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

Webinar Replay: Making the Business Case for Team Coaching

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On October 22, 2015, HMA Information Services hosted the webinar, “Making the Business Case for Team Coaching: Behavior-Based Training for Leaders of Highly Effective Healthcare Organizations.”  

Healthcare organizations are being asked to evolve rapidly – reflecting new business models that rely on team-based organizational structures for success. Getting there will require leaders who can break down barriers and coach employees to thrive in a team-oriented environment. 

During this webinar, HMA experts Jeffrey Ring and Sandra Sperry discuss the importance of behavior-based leadership training for healthcare organizations and demonstrate how effective leaders can positively influence employee commitment, engagement, productivity, and results in a team-oriented environment. Listen to the recording and:

  • Understanding the business case for team coaching, with an emphasis on the role training can play as your organization adjusts to emerging economic models in healthcare.
  • Assess the most important behaviors and attributes of effective leaders in the context of team-based healthcare.
  • Learn how to effectively navigate conflicts and create an environment in which healthcare teams can work through problems and reach consensus. 
  • Assist individuals who aren’t effective in a team environment and help them identify ways to maximize their potential.
  • Understand how consistent behavior-based leadership training exercises can act as a valuable support mechanism for team leaders and managers.

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

Webinar

Webinar Replay: Risk-Ready Primary Care

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On October 21, 2015, HMA Information Services hosted the webinar, “Risk-Ready Primary Care: The Next Wave in Practice Transformation for a Value-Based Future.”

To successfully share risk in a value-based healthcare system, primary care practices need to develop a core set of capabilities that include clinical integration, data analytics, and targeted interventions. We call this type of practice transformation Risk-Ready Primary Care, and it is the next paradigm in primary healthcare delivery and risk-based payments.

During this webinar, HMA Principals Greg Vachon, MD and Lori Weiselberg offered a framework for Risk-Ready Primary Care, with an emphasis on the infrastructure and skill-sets needed to successfully manage patient populations while taking on various degrees of financial risk. More broadly, they provided an update on the evolution of value-based payments and the importance of coupling financial models with high value, population health management. Listen to the recording and:

  • Understand the risk continuum, including an assessment of the various financial models and levels of risk-sharing available to primary care providers.
  • Learn what’s needed for primary care providers to successfully take on risk, including the importance of a practice transformation framework that prioritizes key functions like identifying high-impact patients, improving access, and high-yield interventions.
  • Obtain case studies of successful primary care practice transformations and risk-sharing arrangements.
  • Learn why Risk-Ready Primary Care is poised for growth, driven by a national focus on shifting from fee-for-service to value-based payments.

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

Brief & Report

Report Examines Provider Network Monitoring Practices

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HMA released findings from a qualitative study this week in the report, “Making Affordable Care Act Coverage a Reality: A National Examination of Provider Network Monitoring Practices by States and Health Plans.”

The study examined the standards and practices that state agencies and health plans use to ensure access to care in the period following implementation of the Affordable Care Act (ACA). The report was prepared by HMA’s Karen Brodsky, Diana Rodin, and Barbara Smith with support from the State Health Reform Assistance Network, a Robert Wood Johnson Foundation program.

Based on evidence gathered through surveys of and interviews with key informants in state agencies and plans, the study explores the standards applied by commercial insurance regulators and Medicaid agencies and the practices actually employed by Medicaid managed care organizations (MMCOs) and Qualified Health Plans (QHPs) in Marketplaces to form provider networks and monitor performance.

While the response sample is small, the information provided paints a picture of the range of standards and practices used and the challenges faced, which provides a basis for identifying gaps in current understanding and strategies and opportunities for developing best practices. Among the report’s key findings:

  • Network standards differ significantly between state insurance regulators and Medicaid agencies
  • Health plans report they are exceeding states’ network standards
  • Few states track provider network overlap across plans.
Brief & Report

Making Affordable Care Act Coverage a Reality: A National Examination of Provider Network Monitoring Practices by States and Health Plans

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This qualitative study examines the standards and practices that state agencies and health plans use to ensure access to care in the period following the implementation of the Affordable Care Act (ACA). Based on evidence gathered through surveys of and interviews with key informants in state agencies and plans, the study explores the standards applied by commercial insurance regulators and Medicaid agencies and the practices actually employed by Medicaid managed care organizations (MMCOs) and Qualified Health Plans (QHPs) in Marketplaces to form provider networks and monitor performance. While the response sample is small, the information provided paints a picture of the range of standards and practices used and the challenges faced, which provides a basis for identifying gaps in current understanding and strategies and opportunities for developing best practices.

Brief & Report

HMA’s Breslin Authors Primer on Medicaid Managed Care Capitation Rates

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HMA Senior Consultant Ellen Breslin prepared the recently released “Primer on Medicaid Managed Care Capitation Rates: Understanding How MassHealth Pays MCOs” for the Massachusetts Medicaid Policy Institute. It includes:

  • An explanation of how state Medicaid programs generally pay their managed care organizations (MCOs)
  • The overall process for setting Medicaid managed care capitation rates; and
  • The various tools states use to mitigate the risks that MCOs face when they assume financial responsibility for Medicaid members.
Brief & Report

A Primer on Medicaid Managed Care Capitation Rates: Understanding How MassHealth Pays MCOs

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HMA Senior Consultant Ellen Breslin prepared this recently released primer for the Massachusetts Medicaid Policy Institute. It includes:

  • An explanation of how state Medicaid programs generally pay their managed care organizations (MCOs)
  • The overall process for setting Medicaid managed care capitation rates; and
  • The various tools states use to mitigate the risks that MCOs face when they assume financial responsibility for Medicaid members.
Webinar

Webinar Replay: Emerging Tools and Technology for Consumer Engagement

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On October 15, 2015, HMA Information Services hosted the webinar, “Emerging Tools and Technology for Consumer Engagement in Health Care.”  

Consumer engagement in health care through the use of electronic tools and technology is more than just a trend. Payers are funding the rollout of consumer engagement tools in hopes of increasing the quality of care, improving outcomes and reducing costs. It’s also imperative for providers who wish to receive incentive payments for meeting federal meaningful use guidelines. 

During this webinar, Matt McGeorge and Jean Glossa of HMA’s Health Care IT Advisory Services team outline the current trends in consumer engagement tools and technology, including the key drivers of adoption, the latest innovations, and the impact on quality and cost of care delivery. Listen to the recording and:

  • Recognize the importance of information technology in driving consumer engagement in health care.
  • Understand the meaningful use guidelines related to consumer engagement.
  • Learn about some of the tools and technology helping consumers navigate the healthcare system, manage their health and wellness, and evaluate care options.
  • Discern the role patients play in helping keep electronic health records and information up-to-date and accurate.
  • Gain insight into the implications for clinicians as consumers more actively utilize electronic tools and technology

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

Brief & Report

Annual Survey Finds ACA Drove Record Annual Increases in Enrollment, Total Medicaid Spending

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The Affordable Care Act’s Medicaid expansion resulted in record increases in Medicaid enrollment and spending nationally in fiscal year 2015, with both rising an average of nearly 14 percent. This is just one finding in the 15th annual 50-state Medicaid budget survey by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

Released Oct. 15, this report provides an in-depth examination of the changes taking place in state Medicaid programs across the country. Health Management Associates conducted the survey of Medicaid directors across the country. The survey shows big differences across states driven largely by the states’ decisions on the Medicaid expansion and also provides an examination of state Medicaid policy and program changes across the country. 

HMA Managing Principals Vernon K. Smith, Kathleen Gifford and Eileen Ellis authored the report along with Robin Rudowitz, Laura Snyder and Elizabeth Hinton of the Kaiser Family Foundation.

Two additional issue briefs were developed as well:

Medicaid Enrollment & Spending Growth: FY 2015 & 2016, which provides an analysis of national trends in Medicaid enrollment and spending.

Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2015 and 2016, a collection of three case studies of Medicaid programs in Alaska, California and Tennessee.