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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Webinar

Webinar Replay: ‘Business Associates’ Redefined: What You Need to Know to Comply with Strengthened HIPAA Regulations

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This webinar was held on April 26, 2016. 

Attention healthcare providers, managed care plans and other entities that are covered by HIPAA regulations pertaining to patient data. Your relationship with third-party contractors and other outside “business associates” is coming under increased regulatory scrutiny from the federal government. Revised HIPAA rules have created important new responsibilities and instituted new penalties related to “business associates” who handle personal health information or personal health records for covered entities.

During this webinar, HMA experts Heidi Robbins Brown and Margarita Pereyda, MD will outline the new regulations, provide a framework for protecting patient data, and present a set of best practices your organization and business associates can use in efforts to ensure HIPAA compliance.

Learning Objectives

  • Understand the new enforcement tools and penalties established by the strengthened HIPAA regulations and identify your organization’s most likely areas of vulnerability.
  • Obtain best practices for contracting with business associates, monitoring HIPAA compliance and ensuring accountability.
  • Find out how to work collaboratively with business associates, agreeing upon clear expectations and keeping the lines of communication open in the event of a problem.
  • Learn how to identify business associates who aren’t in compliance with federal HIPAA regulations and help establish a plan of remediation.

HMA Speakers
Heidi Robbins Brown, JD, Principal, Seattle
Margarita Pereyda, MD, Principal, Southern California

Who Should Attend
Executives of Medicaid managed care plans, hospitals, health systems, and clinics serving Medicaid populations; state and federal regulators and healthcare policy analysts; Medicaid directors and staff; state and federal officials for public health.

Webinar

Webinar Replay: Targeting Readmissions

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On March 30, 2016, HMA Information Services hosted the webinar, “Targeting Readmissions: A Collaborative Strategy for Hospitals, Health Plans and Local Communities.”

Even as hospitals work to reduce readmissions through internal quality improvement efforts, local healthcare communities must also play an active role in addressing factors outside the hospital’s control. The truth is that a significant percentage of hospital readmissions are associated with community-related factors such as unemployment, poverty, lack of education, and inadequate access to care.

During this webinar, HMA experts outline the rationale for a collaborative approach to reducing readmissions, involving hospitals, health plans, community-based organizations, and other providers who can address cultural and community-related factors that impact healthcare outcomes. Listen to the replay and:

  • Understand the role that community-related and demographic factors play in driving hospital readmissions, including a look at the most recent research.
  • Identify successful partnerships and programs in which collaborative care can reduce hospital readmissions and improve care quality and outcomes.
  • Find out how team communications, early discharge, care management, and follow-up are key components of any readmissions strategy during and after discharge.
  • Understand the economic and business rationale for hospitals to develop strong collaborative efforts to address readmissions.

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

Webinar

Webinar Replay: Trauma-Informed Care: Overview and Best Practices in Patient Screening

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This webinar was held on April 26, 2016. 

More than three-quarters of Medicaid recipients report experiences of trauma and violence during their childhoods. These experiences may include verbal, physical or sexual abuse; living in poverty or violent surroundings, including war zones; or living with family members who struggle with substance abuse, mental illness or extreme disability. Research demonstrates that there is a direct correlation between traumatic experiences and the 10 most common causes of death in the United States.

The U.S. healthcare system continues to struggle to reach this high-risk population, many whom also have multiple comorbid chronic health conditions. It is imperative that today’s patient-centered and whole-person healthcare teams take a proactive trauma-informed approach to care delivery. Trauma-informed care begins by first understanding the problem and then identifying patients who have endured or witnessed over the course of their lives any number of adverse or traumatic experiences.

Learning Objectives

  • Understand adverse/traumatic experiences and trauma-informed care delivery.
  • Examine the correlation between trauma and physical health as well as the importance of integrating treatment through trauma-informed care.
  • Identify who is at risk for adverse or traumatic experiences.
  • Learn how to recognize and mitigate patient behaviors that often are the result of trauma.
  • Discuss screening tools for primary care practices.

HMA Speakers
Karen Hill, PhD, MSN, ANP-C, Senior Consultant, San Francisco
Laurie Lockert, MS, LPC, Senior Consultant, Portland, OR
Jeffrey Ring, PhD, Principal, Southern California

Who Should Attend
Physicians, physician assistants, nurses, and other healthcare practitioners; executives of health systems, physician practices, FQHCs, and other provider organizations; executives of Medicaid managed care plans; Medicaid directors and staff.

Webinar

Webinar Replay: Transgender Care and Transitioning

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On March 15 2016, HMA Information Services hosted the webinar, “Transgender Care and Transitioning: Implications of New Health Insurance Coverage Guidelines and Research Findings on the Experiences of Transgender Individuals in the Health Care System.”

New proposed federal regulations require health plans to cover all medically necessary care for transgender individuals, including transition-related services. But it’s more than just covering care. It’s also about ensuring access to appropriate services, training staff to understand the needs of transgender populations, and recognizing the social and financial implications of delaying transition-related care.

During this webinar, Marci Eads and John O’Connor of HMA Community Strategies and HMA’s Heidi Robbins Brown and Karen Brodsky outlined what health plans need to know about the needs of transgender individuals and about how to not only comply with the new guidelines, but also to ensure transgender individuals receive the care they need. Listen to the replay and:

  • Understand the implications of new draft federal guidelines requiring health plans to cover transition-related services and healthcare for transgender individuals.
  • Hear data from HMA Community Strategies’ national survey of transgender individuals about unmet health care needs and the social, psychological and financial implications of not having access to transition-related care.
  • Explore the importance of training health plan representatives to understand the needs of transgender individuals and recommend appropriate healthcare services.
  • Identify barriers to access that prevent transgender individuals from receiving transition-related care and other services in a timely manner.
  • Learn about resources available for ongoing reference, learning and development of culturally competent healthcare staff.

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

Webinar

Webinar Replay: Targeting Readmissions: A Collaborative Strategy for Hospitals, Health Plans and Local Communities

Watch Now

This webinar was held on March 30, 2016. 

Even as hospitals work to reduce readmissions through internal quality improvement efforts, local healthcare communities must also play an active role in addressing factors outside the hospital’s control.  The truth is that a significant percentage of hospital readmissions are associated with community-related factors such as unemployment, poverty, lack of education, and inadequate access to care.

During this webinar, experts from HMA will outline the rationale for a collaborative approach to reducing readmissions, involving hospitals, health plans, community-based organizations, and other providers who can address cultural and community-related factors that impact healthcare outcomes.

Learning Objectives

  • Understand the role that community-related and demographic factors play in driving hospital readmissions, including a look at the most recent research.
  • Identify successful partnerships and programs in which collaborative care can reduce hospital readmissions and improve care quality and outcomes.
  • Find out how team communications, early discharge, care management, and follow-up are key components of any readmissions strategy during and after discharge.
  • Understand the economic and business rationale for hospitals to develop strong collaborative efforts to address readmissions.

HMA Speakers
Gina Lasky, Senior Consultant, Denver
Warren Lyons, Principal, San Francisco
Suzanne Mitchell, Principal, Boston
Jeffrey Ring, PhD, Principal, Southern California

Who Should Attend
Executives of health systems, physician practices, FQHCs, SNFs, and other provider organizations; executives of Medicaid managed care plans; Medicaid directors and staff.

Webinar

Webinar Replay: Launching a Successful Medicare Advantage Plan

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On March 9, 2016, HMA Information Services hosted the webinar, “Launching a Successful Medicare Advantage Plan: Key Strategic, Product, and Operational Considerations.”

A growing number of health systems and Managed Care Organizations (MCOs) are moving to become Medicare Advantage plans. The launch of a Medicare Advantage plan can transition a health system to value-based payments and ensure a steady revenue stream. MCOs can serve a broader and complementary base of members with a Medicare Advantage HMO or a Special Needs Plan. However, launching a Medicare Advantage plan is a complex undertaking, requiring clear organizational intent and a well thought-out product and infrastructural strategy to navigate the regulatory environment and manage the population.

During this webinar, HMA expert Mary Hsieh discusses what is required to launch a successful Medicare Advantage plan, with a special focus on product and pricing strategies as well as key infrastructural and operational considerations. Listen to the replay and:

  • Determine the type of Medicare Advantage plan you should launch based on your organization’s strategic intent.
  • Evaluate product design considerations, including optional supplemental benefits such as fitness, dental, vision, transportation and meals.
  • Identify the driving factors that affect the pricing of the products and pricing trends.
  • Create the operational infrastructure needed for a successful Medicare Advantage plan.
  • The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.
Webinar

Webinar Replay: Value-Based Payment Readiness

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On March 3, 2016, HMA Information Services hosted the webinar, “Value-Based Payment Readiness: A Self-Assessment Tool for Primary Care Providers, FQHCs, and Behavioral Health Providers.”

As the shift from volume-based to value-based payment accelerates, primary care providers, including Federally Qualified Health Centers (FQHCs) and behavioral health providers, must make critical changes to become ready for value-based payments and ensure their financial sustainable. But what changes need to be made?

There is now an online self-assessment tool that providers can use to pinpoint specific strengths and gaps in value-based payment readiness and identify core care delivery, operational, and financial capabilities and high-priority elements to implement. The protocol was designed by HMA and CohnReznick in partnership with the DC Primary Care Association. During this webinar, HMA experts Deborah Zahn and Melissa Corrado, along with CohnReznick expert Peter Epp, demonstrated how the readiness tool can help practices as they prepare themselves for value-based payments. Listen to the replay and:

  • Understand how this new web-based, value-based payment readiness assessment tool can help you assess readiness for providers across multiple domains.
  • Lean how this tool can help practices identify gaps and/or areas in which improvements are needed and identify the core capabilities that are essential for value-based payments and high-priority elements that should be implemented first.
  • Identify the key differences between the assessment tool for primary care providers and the version for behavioral health providers.
  • Find out how multiple practices can use the readiness assessment tool to identify opportunities for developing joint strategies.
  • Understand the various components of the readiness assessment tool.

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

Webinar

Webinar Replay: MLTSS Network Adequacy

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On February 25, 2016, HMA Information Services hosted the webinar, “MLTSS Network Adequacy: Meeting the Access Requirements of an Emerging Market.”

A growing number of states are transitioning Long-Term Services and Supports programs to managed care – raising important concerns about provider network adequacy. For health plans, the challenge is how to best meet state mandated access requirements given a fragmented market in which more than half of the care is delivered by home and community-based services providers.

During this webinar, HMA experts Sarah Barth and Karen Brodsky will provide an overview of the market for Managed Long-Term Services and Supports (MLTSS), outline the challenges of maintaining an adequate network, and provide a framework that health plans and states can follow to ensure that MLTSS members receive the best possible care. Listen to the replay and:

  • Obtain a working framework for monitoring, measuring and maintaining MLTSS network adequacy.
  • Understand how to balance in-network, out-of-network, workforce development and other issues that affect provider access to ensure sufficient MLTSS network options.
  • Understand the value of tracking member and provider satisfaction in maintaining a robust MLTSS provider network.
  • Get a complete run-down of the various types of MLTSS providers to ensure comprehensive representation across your MLTSS network

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

Webinar

Webinar Replay: Value Based End-of-Life Care

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On February 25, 2016, HMA Information Services hosted the webinar, “Value Based End-of-Life Care: Having the Conversation Nobody Wants to Have Benefits Everybody.”

There is growing evidence that end-of-life planning and value-based end-of-life care is a win-win for patients, providers, and payers – resulting in higher quality care that is aligned with patients’ preferences and eliminates relatively high cost futile care.

During this webinar, HMA experts Sukey Barnum, Laurie Lockert, and Suzanne Mitchell, MD, build the case for value-based end-of-life care and planning, and provide a roadmap for health plans and providers looking to launch end-of-life care policies and educational programs.

Listen to the replay and understand:

  • The drivers accelerating the need for value-based end-of-life care and planning.
  • The business case, examples and challenges for developing and implementing value-based end-of-life care programs, policies, and initiatives.
  • The added complexities of end-of-life-care and planning for special populations such as people with serious mental illness, and the benefit of using trauma informed care models for such end-of-life care and planning.

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

Webinar

Launching a Successful Medicare Advantage Plan: Key Strategic, Product, and Operational Considerations

Watch Now

A growing number of health systems and Managed Care Organizations (MCOs) are moving to become Medicare Advantage plans. The launch of a Medicare Advantage plan can transition a health system to value-based payments and ensure a steady revenue stream.  MCOs can serve a broader and complementary base of members with a Medicare Advantage HMO or a Special Needs Plan. However, launching a Medicare Advantage plan is a complex undertaking, requiring clear organizational intent and a well thought-out product and infrastructural strategy to navigate the regulatory environment and manage the population.

During this webinar, HMA expert Mary Hsieh will discuss what is required to launch a successful Medicare Advantage plan, with a special focus on product and pricing strategies as well as key infrastructural and operational considerations.

Learning Objectives

  • Identify the driving factors that affect the pricing of the products and pricing trends.
  • Determine the type of Medicare Advantage plan you should launch based on your organization’s strategic intent.
  • Evaluate product design considerations, including optional supplemental benefits such as fitness, dental, vision, transportation and meals.
  • Create the operational infrastructure needed for a successful Medicare Advantage plan.

HMA Speakers
Mary Hsieh, PharmD MPH, Principal, Atlanta

Who Should Attend
Executives of health systems, physician practices, FQHCs, SNFs, and other provider organizations; executives of Medicaid managed care plans; Medicaid directors and staff.

Webinar

Webinar Replay: California Medi-Cal 2020

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On February 3, 2016, HMA Information Services hosted the webinar, “California Medi-Cal 2020: What the State’s 1115 Waiver Renewal Means for Medicaid Providers, Health Plans and Patients.”

California has received federal approval for a five-year, $6.2 billion 1115 waiver renewal, which can best be described as a mix of old and new. The waiver reauthorizes Medi-Cal managed care and other existing state Medicaid programs – as well as initiating important reforms and innovations. Though scaled down from the state’s original proposal, the new waiver moves California closer to value-based purchasing in Medicaid in several ways.

During this webinar, business and policy experts from HMA’s California offices provide a comprehensive overview of the waiver’s various components, with an emphasis on the type of organizational structures, systems, and performance measurement capabilities providers and health plans will need to successfully compete in the state’s emerging value-based environment. Listen to the replay and:

  • Find out what public and district/municipal hospitals need to do to get their share of up to $3.27 billion in performance incentives through PRIME – successor to the state’s DSRIP initiative.
  • Understand the types of reporting requirements, outcome measures and delivery system models needed to successfully implement waiver programs and comply with new rules and regulations.
  • Evaluate various integrated care models, an essential component of the state’s Whole Person Care pilot, which will divvy up $1.5 billion in incentive payments to foster integrated behavioral and physical healthcare.
  • Learn how to organize case management, care management and training to align with the waiver’s quality and performance requirements.
  • Assess the state’s Global Payment Pilot Program, which seeks to move patients out of the emergency room and into primary care with $1.4 billion in incentive payments – funds previously earmarked for Safety Net Care Pool and Medicaid Disproportionate Share Hospital programs.

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

Webinar

Value-Based Payment Readiness: A Self-Assessment Tool for PCPs, FQHCs, and Behavioral Health Providers

Watch Now

As the shift from volume-based to value-based payment accelerates, primary care providers, including Federally Qualified Health Centers (FQHCs) and behavioral health providers, must make critical changes to become ready for value-based payments and ensure their financial sustainable. But what changes need to be made? There is now an online self-assessment tool that providers can use to pinpoint specific strengths and gaps in value-based payment readiness and identify core care delivery, operational, and financial capabilities and high-priority elements to implement. The assessment tool was designed by HMA and CohnReznick in partnership with the DC Primary Care Association. During this webinar, HMA experts Deborah Zahn and Mary Goddeeris, along with CohnReznick expert Peter Epp, will demonstrate how the readiness tool can help practices as they prepare themselves for value-based payments.