new delivery systems that will work to address inequalities and disparities as communities strive to meet the needs of children, youth and families impacted by issues like mental health and substance use disorder, domestic violence, child abuse and neglect, food insecurity, housing instability, incarceration and other traumas that impact them greatly.

HMA can help support foster care prevention or reunification program efforts in the following ways:

Creating additional human service system integration of prevention services to help support families and youth experiencing child welfare interventions or foster care.
Increasing Medicaid providers who offer more Evidenced Based and Informed Practices (EBP) among Community Based Organizations (CBO), Providers, and Local Government.
Supporting Managed Care Organizations to develop programs specifically designed to support the wellbeing of children and youth in the foster care system and their families.
Connecting the Family First Prevention Services Act (FFPSA) & Medicaid funding together to ensure that funding supports the need and enhance service implementation.
Working to implement School Based Mental Health programs in communities. We can help convene stakeholders, create process flows, and support the development of sustainable funding for such programs.
Increasing the meaningful use of youth voice for true collaboration in system redesign.
Enhancing judicial engagement with the child welfare system in a way that supports meaningful youth and family voice and representation in court while maintaining the child welfare system’s responsibilities around assuring child safety. Making the court process less traumatic for children and youth and more part of a solution for them will support better outcomes.
Recognizing longstanding racial inequities in foster care experiences that can and should be addressed holistically in communities and supporting efforts to understand the root causes for the disparities in foster care placement.

Read other parts of this blog series:

If you have questions on how HMA can support your efforts in Child and Family Wellbeing, please contact: Uma Ahluwalia, MSW, MHA, Managing Principal, John Eller, Principal, Jon Rubin, Principal, or Nicole Lehman, Senior Consultant.

[1] Data: https://www.childwelfare.gov/fostercaremonth/awareness/facts/

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1600 Results found.

What does passage of the “debt ceiling” bill mean for the healthcare workforce?

Opportunities for state regulators to shape policy and regulation of treatment for substance abuse disorder

May 2023

May 31, 2023

Health Management Associates selected as CalAIM Technical Assistance vendor

One of only two firms selected in all seven domains out of 46 vendors.

Connecting community partners to improve transitions of care

Youth mental health access: school-based intervention strategies

HMA annual conference on innovations in publicly sponsored healthcare

May 24, 2023