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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: 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.

Webinar

Webinar Replay: An Inside Look at Findings from the 15th Annual Kaiser 50-State Medicaid Budget Survey

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On November 19, 2015, HMA Information Services hosted the webinar, “Medicaid Enrollment and Spending Trends: An Inside Look at Findings from the 15th Annual Kaiser 50-State Medicaid Budget Survey.”

Medicaid enrollment and spending both rose nearly 14 percent in fiscal year 2015 among 50 states and the District of Columbia, according to the 15th annual Medicaid budget survey from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU). Spending growth is expected to slow to 6.9 percent in fiscal 2016, while enrollment growth slows to 4 percent, the study projects.

What’s driving these trends, and what are states doing to improve healthcare quality while controlling costs? That’s the topic of this webinar from Health Management Associates, which works with KCMU each year to conduct the survey. HMA Managing Principals Eileen Ellis, Kathy Gifford, and Vern Smith outline key findings from the budget survey and discuss what it all means for the future of Medicaid. Listen to the replay and:

  • Assess the impact of Medicaid expansion on state budgets, including savings in areas like behavioral health, uncompensated care, and criminal justice.
  • Learn why Medicaid spending and enrollment growth will slow in 2016, and why the gap in the rate of increase between expansion and non-expansion states will narrow.
  • Identify the key drivers of Medicaid spending growth.
  • Understand the extent of major Medicaid payment and delivery system reforms among states.
  • Find out how state Medicaid directors were remarkably accurate in projecting Medicaid enrollment and spending trends in 2015 – and what that may mean for the 2016 outlook.
  • Gain insight into which states could expand Medicaid in the future and what that might mean for struggling state budgets.
  • 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.

Webinar

Webinar Replay: Medicaid, Marketplace Outreach and Enrollment

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On December 1, 2015, HMA Information Services hosted the webinar, “Outreach and Enrollment: Maximizing Medicaid and Marketplace Penetration.”

The only thing more important than offering healthcare coverage through Medicaid or an insurance exchange is making sure that people actually sign up. That’s why outreach and enrollment initiatives are vital.

  • During this webinar, HMA Principal Cathy Kaufmann reports on various efforts by states, health plans and advocacy groups to maximize their outreach and enrollment efforts. The goal: making sure that all those eligible for healthcare coverage – even the hardest to reach populations – understand their options and get signed up. Listen to the replay and:
  • Understand why wide variation in outreach and enrollment initiatives among states has a direct impact on Medicaid and exchange enrollment and penetration.
  • Overcome barriers to successful outreach and enrollment for African-American, Hispanic, Native American, and other hard-to-reach populations.
  • Evaluate alternative funding streams and partnerships with community organizations to help facilitate outreach initiatives, reduce uncompensated care, and connect people to social services, such as the Supplemental Nutrition Assistance Program (SNAP) or housing assistance.
  • Understand the importance of federally funded assisters who screen people for eligibility in Medicaid or the marketplace.
  • Reduce gaps in care, with a special focus on the population of eligibles who churn between Medicaid and the exchange.

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

Webinar

Webinar Replay: FQHC Readiness for Value-Based Payments

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On November 17, 2015, HMA Information Services hosted the webinar, “FQHC Readiness for Value-Based Payments: Priorities for Success.”

Federally Qualified Health Centers (FQHCs) continue to struggle with dramatic changes in the way in which healthcare is financed in a post-ACA world. The shift to value-based payments is the latest test. The question is whether FQHCs are equipped to accept value-based payments while remaining financially sustainable.

During this webinar, HMA Principal Art Jones, MD, Managing Principal Gaylee Morgan, Senior Consultant Rob Werner, and Principal Deborah Zahn outline a step-by-step readiness assessment that FQHCs can implement to measure their ability to successfully take on risk under a value-based payment model. The webinar also provides case studies of FQHCs that have successfully entered into a variety of risk-sharing arrangements, providing important lessons about how FQHCs are adapting to new funding mechanisms. Listen to the replay and:

  • Understand key trends driving the need for FQHCs to shift to value-based payments and explore new partnerships and collaborations.
  • Understand key components of population health management, including how to understand and stratify risk, implement targeted interventions, and consistently deliver and manage care.
  • Learn how FQHCs are playing an important role in accountable care organizations, with an emphasis on reducing the global cost of care while improving patient outcomes.
  • Find out how FQHCs are joining forces to create their own independent practice associations and ACOs, driven by a desire to shift from a fee-for-service model to value-based payments.

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

Webinar

Webinar Replay: Oregon and the Future of Medicaid Managed Care

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On November 12, 2015, HMA Information Services hosted the webinar, “Oregon and the Future of Medicaid Managed Care.”

Oregon is host to the nation’s biggest experiment in Medicaid managed care. Unlike most states, which rely on Medicaid managed care plans, Oregon has enrolled 90 percent of its Medicaid population in newly formed Coordinated Care Organizations (CCOs). These CCOs are networks of local providers who care for a population of Medicaid members under a fixed global budget – with an emphasis on care coordination, integrated care, wellness, and chronic disease management.

During this webinar, HMA Managing Principal Tina Edlund and Principals Cathy Kaufmann and Sean Kolmer provide a status report on the Oregon initiative, including key components of the model, initial quality and cost results, and the likelihood that CCOs represent the Medicaid managed care model of the future. Listen to the replay and:

  • Assess the impact of the Oregon model on total cost of care for a Medicaid population and on the ability of the state to bend the Medicaid cost curve.
  • Compare the performance of CCOs based on 17 quality measures, including substance abuse screenings, hospital readmissions, and primacy care.
  • Understand the role of the Oregon Transformation Center, which works with CCOs to support delivery systems change, improve care and reduce costs.
  • Evaluate the 1115 waiver that enabled implementation of the Oregon Medicaid model, including components that might apply to states with more traditional Medicaid managed care programs.
  • Learn how Medicaid reform can impact the broader healthcare delivery system in a state, resulting in overall improvements in quality and cost.

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

Webinar

Webinar Replay: The Future of Community Behavioral Health

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On November 10, 2015, HMA Information Services hosted the webinar, “The Future of Community Behavioral Health: Leveraging the Transformation to Value-Based Health Care.”   

Community behavioral health has never been more relevant. Not only have the costs of caring for those with behavioral health needs become a focal point of delivery system reform, but the medical system has also come to value the type of person-centered health care and social supports that the community behavioral health sector provides.

Leading healthcare organizations are already taking advantage of the significant opportunities for advancing behavioral health within delivery system redesign. Their success is instructive in an array of areas, including managing organizational change, strategically building out the continuum of care, and pursuing the partnerships, mergers and acquisitions that provide scale, capacity and leverage. 

During this webinar, HMA Principals Heidi Arthur, Josh Rubin, and Meggan Schilkie highlight the opportunities available to community behavioral health providers and offer a roadmap for success. Listen to the replay and:

  • Take advantage of new and innovative payment mechanisms and successfully navigate the transition to value-based payments.
  • Learn how the behavioral health community is addressing the social determinants of health by providing supportive housing and using peer support to complement clinical care.
  • Recognize partnerships, mergers, and acquisitions as important potential vehicles for expanding service lines and building critical mass. 
  • Understand the organizational and clinical advantages to becoming a Certified Community Behavioral Health Center.
  • Assess infrastructure readiness for important functions like data warehousing, continuous quality improvement, compliance, prospective financial modeling, cost-of-care reporting, value-based payments, and managed care.
  • Develop an approach to change management that accommodates rapid transition, promotes stability, and fosters buy-in during expansion and enhancement. 

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

Webinar

Webinar Replay: The Age Wave in Social Programs

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On November 11, 2015, HMA Information Services hosted the webinar, “Are You Ready for the Age Wave in Social Programs?”

America is aging. By 2030, approximately one in five Americans will be 65 or older. This age wave will have dramatic implications for the financing and delivery of government-sponsored social programs, including Medicaid and Medicare-Medicaid dual eligibles.

During this webinar, HMA Vice President Joan Henneberry and Senior Consultant Lisa Shugarman outline the challenges that an aging population poses for Medicaid health plans, state Medicaid programs, and dual eligibles initiatives. They also provide a roadmap to the type of innovative partnerships required among payers, providers and policy makers to better serve this population. Listen to the replay and:

  • Understand the importance of building relationships at the community level to best meet the needs of an aging population.
  • Obtain case studies of the types of partnerships and reimbursement models that have successfully incentivized payers and providers to serve members with complex needs.
  • Learn what health plans can expect as states begin to move Long-Term Services and Supports into a managed care environment.
  • Find out how to leverage home and community-based services to broaden the reach of preventive care and proactively assess an individual’s health needs.

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

Webinar

Webinar Replay: An IT Framework for Accountable Care

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On November 3, 2015, HMA Information Services hosted the webinar, “An IT Framework for Accountable Care: Building Information Technology Capabilities that Support All Necessary Functions in the Risk-Sharing Continuum.”

The importance of information technology continues to grow as healthcare providers venture into care coordination, accountable care, and risk sharing. A structured approach to IT planning is a critical step in any comprehensive effort to enable providers to move effectively along the risk-sharing continuum. This means developing a comprehensive IT capability assessment and planning framework specifically geared towards provider organizations engaging in accountable care. It also means identifying how IT can support each clinical and administrative function necessary to successfully manage risk and coordinate care for a population of patients.

During this webinar, HMA experts Lynn Dierker, Juan Montanez and Greg Vachon outline the steps provider organizations must take to develop a solid, actionable accountable care IT plan.  The webinar also features case studies of provider organizations that have made IT the backbone of a successful, comprehensive approach to accountable care. Listen to the replay and:

  • Understand the value and need for a structured assessment of your organization’s IT capabilities, with an emphasis on the importance of information technology in implementing a comprehensive approach to accountable care.
  • Develop an IT plan that supports each functional area impacting your organization’s ability to successfully share risk – including care management and coordination, risk profiling and stratification, population health management, data sharing, and reporting.
  • Assess various options for filling gaps in your organization’s IT capabilities, while avoiding pitfalls such as “jumping the gun” on particular technology solutions or unnecessarily adding complexity to an organization’s existing IT environment.
  • Ensure providers have access to all of the information – including social factors and determinants of health data – necessary to create and manage a comprehensive, individualized service plan for patients.

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