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HMA Insights: Your source for healthcare news, ideas and analysis.

HMA Insights puts the vast depth of HMA’s expertise at your fingertips, helping you stay informed about the latest healthcare trends and topics. Below, you can easily search based on your topic of interest to find useful information from our blogs, webinars, case studies, reports and more.

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Webinar

Webinar replay: New York State 1115 waiver amendment and the federal climate for waiver approval

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This webinar was held on April 26, 2022. 

On April 13, New York State announced it is requesting $13.52 billion over five years to fund a new amendment to its 1115 Waiver Demonstration that addresses health disparities and systemic healthcare delivery issues highlighted and intensified by the COVID-19 pandemic. During this webinar, speakers provided an overview and analysis of the contents of the state waiver amendment request, including Health Equity Regional Organizations (HEROs), Social Determinant of Health Networks (SDHNs), and Value Based Payment Incentive Payments. Speakers also discussed the current federal climate as CMS begins its review and consideration of New York’s waiver amendment request.

Learning Objectives

  • Understand the components and initiatives included in the New York State 1115 waiver amendment request, including lessons learned from the prior Delivery System Reform Incentive Payment (DSRIP) program
  • Learn about dynamics and considerations at the federal level and how they may impact the evaluation of state 1115 waiver requests
  • Identify potential upcoming funding streams and strategic considerations for your organization as it relates to the initiatives in the New York waiver amendment request

HMA Speakers

Josh Rubin, Principal, New York, NY

Cara Henley, Senior Consultant, Albany, NY

Andrea Maresca, Principal, Federal Policy, Washington, DC

Webinar

Webinar replay: how state leaders can leverage State Opioid Response funds for system transformation

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This webinar was held on March 24, 2022. 

Since 2018, the federal government has granted more than $5 billion in State Opioid Response (SOR) funds aimed at supporting evidence-based prevention, treatment, and recovery of opioid use disorder (OUD).  The most successful state initiatives have focused on driving healthcare delivery system changes designed to increase timely, consistent, high-quality access to treatment and support services, including the use of medication assisted treatment (MAT). During this webinar, speakers showcased best-in-class efforts by states like California, Delaware, and Illinois to leverage SOR funding and achieve measurable, system-wide improvement in OUD treatment and outcomes.

Learning Objectives

  • Understand why a focused approach to the use of SOR funding is needed to drive delivery system transformation and measurable improvement in OUD treatment outcomes
  • Learn how California and Illinois are utilizing a “learning collaborative model” to increase the use of MAT among incarcerated individuals
  • Understand Delaware’s statewide approach to SOR and how building a synergistic and informed provider network is a central strategy
  • Learn how to replicate successful SOR models, with the ultimate goals of increasing access to timely, consistent care

Speakers

Marsha Johnson, Managing Principal, HMA, Philadelphia, PA

Bren Manaugh, Principal, HMA, Austin, TX

Kathleen Monahan, Project Director, State Opioid Response, Illinois

Brent Waninger, Chief, Workforce Development and Education, Project Coordinator, State Opioid Response, Delaware

Reference Materials

Expanding Substance Use Disorder Treatment for Persons Involved in the Justice System

HMA Opioid Team: Experts Leading Crisis Response

Webinar

Webinar replay: summary and implications of the 2023 Medicare Advantage advance notice

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This webinar was held on February 22, 2022. 

The Centers for Medicare & Medicaid Services (CMS) recently released the 2023 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C/D Payment Policies, which proposes important changes in plan payments, risk adjustment, Star Ratings, and other key financial and regulatory requirements for 2023.

During this webinar, consultants from Wakely Consulting Group, an HMA Company, provided an overview of the proposed changes, with an emphasis on the likely impact that the new rates and policies will have on Medicare Advantage bids, membership growth, quality, and strategy. Speakers also touched on other recent public statements from federal regulators that could point to additional future changes for Medicare Advantage plans.

Learning Objectives 

  • Understand how the proposals in the Advance Notice will impact Medicare Advantage payment rates in 2023.
  • Learn about updates to payment models and risk-adjustment methodologies, including a new effort to engage Medicare Advantage plans in value-based models that transform care.
  • Find out how new initiatives to account for how well plans address equity and social determinants of health will impact Star Ratings.
  • Understand the growth prospects for Medicare Advantage, including a look at how COVID-19 continues to affect plan membership growth, financial risk, and profitability.

HMA Speakers

Thomas Grivakis, Senior Consulting Actuary, Wakely

Rachel Stewart, Consulting Actuary, Wakely

Webinar

Webinar Replay: Comparing Medicaid program delivery models on quality outcomes

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This webinar was held on February 15, 2022.

In 2020, state and federal government spending on Medicaid was $646 billion, with just over half going to Medicaid managed care programs and the rest to fee-for-service (FFS), primary care case management (PCCM), and other models. Despite the large investments, little evidence exists on differences in quality between the various models. Using the 2019 CMS Adult and Child Core Set Quality Measures, HMA normalized performance data across states to compare outcomes between managed care, FFS and PCCM. During this webinar, HMA consultants discussed the findings, which were published in an HMA white paper in November 2021.

Learning Objectives: 

  • Understand how the different Medicaid delivery models performed on quality measures from the 2019 Adult and Child Core Set.
  • Learn more about the Adult and Child Quality Measure Core Set and why the 2019 dataset provides one of the first opportunities to make valid comparisons between the Medicaid delivery models.
  • Find out how this research could be expanded upon in the future to assess the key factors that drive higher quality and better performance in population health for low-income individuals.
  • Explore the broader implications of this research for policymakers and state Medicaid officials.

HMA Speakers

Anthony Davis, Managing Director, Quality and Accreditation Services, Portland, OR

David Wedemeyer, Principal, Los Angeles, CA

Joe Moser, Principal, Indianapolis, IN

Beth Kidder, Managing Principal, Tallahassee, FL

Webinar

Webinar Replay: Veteran Medicaid Directors Discuss the Future of State Medicaid Programs

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This webinar was held on November 8, 2021

Veteran Medicaid directors from Florida, South Dakota, and Idaho will provide a frank assessment of the many challenges, opportunities, and competing priorities facing state Medicaid leaders.  Beth Kidder (Florida), Bill Snyder (South Dakota), and Matt Wimmer (Idaho) recently joined HMA after heading up state Medicaid programs during one of the most turbulent public health crises in a generation.  The panel will be moderated by HMA Chief Operating Officer Chuck Milligan.

During this webinar, they shared their thoughts on how Medicaid directors will likely approach such pressing issues as successfully emerging from the public health emergency, assessing opportunities afforded by President Biden’s Build Back Better plan, and addressing looming challenges involving labor shortages, an impeding fiscal cliff, the future of pandemic-related regulatory flexibilities, and the growing role of home and community-based services (HCBS). Finally, they shared recommendations on how organizations can best maximize their effectiveness when meeting with state Medicaid directors by better understanding their world and what they need from various healthcare constituents like you.

Learning Objectives 

  • Understand the major trends and competing priorities facing state Medicaid leadership against a rapidly shifting local, state, and federal landscape.
  • Find out what the “new normal” will look like for state Medicaid programs as they emerge from the public health emergency and wrestle with changes in enrollment, eligibility requirements, fiscal constraints, and the future of regulatory flexibilities installed during the pandemic.
  • Learn how federal legislation and various state initiatives are driving dramatic changes in Medicaid, including expanded funding for HCBS, the success of telehealth services, expanded access to post-partum care, and the likely impact of the Build Back Better plan.
  • Find out how to overcome growing workforce shortages and other challenges that are impacting the ability of Medicaid beneficiaries to access care, including emerging HCBS offerings.
  • Learn how to maximize your effectiveness when meeting with state Medicaid representatives and how to uncover effective ways to partner with and support state Medicaid initiatives.

HMA Speakers

  • Beth Kidder, Managing Principal, Tallahassee, FL
  • Chuck Milligan, Chief Operating Officer (Moderator), Denver, CO
  • Bill Snyder, Principal, Leavitt Partners, an HMA Company, Rapid City, SD
  • Matt Wimmer, Principal, Denver, CO
Webinar

Webinar Replay: The future of healthcare quality improvement

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This webinar was held on November 2, 2021. 

The future of quality improvement is continuously changing, especially within the clinical and member experience space. New and emerging technologies like Data Aggregator Validation (DAV) certification, Natural Language Processing (NLP), digital measurement, member engagement platforms, and new health disparities stratifications are entering the Medicare and Medicaid quality space at a growing rate. This webinar looked at trends in Medicare/Medicaid quality and addressed how new and emerging quality technologies are positioned to help organizations improve their quality scores at multiple levels.

Learning Objectives

  • Find out how new and emerging quality concepts can be used to improve quality scores and better engage within the health plan and provider space.
  • Learn how to take advantage of trends within the Medicare and Medicaid quality space to position your organization for success.
  • Understand key factors impacting quality improvement scores such as HEDIS and CAHPS.
  • Identify emerging technologies like DAV certification, NLP, digital measurement, new member engagement platforms, and new health disparities stratifications.

Speaker

Anthony Davis, HMA Managing Director, Quality and Accreditation Services
Webinar

Webinar Replay: Continuing the Path to Medicare-Medicaid Integration

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This webinar was held on October 4, 2021.

Federal and state policy makers have long been working to expand enrollment in Medicare-Medicaid integrated care programs (ICPs). ICPs can advance independent living and health equity for individuals who are dually eligible for both programs. However, approximately only one in 10 dually eligible individuals was enrolled in an ICP as of 2019. To encourage ICP enrollment and retention, HMA identified 10 essential elements of ICPs centered around, informed by, and made available to dually eligible individuals. (See HMA Brief #3 and the brief fact sheet.)

During this webinar, HMA shared these 10 essential elements for establishing and simplifying ICPs specifically tailored to diverse individuals’ needs and preferences. Panelists involved in health justice and community-based healthcare offered practical next steps for advancing ICPs.

Learning Objectives

  • Hear about the 10 essential elements for ICPs identified through interviews with diverse stakeholders
  • Engage panelists to share their views on how to advance ICPs tailored around members’ needs
  • Consider the types and level of investment required to advance the essential elements for ICPs

Speakers

  • Arielle Mir, MPA, Vice President of Health Care, Arnold Ventures, Washington, DC
  • Sarah Barth, JD, Principal, HMA, New York, NY
  • Ellen Breslin, MPP, Principal, HMA, Boston, MA
  • Dennis Heaphy, M.Div., M.Ed., MPH, Health Justice Policy Analyst, Disability Policy Consortium, Malden, MA
  • Linda Little, MBA, RN, CCM, President and CEO, Neighborhood Service Organization (NSO), Detroit, MI
Webinar

Webinar Replay: Leveraging Your SAMHSA Certified Community Behavioral Health Center Grant

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This webinar, held on August 18, 2021, was the ninth webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.

Winning a SAMHSA Certified Community Behavioral Health Center (CCBHC) grant is just the beginning.  Now the real work beings. During this webinar, SAMHSA grant experts and a previous grant winner provided a step-by-step guide to implementing and leveraging CCBHC grants for maximum results. Speakers addressed the key steps to achieving CCBHC certification, meeting SAMHSA grantee requirements, and strategically building toward sustainability beyond the two-year grant period.

Learning Objectives

  • Learn what makes the CCBHC grant opportunity unique.
  • Understand the activities and processes needed to help ensure a successful implementation.
  • Find out how to develop strategies that support long-term sustainability.
  • Obtain case studies and lessons learned from a previous CCBHC grantee.

Speakers:

Heidi Arthur, Principal, HMA, New York, NY

Kristan McIntosh, Senior Consultant, HMA, New York, NY

Melissa Jillson, Senior Director, Liberty Resources Inc., Syracuse, NY

Liz Krell, Assistant Director of Process Optimization, Liberty Resources Inc., Syracuse, NY

Webinar

Webinar Replay: The Growing Role of Business Intelligence and Information Technology in State Medicaid Population Health Management Programs

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This webinar was held on August 5, 2021. 

State Medicaid agencies (SMAs) are increasingly relying on business intelligence platforms and other information technology (IT) solutions to provide the type of robust analytics needed for successful population health management programs. During this webinar, experts from Health Management Associates (HMA) and Cerner discussed the business intelligence and related IT needs of SMAs specific to population health management, based in part on the results of a recent, proprietary survey of SMAs.  Speakers also discussed how modern IT solutions can be leveraged to address these needs, especially in a world in which modularity and interoperability are king.

Learning Objectives

  • Understand the major SMA drivers of IT investments in support of population health management goals and programs, including the need to better manage cost and improve outcomes among high acuity beneficiaries.
  • Identify common gaps in information technology and business intelligence capabilities at SMAs which can impact the success of population health management initiatives.
  • Find out how business intelligence platforms and information technology solutions can promote interstate and intrastate collaboration on population health management programs, including enterprise initiatives across Medicaid agencies and health and human services agencies.
  • Gain insights into the evolution of population health management analytics, business intelligence platforms, and IT solutions that promote modularity and interoperability.

Speakers

Jake Engle, Senior Director, State Government, Cerner
Nathan Gray, Senior Manager, Information System Architecture, Cerner
Juan Montanez, Managing Director, IT Advisory Services, Health Management Associates

Webinar

Webinar Replay: Improving Child Welfare Outcomes: Role of Behavioral Health and Child Welfare in Strengthening Families, Building Resilience, and Increasing Protective Factors

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This webinar was held on July 20, 2021, was the eighth webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.

This eighth session featured HMA behavioral health, child welfare and Medicaid experts primed to specifically discuss strategies across child welfare and behavioral health to enhance family engagement and collaboration in increasing protective factors and family resilience.

Learning Objectives

  • Learn options for designing policies and implementing infrastructure that support a multisystem response facilitating family engagement and improving protective factors.
  • Learn about other successful state models for prevention and building family resilience.
  • Learn key benchmarks for successful engagement and empowerment that can be incorporated into QI programs.
  • Introduce and engage in dynamic discussion on the importance of the intersection of race equity, social justice, cultural humility, and responsiveness with family centered/multi-generational practice in addressing inequities.

Speakers

Doris Tolliver, JD, Principal, HMA

Uma Ahluwalia, MSW, MHA, Managing Principal, HMA

Susan Smith, Data Advocates, LLC

Annalisa Baker, MPH, LCSW, Senior Consultant, HMA

Webinar

Webinar Replay: Value Propositions and Roadmaps for Integrating Children’s Behavioral Health and Medicaid with Child Welfare Systems

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This held on July 15, 2021, was the seventh webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.

The success of the delivery of state and local child welfare systems is predicated on a strong collaboration across child welfare, children’s behavioral health and Medicaid, building a multigenerational, multisystem response to the problem of child maltreatment. During this webinar, HMA behavioral health, child welfare and Medicaid experts broke down what’s needed to get the integration process started, including a practical approach to workflows as well as an understanding of the touchpoints where integration efforts are likely to have their biggest payoff.

Learning Objectives

  • Understand how child welfare services departments currently interact with the behavioral health service continuum.
  • Learn how to build value by identifying areas where the intersection of child welfare, Medicaid and children’s behavioral health helps improve outcomes and mitigate risk.
  • Identify potential barriers to integration efforts.
  • Learn how other states have applied solutions and strategies aimed at better integrating child welfare systems, Medicaid, and children’s behavioral health.
  • Learn about financing infrastructures that support meaningful whole family approaches to improving protective factors and strengthening family resilience.

 

HMA Speakers:

Uma Ahluwalia, MSW, MHA, Managing Principal, Washington, DC

Annalisa Baker, MPH, LCSW, Senior Consultant, New York, NY

Caitlin Thomas-Henkel, MSW, Principal, Philadelphia, PA

Heidi Arthur, MSW, Principal, New York, NY

Webinar

Webinar Replay: Advancing Health Justice for Medicaid Members with Disabilities, Including Those with Mental Illness and Substance Use Disorder

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This webinar, held on June 25, 2021 and was the sixth webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.”

State Medicaid programs must address health disparities and advance health justice for members with disabilities – including those with mental illness and substance use disorder (SUD). Our presenters outlined the path forward in the 2021 report, Advancing Health Justice Using Medicaid Data: Key Lessons from Minnesota for the Nation, produced by AcademyHealth, Disability Policy Consortium (DPC), and Health Management Associates (HMA). During this webinar, speakers from DPC and HMA discussed how to measure health disparities, present the evidence on health disparities from one state’s Medicaid program, and discussed what federal and state policymakers can do to address health justice stemming from racial injustice, discrimination, bias, and stigma in our healthcare system.

Learning Objectives

  • Understand what health justice and other related terms mean
  • Learn how to measure health disparities affecting Medicaid members with disabilities – including those with mental illness and SUD
  • Examine evidence on health disparities from one state Medicaid program’s efforts
  • Consider the national implications of this evidence on Medicaid members
  • Review what actions policymakers can take to advance health justice

Speakers

  • Ellen Breslin, MPP. Principal, HMA, Boston, MA
  • Dennis Heaphy, M.Div. M.Ed. MPH, Health Justice Policy Analyst, Disability Policy Consortium, Malden, MA
  • Anissa Lambertino, PhD., Senior Consultant, HMA, Chicago, IL