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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: Building Population-Based Integrated Delivery Systems for Vulnerable Populations

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On December 10, 2015, HMA Information Services hosted the webinar, “Building Population-Based Integrated Delivery Systems for Vulnerable Populations.”

Designing and implementing population-based integrated delivery systems, particularly those involving multiple medical, behavioral health, dental and social service providers, has become a focus of states, health plans and providers themselves. This focus is growing to include people covered by Medicaid and other government programs, in addition to Medicare. New models are emerging and lessons being learned about effective approaches.

During this webinar you’ll hear from HMA Principals Art Jones, MD, Jeanene Smith, MD, MPH, and Vice President Pat Terrell and about some of these approaches, as well as experiences to build upon. Listen to the replay and:

  • Understand the key elements of and best approaches to the design and implementation of multiple provider integrated delivery systems serving primarily Medicaid and uninsured populations.
  • Learn how Oregon’s experience with the Coordinated Care Model is shaping both care delivery in that state as well as influencing other similar approaches across the country.
  • Learn about a model in Chicago, the Medical Home Network, which is now fully operating as an integrated delivery system for a significant Medicaid membership.
  • Hear discussion about barriers and challenges (and strategies to overcome them) as well as the emerging benefits to providers, payers and patients alike.

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

Webinar

Webinar Replay: Total Cost of Care Benchmarks and Physician Practices

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On December 9, 2015, HMA Information Services hosted the webinar, “Total Cost of Care Benchmarks and Physician Practices: An Early Stage Evaluation of Five Regional Healthcare Improvement Collaboratives Funded by the Robert Wood Johnson Foundation.”   

The Total Cost of Care and Resource Use framework developed by HealthPartners is at the center of a pilot program funded by the Robert Wood Johnson Foundation (RWJF) to identify and address healthcare overuse and inefficiency in five areas of the country. RWJF funded (NRHI) – along with five regional healthcare improvement collaboratives (RHICs) – to implement the first phase of the pilot, which involves the use of multi-payer commercial claims data to produce and share total cost of care benchmarks with physicians and practices. 

During this webinar, representatives of NRHI, the Oregon Health Care Quality Corp., MN Community Measurement, and Health Management Associates (HMA) share findings from an evaluation of this first phase of the pilot. The results of the evaluation, conducted by HMA, illustrate both the challenges and promises of using cost transparency initiatives to drive delivery system change. Listen to the replay and:

  • Understand how each RHIC’s specific approaches and progress vary according to pre-existing data collection infrastructures, stakeholder dynamics and the local healthcare environment.
  • Learn how RHICs are dealing with concerns over the measurements and public reporting, and how they are incorporating technical assistance and checklists to improve data quality.
  • Understand the importance of seeking physician input and feedback as early as possible to help design and plan the project and to ensure that total cost of care reporting is actionable. 
  • Find out how efforts among RHICs to work collaboratively and share lessons learned helped accelerate progress toward the development and dissemination of total cost of care reporting in their communities.
  • Learn how the early experiences of RHICs can be applied to other regionally based healthcare transparency and reform initiatives.

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

Webinar

Webinar Replay: Transforming Care: From Volume to Value

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On December 9, 2015, HMA and IBM Watson Health presented a webinar, “Transforming Care: From Volume to Value.”  

As the federal government, state governments, payers, and health care providers across the country move from traditional fee-for-service payment models toward value-based care models,  initiatives such as Medicaid Health Homes, Medicare Accountable Care Organizations and Delivery System Reform Incentive Payment (DSRIP) programs are dramatically changing the way health care services are delivered, managed and paid for.

During this webinar, experts discussed the principles and goals of value-based care that underpin state and national reform efforts, the role that information technology (IT) will play in support of these goals, and examples of how IT has enabled provider and payer organizations to pursue value-based care initiatives.

HMA:

  • The principles and goals of value-based care (Tony D. Rodgers, HMA Principal)
  • The implications of value-based care for physicians and other health care providers (Jean Glossa, MD, HMA Principal)
  • The role of health care IT in moving the U.S. health care system from volume to value (Lynn Dierker, HMA Principal)

IBM Watson Health:

  • The technology innovations that exist to enhance, scale and accelerate human expertise to help individuals live healthier and more productive lives (Eric Fichtel, Care Management Director at IBM Watson Health)

The HMA and IBM Watson Health slide decks for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

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    Webinar

    Webinar Replay: Provider Network Adequacy Monitoring

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    On December 8, 2015, HMA Information Services hosted the webinar, “Provider Network Adequacy Monitoring: Findings and Recommendations from the 2015 Robert Wood Johnson Foundation-Funded Survey of States and Health Plans.”

    Invest in network standards. Monitor program-wide provider capacity. Increase after-hours access. Deploy data analytics. Increase states’ role in network oversight. These are some of the key findings and recommendations from the Robert Wood Johnson Foundation-funded survey of health plans and state regulators concerning provider network adequacy compliance and monitoring standards. The survey, conducted by Health Management Associates (HMA), was designed to identify important trends and potential challenges in provider access monitoring and compliance given the dramatic increase in health insurance coverage under the Affordable Care Act.

    During this webinar, HMA Principals Karen Brodsky and Barbara Markham Smith outline nearly a dozen findings and recommendations, providing a roadmap for both states and health plans seeking more effective and efficient ways of ensuring adequate provider access for members. Listen to the replay and:

    • Identify key differences in network adequacy compliance and monitoring standards among states and learn why a push for more standardization of methods and metrics is necessary.
    • Understand the need to track provider overlap among competing health plan networks to get a true read on provider capacity in a state or region.
    • Learn why health plans are increasingly including essential community providers in Medicaid, commercial and exchange networks.
    • Understand health plan reports regarding where they exceed state network requirements in order to ensure better provider access.
    • Find out how after-hours access is being addressed for primary care service access.
    • Understand the importance of data analytics in identifying network access problems, especially the type of problems that result in increased use of emergency room and out-of-network care.
    • Assess the role of state insurance regulators and the likelihood they will need to step up their involvement in monitoring network adequacy among health plans.

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

    Webinar

    Webinar Replay: Care Management Essentials

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    On December 2, 2015, HMA Information Services hosted the webinar, “Care Management Essentials: Practical Approaches to Implementing a Successful Care Management Program.”

    Care management is growing in importance as healthcare providers taking on risk seek effective ways of improving patient outcomes while controlling costs. The most successful care management programs offer practical methods for identifying members in need of interventions, effective care plans, face-to-face consultation, and reliable methodologies for tracking results.

    During this webinar, HMA Principal Nancy Jaeckels Kamp provides the key steps for designing and implementing a successful care management program – including the type of infrastructure and workflow redesign needed to ensure your organization’s care management efforts deliver measureable results. Listen to the replay and:

    • Understand the key elements of a successful care management program.
    • Learn practical approaches to identifying eligible patients for appropriate care management interventions.
    • Identify infrastructure needs, workflows and processes that support care management.
    • Find out how care management initiatives aimed at complex medical conditions can dovetail with similar efforts targeting depression and other mental health issues.

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

    Brief & Report

    HMA Releases Medicaid Managed Care White Paper

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    Medicaid Managed Care is the subject of a recently released HMA white paper.

    In “The Value of Medicaid Managed Care,” HMA authors Lisa Shugarman, Jaimie Bern and Jessica Foster review the literature describing the evolving Medicaid delivery system, focusing specifically on the growth of Medicaid managed care in the form of comprehensive risk-based managed care (RBMC) organizations. The paper, prepared for United HealthCare, also explores the role of Medicaid RBMC relative to the fee for service (FFS) delivery system and draws comparisons of the experience of these delivery systems from the perspective of the Medicaid beneficiary, the provider, and the state.

    The paper concludes by sharing lessons learned from the last decade of Medicaid managed care expansion, including:

    • Planning and implementation
    • Stakeholder engagement
    • Procurement approaches
    • Outreach and enrollment
    • Contract management and monitoring
    Brief & Report

    The Value of Medicaid Managed Care

    Download

    In “The Value of Medicaid Managed Care,” HMA authors Lisa Shugarman, Jaimie Bern and Jessica Foster review the literature describing the evolving Medicaid delivery system, focusing specifically on the growth of Medicaid managed care in the form of comprehensive risk-based managed care (RBMC) organizations. The paper, prepared for United HealthCare, also explores the role of Medicaid RBMC relative to the fee for service (FFS) delivery system and draws comparisons of the experience of these delivery systems from the perspective of the Medicaid beneficiary, the provider, and the state.

    The paper concludes by sharing lessons learned from the last decade of Medicaid managed care expansion, including:

    • Planning and implementation
    • Stakeholder engagement
    • Procurement approaches
    • Outreach and enrollment
    • Contract management and monitoring
    Webinar

    Webinar Replay: Trends in State Medicaid Programs

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    On November 18, 2015, HMA Information Services hosted the webinar, “Trends in State Medicaid Programs: Emerging Models and Innovations.”

    CCOs, RCOs, ACOs, Medicaid managed care, 1115 Waivers, 1332 Waivers, block grants, DSRIP, consumerism, integrated care, managed long-term care, patient-centered medical homes, duals demonstrations, evidence-based care. Let’s face it, there is a wide variety of economic and service delivery models emerging to serve the nation’s rapidly growing Medicaid population. While the use of Medicaid managed care continues to increase, other models are vying for relevance – and attracting interest and attention.

    During this webinar, HMA Managing Principal Tina Edlund and Principals Barbara Coulter Edwards and Steve Fitton provide a high-level, strategic look at trends in state Medicaid programs – with an emphasis on how innovations in payment reform, service integration, and coordinated care models may impact the future of Medicaid. Listen to the replay and:

    • Assess the strategic implications of emerging economic and service delivery models for state Medicaid populations and weigh the strengths and weaknesses of the various approaches.
    • Understand the role that delivery system redesign can play in assuring program sustainability as states expand coverage.
    • Find out whether the shift to consumerism in health care will impact Medicaid benefit design and financial assumptions.
    • Get the latest on Medicaid financing, budget and payment reform initiatives that are at the center of virtually every attempt to address the quality, sustainability and cost of Medicaid.

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