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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1852 Results found.

Webinar

Webinar Replay: MLTSS: Understanding the Impact of the New Medicaid Managed Care Regulations

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On July 1, 2015, HMA Information Services hosted the webinar, “Managed Long-Term Services and Supports: Understanding the Impact of the New Medicaid Managed Care Regulations.”

As part of the newly proposed Medicaid managed care regulations, CMS is seeking to codify the way in which state and federal regulators oversee MLTSS programs. It’s no surprise CMS is taking action, given the dramatic growth of MLTSS. But the proposed rules mean states, health plans, and providers will have to shoulder a wide variety of new compliance requirements in areas such as network adequacy, patient-centered planning, care coordination and quality measurement.

During this webinar, HMA Senior Consultant Lisa Shugarman and Managing Principal Susan Tucker outlined the proposed MLTSS rules and discussed the implications for states, health plans, and providers serving the long-term care market. Listen to the recording and:

  • Understand the framework for MLTSS as codified in the proposed rule.
  • Learn about CMS’ proposed definition of long-term services and supports.
  • Assess changes to network adequacy standards as well as person-centered planning and care coordination standards for MLTSS.
  • Gain insight into CMS’ quality focus for MLTSS.

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

Webinar

Webinar Replay: What New Medicaid Managed Care Regulations Mean for Health Plan Quality, Performance Measurement

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On June 17, 2015, HMA Information Services hosted the webinar, “What the New Medicaid Managed Care Regulations Mean for Health Plan Quality and Performance Measurement.”

The proposed Medicaid managed care regulations released last month by CMS include fundamental changes in the way quality and performance is measured among health plans in state-sponsored programs. The rules seek to align quality and performance measures with existing government programs like Medicare Advantage, institute a quality ratings system, support a variety of performance improvement projects, and increase the role of external quality review.

During this webinar, HMA Principal Matt Roan and Senior Consultant Lisa Shugarman outline the proposed quality rules and discuss the implication for states, Medicaid managed care plans and other stakeholders. Listen to the recording and:

  • Understand the implications of the proposed Medicaid Managed Care Quality Rating System
  • Learn how new, federal, standardized quality measures and performance improvement projects requirements will be incorporated into existing quality programs
  • Gain insight into CMS’ quality focus for Managed Long Term Services and Supports
  • Assess changes to the external quality review process as well as the role of accreditation in state review and approval of Medicaid health plans
  • Identify managed care elements of Comprehensive State Quality Strategies

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

Webinar

Webinar Replay: Minimum MLRs and Rate Setting Requirements

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On June 16, 2015, HMA Information Services hosted the webinar, “Minimum MLRs and Rate Setting Requirements: Implications of the Proposed Medicaid Managed Care Regulations.”

Health Management Associates Managing Principal Eileen Ellis and Steve Schramm, managing director of Optumas, talked about the proposed changes to the rate setting process and the implications for states, Medicaid managed care plans and other stakeholders. Listen to the recording and:

  • Understand how the 85% MLR requirement may impact the financial flexibility of Medicaid managed care plans.
  • Assess how the shift to actuarial certification of specific rate cells will impact the competitive environment for Medicaid managed care plans.
  • Learn how the new rules may provide Medicaid managed care plans with additional risk-sharing opportunities.
  • Find out how the proposed 85% MLR rules for Medicaid managed care align with existing state and NAIC regulations.
  • Explore the additional documentation requirements from the perspectives of states as well as managed care organizations.

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

Webinar

Webinar Replay: New York State’s Ambitious DSRIP Program: A Case Study

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On May 28, 2015, HMA Information Services hosted the webinar, “New York State’s Ambitious DSRIP Program: A Case Study.”

New York has by far the most ambitious Delivery System Reform Incentive Payment (DSRIP) Program in the nation. The program has a clear focus on full health system transformation and payment reform. The state will invest $6.4 billion to incentivize collaboration among health care providers, social service providers, and community-based organizations to dramatically alter the way health care is delivered to Medicaid recipients. The primary goal: a 25% reduction in avoidable hospital use over five years. Getting there will require huge investments in community-based care, improvements in key quality metrics like hospital readmissions, and the continued shift from traditional fee-for-service payment models to value-based care.

Health Management Associates Principal Denise Soffel, PhD, has been on the front lines in helping New York plan, develop, and implement its DSRIP initiative. She provided an in-depth look at the initiative, including how the New York program will inform the thinking of other states considering applying for waivers, and why New York’s clear focus on health system transformation and payment reform signals the future direction of DSRIP nationwide.

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