In this season of gratitude and joy, we reflect on a year filled with purpose and partnership. At HMA, we’re honored to support our clients and partners working to improve the health of individuals, families, and communities nationwide.
Watch our video to find out what fuels our passion to create a positive impact in all the work we do, from addressing health equity and improving maternal outcomes to advancing healthcare policy and helping organizations deliver the highest quality care.
All of us at HMA are wishing you a joyous holiday season and new year filled with continued success.
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New experts join HMA in second quarter of 2024
HMA is pleased to welcome new experts to our family of companies in the second quarter of 2024. This group of leaders has decades of experience in health policy, Medicaid, public health, and healthcare strategy. They have led initiatives to enhance access, operational efficiency, and equity and have expertise in areas such as behavioral health, data analysis, and serving underserved populations.
Learn more about our new HMA colleagues
APRIL
Associate Principal
Vice President of Finance
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MAY
Principal
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JUNE
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Senior Consulting Actuary II
New HMA white paper examines Medicare’s reimbursement system for physicians’ services
Researchers explore its history, reasons behind calls for reform, and provide recommendations for improvements
Today, HMA released a new white paper, “Medicare Physician Fee Schedule Reform: Structural Topics and Recommendations to Strengthen the System for the Future.” It provides an in-depth analysis of the Medicare Physician Fee Schedule, including the history of its implementation, stakeholder perspectives on reform, major structural issues, and recommendations for improving the $90-plus billion payment system.
Recent years have witnessed a growing bipartisan call to reform how Medicare reimburses for physician and other health professional services. A wide array of stakeholders assert that the current system—the Medicare Physician Fee Schedule (PFS)—is misaligned with today’s practice patterns and market dynamics. Many constituencies maintain that the PFS is insufficiently updated, embeds known pricing distortions, and does not appropriately effectuate value-based care principles. Although a considerable number of legislative and regulatory changes have been implemented to refine and modernize the system, the PFS has never been subject to a major statutory overhaul that would comprehensively address pressing issues.
HMA studied these issues with support from Arnold Ventures in “Medicare Physician Fee Schedule Reform: Structural Topics and Recommendations to Strengthen the System for the Future.” HMA’s white paper is an accessible primer on the PFS and key moments that led to the current policy situation. The white paper describes structural topics in the PFS that raise concern or prompt calls for change, provides context on the history and progress of the payment system and highlights stakeholder perspectives on reform.
For accessible background and context on the PFS and why the stakeholder community is calling for reforms to the fee schedule, click below.
View an electronic timeline of key policy developments and highlights of topics related to the PFS since implementation in 1992 here.
About HMA
Founded in 1985, HMA is an independent, national research and consulting firm specializing in healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. Leavitt Partners, an HMA Company has been at the forefront of navigating change in healthcare for over a decade and works at the intersection of government and health care, helping clients stay one step ahead of the influences impacting the industry, including economic, market, delivery system, public policy, and political developments. HMA has offices in more than 30 locations across the country and over 700 multidisciplinary consultants coast to coast. Learn more about HMA at healthmanagement.com, or on LinkedIn and X.
About Arnold Ventures
Arnold Ventures is a philanthropy dedicated to tackling some of the most pressing problems in the United States. It is a team of more than 120 subject-matter experts headquartered in Houston with offices in New York and Washington, D.C. It works in five key issue areas: Criminal Justice, Education, Health, Infrastructure, and Public Finance. Its work is guided by evidence-based policy, research, and advocacy.
New experts join HMA in first quarter of 2024
HMA is pleased to welcome new experts to our family of companies in the first quarter of 2024. These colleagues bring expertise in strategic planning, project management, healthcare leadership and operations, delivery systems, government programs, community services, managed care leadership, behavioral health, public health, and actuarial services.
Learn more about our new HMA colleagues
January
Senior Consultant
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Principal
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Consulting Actuary II
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Senior Consulting Actuary I
Senior Consultant
Associate Principal
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February
Vice President, Client Solutions
Principal
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Director
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Chief Information Officer
March
Senior Consultant
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Health Management Associates’ CEO Douglas Elwell retiring; COO Charles (Chuck) Milligan to lead firm
Today, Jay Rosen, founder, president, and chairman of Health Management Associates (HMA), announced Chief Executive Officer (CEO) Douglas L. Elwell is retiring. Chief Operating Officer (COO) Charles (Chuck) Milligan will succeed him as CEO effective May 17.
Elwell assumed the role of HMA’s CEO in November 2020. He had rejoined the firm as COO in February of that year after serving as the Illinois Medicaid director. During his first tenure with HMA, Elwell was a principal and managing principal in the Indianapolis office from July 2003 through October 2014. Much of his career, prior to joining HMA, was dedicated to leading hospital systems in roles as CEO, COO, and CFO. Elwell was deputy chief executive officer for finance and strategy for the Cook County Health and Hospitals System from November 2014 until early 2019.
“Doug has been an exceptional leader, expertly guiding the expansion of HMA’s breadth and depth of expertise so we continue to meet our clients’ needs and exceed their expectations well into the future,” Rosen said. “His passion for serving our clients, supporting our colleagues, and improving the lives of others has made an indelible impact on not only our company but communities across the country.
Elwell will continue to provide consulting services as Senior Advisor to the firm.
Milligan joined HMA as COO in November 2020. A seasoned healthcare leader and consulting executive who has worked with health plans, states, and policy organizations, his contributions span both the public and private sectors.
The United States Government Accountability Office (GAO) appointed Milligan a commissioner to the Medicaid and CHIP Payment and Access Commission (MACPAC) in January 2015, and appointed him vice chairman in May 2019. He has served as the Medicaid director for two states, New Mexico and Maryland.
“Chuck has played an integral role in growing and shaping the multitude of ways we can serve clients by leveraging the varied expertise across all of the organizations within HMA,” Rosen said. “He is a trusted leader, who will spur innovation and propel our partnerships to develop solutions for the toughest healthcare and human services challenges.”
Prior to joining HMA, Milligan served as CEO for UnitedHealthcare’s Community Plan in New Mexico, with accountability for the Medicaid and DSNP lines of business in the state. He also served as interim CEO for UnitedHealthcare’s Community Plan in Maryland, and as national vice president for UnitedHealthcare’s Dual Special Needs Plans. Milligan’s career includes having been senior vice president of Enterprise Government Programs at Presbyterian Healthcare Services and executive director of The Hilltop Institute at University of Maryland, Baltimore County. He began his career as an attorney practicing healthcare law in California.
Meggan Christman Schilkie, currently senior vice president of HMA’s Practice Groups, will assume the role of COO at HMA. She joined HMA in 2014 and has held leadership roles in the firm’s Northeast Region and its New York office.
During her time at HMA, Schilkie has supported clients across the country including providers, associations, state and local governments, payers, large delivery systems and other stakeholders to expand the quality of and access to healthcare with a particular focus on developing new and innovative models of behavioral healthcare.
Prior to joining HMA, Schilkie served as chief program officer for Mental Health at the New York City Department of Health and Mental Hygiene where she oversaw a portfolio of behavioral health services. During her career she has been interim CEO for three health homes in New York serving individuals with serious behavioral health needs, chronic health conditions, intellectual and developmental disabilities and substance use disorders. Schilkie was the founding executive director of the Coalition of New York State Health Homes providing leadership for this statewide provider association.
New experts join HMA in November 2023
HMA is pleased to welcome new experts to our family of companies in November 2023.
Ken Cochran – Principal
HMA
Kenneth Cochran is a healthcare executive with more than 20 years leveraging his clinical, business and academic background to deliver strategic planning, operational excellence, top-line revenue growth, positive physician relations and organizational alignment.
Matt Smith – Consulting Actuary I
Wakely
Matt Smith, ASA, has experience with population health analytics, total cost of care analysis, value-based care contracts, financial modeling, pricing and reserving, and risk adjustment. Read more about Matt.
Jimmy Mans – Consulting Actuary I
Wakely
Jimmy Mans, FSA, MAAA, has extensive experience working with health plans, providers, state and federal governments, and pharmaceutical manufacturers. Read more about Jimmy.
Read more about our new HMA colleagues
Managing Director, Delivery Systems
Nine States Selected for Children’s Behavioral Health Policy Lab
State behavioral health and children’s welfare agency officials from Georgia, Kansas, Kentucky, Maryland, Missouri, Pennsylvania, Texas, Utah, and Wisconsin selected to participate.
Health Management Associates (HMA), in partnership with the Annie E. Casey Foundation, Casey Family Programs, National Association of State Mental Health Program Directors (NASMHPD), the Child Welfare League of America (CWLA), the American Public Human Services Association (APHSA), and the National Association of Medicaid Directors (NAMD), will convene a Children’s Behavioral Health (CBH) State Policy Lab, February 7-9 in Baltimore. HMA today announced the selection of nine states – Georgia, Kansas, Kentucky, Maryland, Missouri, Pennsylvania, Texas, Utah, and Wisconsin – that will participate in the policy lab. MITRE, which previously hosted a related federal convening, will also take part in this state convening.
This pioneering effort, made possible by the partner organizations, aims to convene state interagency teams – including child welfare, juvenile justice, behavioral health, Medicaid, and K-12 public education – to collectively strategize, learn from innovators in the sector and promote cross-system alignment to drive outcomes for children, youth, and families.
COVID-19 has exacerbated long-standing system collaboration challenges across state child welfare, behavioral health, and Medicaid that lead to unsatisfactory outcomes for the most vulnerable children in our communities. Most worrisome is the worsening of behavioral and physical health challenges and trauma because of uncoordinated or fragmented care. This lack of coordinated strategy and policy leads to higher costs of treatment and also increasingly exposes states and local jurisdictions to threats or filings of class action lawsuits, and related settlements or those arising from Department of Justice investigations. Fortunately, federal and state efforts and investments to address the youth systems of care – including schools, community, delivery systems, and community-based child placing agencies – are in motion.
In November, a call for applications was released to U.S. states and territories for potential participation in the State Policy Lab. Applicants were required to identify demonstrated need, existing state agency governance structures focused on children and youth, technical assistance needs, and outcomes for attending the policy lab. The applications required demonstrated participation from Medicaid, child welfare and behavioral health agencies; a commitment to creating sustainable interagency solutions for children, youth, and their families and had to certify formal support of Governor/Cabinet level.
An external independent panel reviewed applications for state agency participation using a standardized rubric that covered four domains:
- Gaps and opportunities analysis
- Intent of collaborative partnerships
- Approach to engagement of youth and adults with lived experience
- Imminent risks to public agency operations as a result of poor outcomes for children, youth, and their families
This convening is aimed at assisting child welfare, juvenile justice, behavioral health, Medicaid, and K-12 public education where possible to build upon existing efforts to improve outcomes for children, youth, and families, strategically layering on missing components and promoting alignment between them and with other agency priorities. Examples of what could be co-designed with state partners:
- Build a shared strategic vision for a comprehensive continuum of care that ensures access to the “right service, at the right time based on individual and family need.” This vision can strengthen prevention initiatives and ensure the full array of evidence-based community-based interventions including use of crisis response and stabilization models.
- Develop policies and strategies for improving the engagement of children, youth, and families with lived experiences to the “right part of the system for the right level of care,” agnostic of the door through which they enter any coordinated child serving system, while ensuring that all aspects of this system are anchored in equity.
Following the event, learnings and findings will be disseminated to help states and counties adopt innovative solutions to improve outcomes for children, youth, and their families.
For more information email: [email protected]
Health Management Associates Successfully Completes SOC 2 Type 2 Examination
Health Management Associates (HMA), a leading independent, national healthcare consulting firm today announced that it has successfully completed a Service Organization Control Type 2 (SOC 2 Type 2) audit.
The SOC 2 Type 2 audit was developed by the American Institute of Certified Public Accountants to evaluate an organization’s information security controls over a period of time. It assessed both the suitability of HMA’s controls and its operating effectiveness, covering the HMA organization as a whole, service offerings, resources used to deliver client work, and technical (cybersecurity) and non-technical controls (administrative strengths such as excellent training and a culture that promotes anti-fraud and ethical behaviors).
“Increasingly, completing a SOC 2 Type 2 audit is an important distinction for many of our clients and partners,” said Doug Elwell, chief executive officer. “Achieving this with no material findings across the firm is yet another way to meet client needs and further demonstrates our commitment to our core values of accountability, client commitment and integrity.”
Founded in 1985, HMA is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 30 locations across the country and over 700 multidisciplinary consultants coast to coast, HMA’s expertise, services, and team are always within client reach. Learn more about HMA at healthmanagement.com, or on LinkedIn and X.
Elizabeth Mitchell to keynote HMA’s Spring Workshop on value based care March 5-6 in Chicago
We are excited to announce that Elizabeth Mitchell, President and CEO of Purchaser Business Group on Health (PBGH), will provide the keynote address “The Purchaser’s Dilemma: Why Employers Should Demand Value (and Why They Don’t)” at HMA’s 2024 Spring Workshop on value-based care, March 5-6 at the Fairmont in Chicago.
In her role at PBGH, a nonprofit coalition representing nearly 40 private employers and public entities across the U.S. that collectively spend $350 billion annually purchasing healthcare services for more than 21 million Americans and their families, Mitchell represents a coalition of large purchasers – private employers and public entities – across the U.S. mobilizing to create functional health care markets that support high-quality affordable care that produces measurable outcomes. She will talk about the successes and challenges of creating greater alignment on value-based approaches to the $350 billion annual private purchaser spend on healthcare services.
Her remarks – and the input of others engaged in improving our healthcare system – will be unvarnished and focused on solutions to advance value-based care. Be part of this exciting discussion among top industry experts, health plan executives, state and federal leaders, and policy experts in working sessions to generate new solutions and actions to get us to the next level of quality and value.
Fueling Change: Reflecting on a Year of Successful Collaboration
While 2023 was challenging for many, it was also a year of successful partnerships and action that fueled positive change in the lives of individuals and within communities nationwide. This short video highlights just a few examples of that critical work that happens every day.
At HMA, we are honored to serve as trusted advisors to our clients and partners as we work side by side to tackle the most complex health and human services challenges. We look forward to creating even more positive change in 2024, together.
New experts join HMA in October 2023
HMA is pleased to welcome new experts to our family of companies in October 2023.
Anika Alvanzo- Principal
HMA
Dr. Anika Alvanzo is a distinguished healthcare executive with over 20 years of experience in specialty addiction treatment, behavioral health integration and quality improvement.
Kristine Malana Barrientos – Senior Consultant
HMA
Kristine Malana Barrientos brings expertise in the Program of All-inclusive Care for the Elderly (PACE) senior leadership and operational experience from her work in California’s PACE market.
Craig Cartossa – Consulting Actuary II
Wakely
Craig Cartossa, ASA, MAAA, has expertise in Advanced Analytics, Healthcare Economics, Medicare Part D, Value Based Contracting, and Disease Management and Care Management Predictive Modeling and ID/Stratification. Read more about Craig.
Shannon Mayer – Principal
HMA
Shannon Mayer is an impactful healthcare executive with over 30 years of experience. She is recognized for attaining results in Medicaid and Medicare Advantage’s highly regulated environments.
Cotrina McGue – Senior Consultant
HMA
Cotrina McGue is a highly skilled information technology (IT) professional with over 35 years of experience and over 25 years specializing in healthcare systems.
Patricia Miles – Senior Consultant
HMA
Patricia Miles is a performance-driven managed care leader with over 25 years of experience in the Medicaid and Medicare markets.
Jason Pettry – Senior Consultant
HMA
Jason Pettry is a dedicated healthcare executive with over 10 years of experience with the Programs of All-Inclusive Care for the Elderly (PACE).
Corrie Piontak – Principal
HMA
Corrie Piontak is a skilled healthcare professional with over 15 years of focused experience in management consulting, payer and provider strategy, and partnership strategy.
Aaron Ramthun – Associate Principal
HMA
Aaron Ramthun is a financial professional with more than 20 years of experience working across the healthcare finance field, including Medicare bids, Medicaid rate book reviews, and budgeting. Aaron has a demonstrated track record of improving operational efficiency and implementing innovative forecasting practices.
Matt Smith – Consulting Actuary I
Wakely
Matt Smith, ASA, has experience with population health analytics, total cost of care analysis, value-based care contracts, financial modeling, pricing and reserving, and risk adjustment. Read more about Matt.
Read more about our new HMA colleagues
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HMA Information Services names Andrea Maresca as Managing Director
Health Management Associates has named Andrea Maresca as Managing Director of HMA Information Services, one of the nation’s leading subscription-based repositories of data and public documents on publicly sponsored healthcare programs.
Maresca replaces HMAIS founding publisher Carl Mercurio, who will stay on as Senior Advisor until the end of the year when he retires after nearly a decade with HMA and 37 years in business information publishing.
Maresca has more than two decades of healthcare experience, having served in private and public organizations including the Centers for Medicare & Medicaid Services (CMS) and the National Association of Medicaid Directors (NAMD). She joined HMA in 2021.