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Lee Fleisher of CMS to keynote HMA national quality conference
Join us on Monday, March 6, 2023, at the Fairmont Chicago, Millennium Park, for “Healthcare Quality Conference: A Deep Dive on What’s Next for Providers, Payers, and Policymakers,” where Lee Fleisher, MD, chief medical officer and director of CMS’ Center for Clinical Standards and Quality, will deliver the keynote titled A Vision for Healthcare Quality: How Policy Can Drive Improved Outcomes.
HMA’s first annual quality conference will provide organizations the opportunity to “Focus on Quality to Improve Patients’ Lives.” Attendees will hear from industry leaders and policy makers about evolving health care quality initiatives and participate in substantive workshops where they will learn about and discuss solutions that are using quality frameworks to create a more equitable health system.
In addition to Fleisher, featured speakers will executives from ANCOR, CareOregon, Commonwealth Care Alliance, Council on Quality and Leadership, Intermountain Healthcare, NCQA, Reema Health, Kaiser Permanente, United Hospital Fund, and others.
Working sessions will provide expert-led discussions about how quality is driving federal and state policy, behavioral health integration, approaches to improving equity and measuring the social determinants of health, integration of disability support services, stronger Medicaid core measures, strategies for Medicare Star Ratings, value-based payments, and digital measures and measurement tools. Speakers will provide case studies and innovative approaches to ensuring quality efforts result in lasting improvements in health outcomes.
“What’s different about this conference is that participants will engage in working sessions that provide healthcare executives tools and models for directly impacting quality at their organizations,” said Carl Mercurio, Principal and Publisher, HMA Information Services.
Early Bird registration ends January 30. Visit the conference website for complete details. Group rates and sponsorships are available.
2022 Yearly Roundup: a year of successful partnerships
The holiday season is grounded in gratitude. At HMA, we are grateful for successful partnerships that have fueled change to improve lives.
We are proud to be trusted advisors to our clients and partners. Their success is our success. In 2022 our clients and partners made significant strides tackling the biggest healthcare challenges, seizing opportunities for growth and innovation, and shaping the healthcare landscape in a way that improves the health and wellness of individuals and communities.
Reforming Colorado’s Behavioral Health System
HMA partnered with the Colorado Department of Human Services to support the planning and implementation of a new Behavioral Health Administration (BHA). HMA provided technical research and extensive stakeholder engagement, drafted models for forming and implementing the BHA, employed an extensive change management approach, and created a detailed implementation plan with ongoing support. Today the BHA is a cabinet member-led agency that collaborates across agencies and sectors to drive a comprehensive and coordinated strategic approach to behavioral health.
Wakely Consulting Group, an HMA Company, was engaged to support the launch of a Medicare Advantage (MA) joint venture partnership between a health plan and a provider system. Wakely was responsible for preparing and certifying MA and Medicare Part D (PD) bids, a highly complex, exacting, and iterative effort. The Wakely team quickly became a trusted advisor and go-to resource for the joint venture decision makers. The joint venture has driven significant market growth over its initial years, fueled by a competitive benefit package determined by the client product team.
Laying the Foundation for Modernizing Indiana’s Public Health System
In 2021 Indiana Governor Eric Holcomb appointed a 15-member commission to assess Indiana’s public health system and make recommendations for improvements. The Indiana Department of Health (IDOH) engaged HMA to provide extensive project management and support for six workstreams. HMA prepared a draft report summarizing public input as well as research findings and recommendations. The commission’s final report will form the basis of proposed 2023 legislation, including proposals to substantially increase public health service and funding across the state.
Multiple Clients Accepted into ACO REACH Model
In early 2022 HMA and Wakely Consulting Group, an HMA Company, assisted multiple clients with their applications to participate in the new CMS ACO REACH model. 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. The team tailored their support depending on each client’s needs. The application selection process was highly competitive. Of the 271 applications received, CMS accepted just under 50 percent. Notably, nine out of the 10 organizations HMA and Wakely supported were accepted into the model.
Pipeline Research and Policy Recommendations to Address New Innovative Therapies
HMA, and subsidiaries The Moran Company and Leavitt Partners, were selected by a large pharmaceutical manufacturer to analyze the current pipeline of innovative therapies, examine 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. The project equipped the client with a holistic understanding of future potential impacts and actions to address challenges in a detailed pipeline analysis of innovative therapies.
Reforming Colorado’s Behavioral Health System
THE CLIENT
Colorado Department of Human Services and Behavioral Health Administration.
BACKGROUND
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.
APPROACH
In 2021, HMA began an extensive partnership with the Colorado Department of Human Services to support the planning and implementation of the BHA. The initial project approach incorporated technical research, extensive stakeholder engagement, model design, and change management.
Technical research:
HMA conducted a technical review of over 100 behavioral health programs across 14 state agencies and branches of government including each program’s funding source, program details, population served, eligibility, relevant past and current legislation, administrative rule, waiver authority, contracts, data reporting, and data infrastructure. HMA also conducted research into other state models of reform and conducted interviews with six states on detailed lessons learned from reform efforts.
Stakeholder engagement:
HMA conducted three rounds of extensive statewide stakeholder engagement with more than 700 representatives across all Colorado counties. Stakeholders represented various sectors and feedback focused on: 1) understanding what stakeholders wanted from a BHA which turned into a detailed list of BHA functions; 2) gaining feedback on draft models of the BHA structure and 3) providing an update and response to the final BHA model chosen.
Model design:
HMA drafted multiple models for the BHA and facilitated a detailed evaluation process with the Behavioral Health Reform Executive Committee comprised of the Lieutenant Governor, Executive Directors of the Colorado Departments of Health Care Policy and Financing, Human Services, and Public Health and Environment, the Commissioner of Insurance, and a Deputy County Manager. The process was designed to help the committee consider multiple design elements, weigh pros and cons, and ultimately provide a BHA design recommendation to Governor Polis.
Change management:
HMA employed an extensive change management approach centered on communication and transparency, partnering with communications vendor Merritt+Grace to create a website, a weekly Frequently Asked Questions update, a communication ambassador program across 14 agencies, and a formal change management plan for the BHA process.
RESULTS
The Executive Committee and Governor Polis ultimately chose a model that gives the state the ability to streamline strategy, regulation, funding for high quality and equitable care, and serves as an innovative approach for the nation. Rather than consolidating or moving all behavioral health into one department, the design provides a networked approach to behavioral health and allows for the recognition of expertise in context. The model also positions the state for an expanding impact of behavioral health with future funding on climate change, economics and other factors.
Specific design elements include:
- A cabinet-level position that elevates the criticality of behavioral health
- A single cross-payer and cross-sector behavioral health entity tasked with collaborating across agencies and sectors to drive a comprehensive and coordinated strategic approach to behavioral health
- Better strategy and planning to leverage all funding streams including non-Medicaid, Medicaid and commercial, education, criminal justice, etc., payments for behavioral health, and ensure the state maximizes federal dollars to support the system
- System and services that reflect the “voice” of individuals and families
The governance for the BHA is a cabinet-level commissioner, an interagency council of cabinet members, and an advisory council with diverse representation of individuals and family members with lived experience, local government officials, providers, tribal governments, and others.
ONGOING SUPPORT
HMA created a detailed implementation plan as a final deliverable for the project and has been subsequently providing ongoing support with implementation. HMA has also provided support in the drafting of authorizing legislation, hiring and onboarding of new staff, support in drafting a report for the legislature, additional stakeholder engagement, creation of an innovative access -to-care methodology, and development of interagency agreements to support collaboration with the BHA across all departments. HMA has also continued change management support for the BHA including multiple aspects of the daily operation of the new Administration, which necessitated changes and adjustments to previously existing state offices. It has been our privilege to support Commissioner Dr. Morgan Medlock and her leadership team as they work tirelessly to bring the vision of the BHA to Colorado.
HMA conducts assessment of unmet mental health needs of people living with HIV in Los Angeles County
HMA Community Strategies conducted an assessment of unmet mental health needs of people living with HIV in Los Angeles County. The study aimed to understand behavioral health service utilization and the role that facility staff and institutional structures play in charting the trajectory of clients. The assessment includes the breadth of experiences and perspectives represented by each facet of the delivery system to inform stakeholders and funders of the best approach for future success.