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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1808 Results found.

Webinar

How to Identify Social Determinants of Health, Engage Hard-to-Reach Populations

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This webinar was held on June 28, 2016. 

Many organizations, including health care and community based organizations, are working hard to address the impact of social, economic, and environmental factors that negatively affect the overall health of a community. These social determinants of health can be difficult to identify, disproportionately strike hard-to-reach populations, and require targeted responses that engage members and help them stay connected to appropriate services, treatments, and interventions. During this webinar, experts from HMA Community Strategies (HMACS) and the San Francisco Jewish Women’s Fund will outline one such initiative to explore qualitatively what the most important needs of a specific population are, and the solutions that they suggest would be helpful.

While targeted specifically to single, Jewish mothers in the San Francisco area, the initiative offers important lessons for other organizations attempting to learn more deeply about the needs of their populations, using a community-based participatory research model.

Speakers

Marci Eads, HMACS Managing Principal, Denver
Robyn Odendahl, HMACS Associate, Denver
Sue Schwartzman, Director of Philanthropic Education, San Francisco Jewish Community Federation

Learning Objectives

  1. Understand the philosophy and methods of community-based participatory research, including the type of interviews, focus groups, and outreach initiatives required to identify community needs.
  2. Learn how to identify and engage hard-to-reach, underserved populations in authentic and participatory ways.
  3. Understand the best model for connecting underserved populations with childcare, food services, transportation, and other community-based services.
  4. Assess efforts by the San Francisco Jewish Women’s Fund to identify and engage low-income, single Jewish mothers and help them foster relationships and build connections rooted in the local community.

Who Should Attend

Leaders of community-based organizations, healthcare funds, social services organizations, state and local governments, Medicaid managed care plans, health systems, integrated delivery systems, accountable care organizations, hospitals, health homes, clinics and public health agencies.

Blog

HMA Authors Explore New Models of Care in Correctional Health

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HMA Principals Donna Strugar-Fritsch and Linda Follenweider are featured authors in the spring edition of CorrectCare, the magazine of the National Commission on Correctional Health Care (NCCHC).

Based on a presentation at the NCCHC’s 2015 Leadership Institutes, “A Call for New Models of Care in Correctional Health” takes a look at components of new primary care models, how they’ve advanced care – and how they can be used in correctional settings.

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Webinar

Webinar Replay: Patient-Centered Medical Home Transformation

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On May 18, 2016, HMA Information Services hosted the webinar, “Patient-Centered Medical Home Transformation: The Right Thing to Do for Patients and for Your Organization.”

Physician practices and clinics have good reason to transform themselves into Patient-Centered Medical Homes (PCMH). While many of the care coordination services provided by PCMHs aren’t currently reimbursed, a growing number of payers are looking to reward providers for these services – and providers need to be ready to benefit from all payment opportunities. More importantly, PCMH transformation is the right thing to do for patients. PCMHs are positioned to provide the highest quality care to members, with improved outcomes, prevention and patient satisfaction. Even if there isn’t an immediate financial reward, practices benefit strategically by positioning themselves as care leaders in the local community and solidifying relationships with other healthcare institutions.

During this webinar, HMA experts Linda Follenweider and Jodi Bitterman outlined the steps physician practices must take to transform into PCMHs and provided a list of lessons learned from various transformations to date. Listen to the recording and:

  • Understand the resource requirements necessary for implementing a PCMH transformation and find out about cost-effective tools, technologies and transformation strategies.
  • Learn how to best position your practice to benefit from emerging value-based payment models.
  • Obtain HMA’s list of 10 lessons learned from PCMH transformations, including a run-down of common challenges and pitfalls.
  • Understand the importance of involving the “C-Suite” in any transformation initiatives and learn how to get their support and buy-in.

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

Webinar

Webinar Replay: Preparing for the New Medicaid Managed Care Regulations

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On May 17, 2016, HMA Information Services hosted the webinar, “Preparing Your Organization for the New Medicaid Managed Care Regulations.”

After months of comment, discussion, and revision, CMS has released the final version of its new Medicaid managed care regulations, and now it’s up to health plans, states, and providers to comply. What’s required is not just an understanding of what’s in the final rule, but how it impacts your organization – specifically the procedures, processes, staffing, technology, and operational changes required to implement the regulations.

During this webinar, HMA experts provide a framework for assessing the final rule, analyzing your organizational needs, and implementing the operational and functional changes needed.  Hear HMA experts Debby McNamara and Kathleen Nolan provide an overview of the final rule and outline the HMA Impact Analysis and Implementation Tool, a rigorous process for identifying opportunities and challenges the new rules pose to managed care organizations. Listen to the recording and:

  • Understand the impact of the final rule on Medicaid managed care plans, providers who serve vulnerable populations, and state Medicaid programs.
  • Find out how the final rule differs from earlier versions, including information on member plan selection and enrollment, fraud and abuse, and other requirements.
  • Identify operational and process changes needed to implement the new regulations through a rigorous analysis based on HMA’s Impact Analysis and Implementation Tool.

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

Webinar

Webinar Replay: Marrying Strategic, Operational and Information Technology Planning

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On May 17, 2016, HMA Information Services hosted the webinar, “Marrying Strategic, Operational and Information Technology Planning: Two Separate Frameworks in Support of Common Goals for Healthcare Organizational Efficiency and Effectiveness.”

Strategic planning and operations needs assessment go hand-in-hand. That’s especially true for healthcare organizations in an emerging world of risk-sharing, population health management, and integrated care.

During this webinar, HMA and Day Health Strategies outline two complementary frameworks designed to help healthcare organizations achieve higher levels of performance by marrying strategic planning with a clear assessment of the operational and information technology (IT) investments needed to achieve long-term goals. The frameworks include tools that help diagnose critical areas of organizational performance which, if improved, can drive significant efficiency gains across your organization. Listen to the recording and:

  • Understand the value of having strategic planning and operations assessment tools work hand-in-hand to improve your organization’s performance and effectiveness.
  • Identify and address gaps in your organization’s operational and IT capabilities.
  • Develop credible strategic goals, based on a complete understanding of your organizational capability of meeting stated targets.

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

Webinar

Webinar Replay: Implementing the Final Medicaid Managed Care Rules

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This webinar was held on May 24, 2016. 

How to Drive Compliance and Delivery System Performance for States and Health Plans

The hard work of implementing the new Medicaid managed care regulations will fall squarely on the shoulders of states and health plans. For states, the changes come at a time when Medicaid staff are already stretched thin by budgetary constraints and the impact of the continual state and federal regulatory and innovation projects. Now states must drive and oversee new requirements, including a variety of tighter rules around encounter data quality and submission, provider network adequacy, quality rating systems, provider screenings, and program integrity. Medicaid managed care plans, meanwhile, must step up their operational, administrative, and reporting capabilities to accommodate new state oversight requirements across all aspects of the contract performance.

During this webinar, experts from HMA and CNSI will demonstrate the value of using automated dashboard technology and data analytics to establish a single electronic data and reporting portal between states and Medicaid managed care plans for the submission of data and tracking of performance – creating an efficient and centralized compliance audit trail in real time.

Learning Objectives

  • Explore the requirements of the new Medicaid managed care regulations and methods for monitoring for compliance.
  • View compliance solutions like MCTrack, which effectively monitors performance and creates an audit trail to meet expectations of both internal and external stakeholders and auditors.
  • Learn about data analysis and an automated dashboard for tracking key performance criteria, including access to care, quality, enrollment, member and provider satisfaction, accurate encounter data and network adequacy.
  • Find out about dashboards that allow regular monitoring of Medicaid pay for performance requirements, providing health plan with the ability to maximize incentives payments and withholds.
  • Track and drive to completion all Medicaid managed care corrective action and quality improvement plans.
  • Capture health plan readiness metrics during new contract cycles.

Speakers
Heidi Robbins Brown, HMA Principal, Seattle
Diana Criss, HMA Senior Consultant, Lansing, MI
Kathleen Nolan, HMA Managing Principal, Washington, DC
Arvinder Singh, Chief Health Innovation Officer, CNSI

Who Should Attend
Medicaid directors, managed care contract managers, quality oversight directors, program integrity officials and staff; federal and state regulators and auditors; executives of Medicaid managed care plans, including compliance officers.

Blog

MACRA: Will these carrots and sticks work?

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The comment period for MACRA proposed rules started a couple of weeks ago and ends June 26, 2016. CMS is to be commended for valiantly translating MACRA legislation into specific rules that will apply at the start of the first performance period scheduled to be January 1, 2017 (wow!). However commendable though, we should all be clear about the inherent problems, of which there are a number. I’ll briefly outline one central problem: behavioral economics.

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Webinar

Webinar Replay: Using a Policy Framework to Foster Provider Practice Transformation

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On May 12, 2016, HMA Information Services hosted the webinar, “Using a Policy Framework to Foster Provider Practice Transformation: How the District of Columbia Launched Major Delivery System Change through its Medicaid Health Home Program for Individuals with Serious Mental Illness.”

Many states are looking to health homes to coordinate care and reduce costs for individuals with complex physical and behavioral health needs as well as for individuals with serious and persistent mental health conditions. The District of Columbia is a unique urban environment facing challenges to serve a large Medicaid population with a high prevalence of behavioral health issues. Yet, DC has been a leader in leveraging its health home strategy to drive widespread delivery system transformation – aligning a vision for improved health with policy, payments, and a real-world understanding of the needs and capabilities of providers.

During this webinar, leaders from the DC Departments of Behavioral Health and Health Care Finance describe how they set a course toward integrated care with the structure of the DC health homes, and provide important lessons learned for other states. The webinar also addresses how providers can play an important role during the policy planning process to ensure the effectiveness and feasibility of state initiatives and requirements. Listen to the recording and:

  • Examine a set of important considerations for crafting effective health home policy to drive widespread delivery system transformation.
  • Hear about the process DC used to establish rate structures to ensure provider participation while taking into account variable provider characteristics and the need to ensure improved consumer outcomes.
  • Gain insights into what it takes to attain global buy-in from various constituents and relevant parties, including agencies and behavioral health practices and their executive management teams.
  • Understand the importance of charting a course toward physical and behavioral health integration by aligning with a real-world understanding of provider processes, capabilities and business models at the ground level.

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

Webinar

Webinar Replay: The Impact of the Mental Health Parity and Addiction Equity Act

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On May 11, 2016, HMA Information Services hosted the webinar, “Understanding the Impact of the Mental Health Parity and Addiction Equity Act – Final Regulations.”

The long awaited final regulations for the Mental Health Parity and Addiction Equity Act are out, with important implications for Medicaid managed care plans, behavioral health providers, and other stakeholders serving vulnerable patient populations. The new federal rules have a broad reach, with the intention of improving ease of access to behavioral care, benefit levels, service classifications, coverage decisions, treatment protocols, and billing procedures. The rules also clarify the relationship between payers, providers and federal and state regulators.

During this webinar, HMA experts Barbara Leadholm, Don Novo, and Rich VandenHeuvel summarize key components of the final regulations, with a special focus on opportunities and challenges facing states and Medicaid managed care plans working to comply with the rules and government regulators monitoring their progress. Listen to the recording and:

  • Identify key considerations and actions for behavioral health stakeholders, including managed care plans, state Medicaid regulators, and providers of care for individuals with behavioral health conditions or substance abuse disorders.
  • Learn how the rules impact behavioral health coverage decisions by Medicaid managed care plans, including the criteria for medical necessity determinations.
  • Understand how state and federal regulators will work together to balance their roles in monitoring and assuring compliance and what that means for health plans and providers evaluating the rules’ various provisions.
  • Find out how the rules impact the Medicaid managed care rate setting process, the flexibility afforded states to include the cost of additional services, and the easing of benefit limitations.

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