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35 Results found.

Case Study

Pipeline research and policy recommendations to address new innovative therapies

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The client was looking for an experienced team who could assess the current pipeline of innovative therapies, examine current reimbursement policies to assess long-term compatibility with the adoption of innovative therapies and novel delivery mechanisms, and make policy recommendations to address any challenges identified through the process. HMA, The Moran Company, and Leavitt Partners, both HMA subsidiaries, were selected as the team with the needed expertise and capacity to create several deliverables. These deliverables were focused on the impact of the upcoming pipeline of certain innovative therapies on different payment systems, as well as working with the client’s team to develop and refine federal and state policy recommendations to address identified challenges. 

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Case Study

Laying the foundation for modernizing Indiana’s public health system

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Even before the COVID-19 pandemic, Indiana’s public health system, administered primarily at the local level, struggled to meet the state’s public health challenges. The pandemic further exposed the system’s deficiencies, as well as the geographic, racial, ethnic, and socio-economic disparities in health outcomes that exist across the state. Recognizing that the state can and must do better, Governor Eric Holcomb appointed a 15 member Governor’s Public Health Commission (“the Commission”) charged with examining the strengths and weaknesses of Indiana’s public health system and making recommendations for improvements.

The Commission held monthly meetings from September 2021 through July 2022. Its work was driven through the following six workstreams led by designated policy advisors who conducted research, engaged experts and stakeholders, and developed draft recommendations for the Commission’s consideration: 1) governance, infrastructure, and services, 2) public health funding, 3) workforce, 4) data and information integration, 5) emergency preparedness, and 6) child and adolescent health.

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Case Study

Reforming Colorado’s behavioral health system

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Like many states Colorado has historically struggled with a mixture of challenges relating to its public behavioral health system including funding issues, duplicate processes across multiple state systems, and the absence of a cohesive statewide strategy, which has proved increasingly problematic for Coloradans, especially those with complex needs. The state set out to create a system with a coherent vision and strategy that could provide high quality, equitable and accountable care to all Coloradans. 

In 2019, Colorado Governor Jared Polis created a Behavioral Health Taskforce (BHTF) charged with evaluating and setting a roadmap to improve the state’s behavioral health system. The BHTF created a set of more than 200 recommendations that were both structural and programmatic in nature. The most significant structural change was a recommendation to create the Behavioral Health Administration (BHA)—a single accountable entity that would reduce fragmentation across sectors and programs and build a more strategic approach to ultimately improve behavioral health outcomes. 

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Case Study

Multiple clients accepted into ACO REACH Model

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In early 2022 HMA and Wakely Consulting Group, an HMA Company, assisted multiple clients with their applications to participate in the new Centers for Medicare and Medicaid Services (CMS) Medicare Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model program. The purpose of this model is to improve quality of care for Medicare beneficiaries through better care coordination and increased engagement between providers and patients including those who are underserved. ACOs and participating providers are held responsible for patients’ total cost of care and must meet certain quality metrics. In return, they have more flexible payment arrangements, can achieve shared savings, and can provide additional services such as telehealth, home-based care, and more options for post-acute care.

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Case Study

Expanding access to CenteringPregnancy group care through telehealth

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Poor birth outcomes, especially for communities of color, are a persistent health issue for our country. While there is no “cure” for preterm birth, the leading contributor to poor birth outcomes, group prenatal care is an evidence-based practice to reduce pre-term birth, especially for urban African American communities.

Group prenatal care provides a host of other benefits including improved breastfeeding rates, enhanced parental knowledge, and better pregnancy spacing. In addition, decreasing preterm birth provides tremendous cost savings.

The Centering Health Institute (CHI) has developed a successful model of group prenatal care called CenteringPregnancy™. CenteringPregnancy empowers patients, strengthens patient-provider relationships, and builds communities through three main components of health assessment, community building, and interactive learning delivered as a series of group visits with pregnant individuals at similar gestational age.

While more prenatal providers are offering Centering as a model of care, not every pregnant individual has access to this model. Maternity care in rural America is facing a crisis in access, and the COVID-19 pandemic required organizations to shift to care delivered through telehealth.

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Case Study

Strengthening MAT processes and OUD care in emergency departments

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The prevalence of opioid use disorder (OUD) and the resultant harms from this disorder continue to escalate in the United States. The CDC’s National Center for Health Statistics released a report noting that in 2020, drug overdose deaths in the United States increased by nearly 30% over the previous year, reaching an all-time high of more than 100,000. The majority of these deaths are attributable to opioids.

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Case Study

Accreditation Association for Ambulatory Healthcare

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A health plan with a newly awarded contract was entering a new market to provide long-term services and supports (LTSS) and was seeking required, nationally recognized accreditation in order to comply with the state contract requirements. The client was working against a short three-month timeline and needed document review, report analysis, policy and procedure development, and assistance preparing for the review and evaluation process to secure accreditation.

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Case Study

Evaluation of investment in multi-state personal care services provider for LTSS qualifiers

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The client was evaluating an investment opportunity in a multi-state personal care services (PCS) provider for elderly and disabled Medicaid beneficiaries that qualify for long term services and supports (LTSS). HMA was asked to evaluate the market environment for personal care services providers in 13 states to determine the stability of the regulatory environment and the outlook for Medicaid funding. The timeline for this due diligence engagement was five weeks.

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Case Study

Individualized technical assistance to Medicaid providers in the My Health GPS program

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The My Health GPS (MHGPS) initiative, a Health Homes program, was launched by the District of Columbia, Department of Health Care Finance (DHCF) to deliver care coordination services to Medicaid beneficiaries with multiple chronic conditions. The MHGPS program was led by multi-disciplinary teams within the primary care setting to coordinate care across medical, behavioral, and social service systems.

The initiative was designed to improve MHGPS enrollees’ health outcomes and reduce avoidable and preventable hospital admissions and emergency room visits.

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Case Study

Los Angeles County complex care management training for registered nurses

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The client’s goal was to increase and enhance leadership skills and critical thinking approaches as well as increase chronic disease expertise of the 100 Registered Nurse (RN) Care Managers in the Los Angeles County Department of Health Services (LACDHS) ambulatory care system through training, standardized complex care management (CCM) across the county, hiring new care managers and integration of care management software.

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