Comparative Analysis of the Engagement in Care for Children in Medi-Cal Fee-for-Service vs. Managed Care and Learnings from Enhanced Care Management Early Implementation In November 2023, the Los Angeles (LA) County Board of Supervisors passed a motion to address the implementation of new benefits for the child welfare-involved population launched through California’s Medicaid waiver, California … Read More
Medicaid Expansion: Data-Driven Insights into Healthcare Needs and State 1115 Implementation Trends
June 16, 2025
This 10-slide presentation, Medicaid Expansion: Data-Driven Insights into Healthcare Needs, offers a focused analysis of the Medicaid Expansion population—non-disabled adults ages 19–64 with incomes up to 138% of the Federal Poverty Level—across more than 40 states. Using recent T-MSIS data, the deck highlights the high prevalence of chronic and behavioral health conditions within this group, while … Read More
Disaggregating Managed Care Payments Provides Opportunities for New Insights into Medicaid Spending for Critical Populations
June 10, 2025
HMA focused this paper on how states disperse Medicaid funds to certain subpopulations within the program’s categorical eligibility infrastructure. A previous companion paper centered on increasing our understanding of Medicaid managed care spending by provider, offering more detail on the relative order of magnitude of the amounts spent on inpatient and outpatient hospital care, professional … Read More
Section 1115 Justice-Involved Reentry Demonstration Implementation Toolkit for Jail, Prison, and Juvenile Settings
May 19, 2025
This toolkit provides a set of implementation checklists for Section 1115 Justice-Involved Reentry Demonstrations tailored to three carceral settings: jails, prisons, and juvenile facilities. Each checklist outlines operational tasks across core domains to support effective planning, coordination, and continuity of care pre- and post-release. This toolkit is intended to provide information for jails, prisons, and … Read More
What’s Really Causing the Rise in Insurance Premiums, and What Can States Do About It?
May 12, 2025
Healthcare cost increases are outpacing general inflation, which jeopardizes access to coverage and care, as well as investments in other priorities. As a result, states are looking for ways to reduce the cost burden for consumers, employers, and taxpayers. The State of Maine engaged Wakely Consulting Group, an HMA Company, to analyze historical medical trends … Read More
Unlocking Solutions in Medicaid for Addressing the National Crisis and Improving Children’s Behavioral Health
April 28, 2025
Late 2024, HMA convened a panel of experts, including individuals with lived experience and state leaders, to spotlight the critical need for cross-system transformation. The discussion underscored the importance of centering youth and family voices, aligning placement and community-based services, and leveraging opportunities like the Family First Prevention Services Act, Medicaid waivers, and specialty managed … Read More
State Medicaid Non-Emergency Medical Transportation Contracts: Key Provisions, Standards, and Considerations
April 21, 2025
Federal statute requires states to provide non-emergency medical transportation (NEMT) to Medicaid beneficiaries who have no other means of getting to medically necessary healthcare facilities. Though NEMT programs must meet certain federal requirements, states have considerable flexibility in the design and operation of their NEMT program. As a result, states vary widely in their NEMT … Read More
Amber ground ambulance dataset reflects complexity and challenges of the industry, highlights the need to improve and continue cost data collection
April 10, 2025
The Centers for Medicare & Medicaid Services (CMS) is on the cusp of possessing the data needed to make long anticipated changes to the Medicare fee-for-service (FFS) ground ambulance payment system. It has been more than two decades since CMS revised these payment rates through a negotiated rulemaking process that was exclusive of actual cost … Read More
Private Equity Investment in AI in the Healthcare Sector
April 1, 2025
HMA will be offering analyses on various investor related topics in the healthcare sector. Our first report examines the growth of Artificial intelligence (AI) in the US healthcare market. AI is expected to reach projected revenues of $102 billion by 2030. Learn more in this analysis.
New Insights on Medicaid Spending: An Analysis of Disaggregated Managed Care Spending
March 20, 2025
Medicaid is a federal/state health insurance program that served more than 86 million lower-income people in fiscal year (FY) 2021. The combined federal and state spending for Medicaid totaled $717 billion that year, $420 billion of which was spent on providing care to Medicaid managed care organization (MCO) members, and $297 billion on services provided … Read More