Insights

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

HMA Insights – including our new podcast – 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 podcast, blogs, webinars, case studies, reports and more.

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Case Study

Building a Behavioral Health and Chemical Dependency Clinical Institute

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The Challenge:
The client is one of several acute care hospitals belonging to a larger organization in California and the
only one of the group that manages the full continuum of mental health and chemical addiction treatment,
including an LPS-designated behavioral health inpatient unit, inpatient detox, partial hospitalization
and intensive outpatient programs for mental health and chemical dependency, and an eating disorder
outpatient counseling program. Complicated by operational challenges of running multiple campuses,
the client is endeavoring to build a behavioral health and chemical dependency clinical institute within the
organization; at the same time, the parent organization is looking to standardize the behavioral health
service line across facilities throughout the region.

Blog

Virginia JLARC Issues Report on Medicaid Spending Management

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This week, our In Focus section comes to us from HMA Principal Barbara Markham Smith, JD, of our Washington, DC office. On December 12, 2016, Virginia’s Joint Legislative Audit and Review Commission (JLARC), the audit arm of the General Assembly, issued findings from its two-year review of the Department of Medical Assistance Service’s (DMAS’s) management of the Medicaid program. In a review of DMAS’s performance that largely foreshadows Medicaid reforms to be implemented in 2017-2018, JLARC notes that inflation-adjusted Medicaid spending in Virginia, per enrollee, remained essentially flat from FY2011 to FY2015. Program spending increases came from growing enrollment due to expanded outreach activities and the addition of new waiver slots for people with intellectual and developmental disabilities.  The growth in total spending (as opposed to per capita spending), amounted to average annual cost increases of 8.9 percent over the past 10 years. Services for individuals with disabilities accounted for the lion’s share of cost increases, according to a budget report released earlier this year. Medicaid spending accounted for 22 percent of Virginia’s general fund budget in FY2016. 

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Webinar

Webinar Replay: A Comprehensive Approach to Managed Long-Term Services and Supports

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On December 7, 2016, HMA Information Services hosted the webinar, “A Comprehensive Approach to Managed Long-Term Services and Supports: Assessing Health Plan Partnerships with Community-Based Organizations to Serve Members Who Qualify for MLTSS.”

Health plans serving the market for MLTSS have a unique opportunity to strengthen their relationships with existing and new community-based organizational partners to fill important gaps in care for elderly and disabled members. During this webinar, HMA Principals Karen Brodsky and Liddy Garcia-Bunuel discuss how managed care organizations can assess their MLTSS-specific partnerships to better serve members and foster a comprehensive approach to meeting the long-term needs of some of the most vulnerable and high-cost members. Listen to the recording and:

  • Identify and address gaps in care by building a broad array of relationships and partnerships with community-based organizations.
  • Maximize outreach efforts to ensure MLTSS members take advantage of available community-based services and options.
  • Train employees across your health plan – including administrative and clinical staff – to recognize opportunities where members can benefit from community-based organizations.
  • Develop an infrastructure to maintain a current roster of community-based organizations and the availability of various services to MLTSS members.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Blog

Oklahoma Releases Soonerhealth+ RFP

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This week, we reviewed the Oklahoma Health Care Authority’s (OHCA’s) request for proposals (RFP) for a new statewide Medicaid managed care program for individuals who are aged and individuals with disabilities (ABD). The program, called SoonerHealth+, will provide managed acute care, behavioral health, and managed long-term services and supports (MLTSS) to roughly 155,000 members, to be phased in over two years beginning in April 2018. Based on state fiscal year 2014 data, SoonerHealth+ spending per year could exceed $2.5 billion when fully implemented. Proposals are due on February 28, 2017.

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Webinar

Webinar Replay: Essential Attributes of a High-Quality System of Care

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On November 22, 2016, HMA Information Services hosted the webinar, “What Matters Most: Essential Attributes of a High-Quality System of Care for Adults with Complex Care Needs.”

What are the Essential Attributes of a high-performing healthcare system for adults with complex care needs? The SCAN Foundation convened a working group of national experts that identified four “Essential Attributes,” based on person-centered care that serves the goals and needs of individuals, their families, and caregivers.

During this webinar, representatives from Health Management Associates, The SCAN Foundation, and leading quality measurement organizations discuss how a growing understanding of the Essential Attributes of high-performing healthcare systems will impact quality reporting and measurement in the future – fostering systems of care that support the independence, health, and well-being of adults with complex care needs in the least restrictive settings possible. Listen to the recording and:

  • Understand the four Essential Attributes of high-performing systems of care for adults with complex care needs, including the development of informed, compassionate, and accessible care systems that meet the medical and non-medical goals of individuals, their families, and caregivers.
  • Learn how quality measurement organizations are developing metrics that incorporate the Essential Attributes and focus on individuals, their families, and caregivers.
  • Ensure that technical quality metrics result in tangible person-focused care and outcomes for adults with complex care needs.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Webinar

Webinar Replay: What’s Next for Medicaid?

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On November 16, 2016, HMA Information Services hosted the webinar, “What’s Next for Medicaid? An Inside Look at Findings from the 16th Annual Kaiser 50-State Medicaid Budget Survey.”

Medicaid enrollment and spending growth slowed considerably in fiscal 2016 following strong gains in 2015 driven by expansion under the Affordable Care Act, according to the 16th annual Medicaid budget survey from The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU). Still, states continue to push hard to further reform the Medicaid program, initiating a wide array of efforts to coordinate care, expand access, revamp payments, improve quality, and control costs.

During this webinar, experts from Health Management Associates, which works with KCMU and the National Association of Medicaid Directors each year to conduct the survey, outline key findings from the recently-released budget survey and discuss what it all means for the future of Medicaid. Listen to the recording and:

  • Assess the latest trends in long-term services and supports programs, including the continued push by states to implement Managed LTSS initiatives.
  • Find out how Medicaid programs are working to better understand social determinants of health and coordinate with organizations involved in housing supports, foster care, correctional health, and other programs for vulnerable populations.
  • Get details about state-based Medicaid delivery system and payment reform efforts, including developments in patient-centered medical homes, accountable care, and Delivery System Reform Incentive Payment (DSRIP) programs.
  • Learn why Medicaid spending and enrollment growth will continue to slow in 2017, and identify the key drivers of Medicaid spending growth.
  • Assess the financing of Medicaid in 2017 and beyond, when the federal matching rate for expansion enrollees begins to decline.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Blog

Revisiting Congressman Tom Price’s ACA Repeal Legislation

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This week, we revisited 2015 legislation introduced by Georgia Congressman Tom Price, who was announced this week as President-elect Donald Trump’s nominee for Secretary of the U.S. Department of Health & Human Services (HHS). Representative Price’s 2015 bill, H.R. 2300, known as the “Empowering Patients First Act,” included a full repeal of the Affordable Care Act (ACA) as well as all health care provisions in the related Health Care and Education Reconciliation Act passed in 2010. A version of the Empowering Patients First Act has been introduced in Congress every year since 2009. Below, we review Representative Price’s proposed replacement plans around insurance coverage, and provide brief summaries of some of the other provisions in the legislation.

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