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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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Brief & Report

HMA develops brief exploring equity and innovation in children’s behavioral health systems

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Lifting Voices is an initiative developed to inform the transformation of the youth behavioral health care system. The project leaders are parents of children who nearly died on multiple occasions from severe behavioral health conditions, and they are professionals with a deep understanding of the opportunities and challenges faced by behavioral health care policy makers and reformers. They share the belief that their knowledge, desperation, and resources afforded their children access to interventions that should be accessible to every youth who needs them. Their experience of the care delivery system has also inspired their commitment to highlight the urgent improvements necessary to support struggling children and parents affected by the nation’s youth behavioral health crisis.

To learn more about Lifting Voices, see the October 2023 report here.

HMA Principals and behavioral health policy and practice transformation consultants Heidi Arthur, LMSW and Ellen Breslin, MPP partnered with Sheilah Gauch, LISW, M.Ed., Principal and Clinical Director with the Dearborn Academy and Echo Lustig, B.A., young adult behavioral health advocate, to share findings from the first phase of the three-part Lifting Voices initiative at Putting Care at the Center, the annual conference of the Camden Coalition’s National Center for Complex Health and Social Needs Initiative. See: Putting Care at the Center 2023, Elevating behavioral health in whole-person care. Boston, MA, November 1-3, 2023. Please look for us at the Beehive poster station on:

  1. Thursday, November 2 from 2:45 pm – 4:30 pm ET
  2. Friday, November 3 from 8:45 am – 10:30 am ET
Brief & Report

HMA publishes white paper, “Implementing the National Diabetes Prevention Program Lifestyle Change Program in Correctional Settings”

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Correctional facilities can decrease the number of individuals with prediabetes who progress to type 2 diabetes by offering the National Diabetes Prevention Program (National DPP) lifestyle change program. HMA has published a white paper describing (1) the financial and individual impact of type 2 diabetes, (2) the prevalence of type 2 diabetes risk factors in correctional settings, and (3) how the National DPP lifestyle change program, which was created by the Centers for Disease Control and Prevention (CDC), can be used to achieve cost savings and better health for people at risk of developing type 2 diabetes in correctional settings.

This white paper also features a program spotlight from the Wisconsin Department of Corrections (DOC), where the National DPP lifestyle change program has successfully been implemented in three state correctional facilities. Wisconsin’s DOC is currently the only correctional system in the United States providing this program that has been awarded full-recognition status as a supplier of the National DPP lifestyle change program by CDC. A total of 131 individuals have participated in the program, and people who completed the program in 2018-2019 lost an average of 8.3 percent of their body weight.

Administrators of correctional settings, where the length of stay is a year or longer, might consider implementing the National DPP lifestyle change program in their facilities. A cogent argument can be made that type 2 diabetes prevention provides a good return on investment in downstream costs. Offering the program would also be an important step in promoting health equity within correctional settings.

For help starting the National DPP lifestyle change program in a correctional facility, contact the white paper’s authors below.                 

Brief & Report

HMA publishes white paper “Restoring Capitation’s Incentives to Advance State Goals Post-Public Health Emergency (PHE)”

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HMA has published a white paper examining the use of risk mitigation strategies among state Medicaid programs and assessing their limiting impact on capitation’s incentives for managed care organizations (MCOs). This paper seeks to assist policymakers in designing future Medicaid program payment policies that advance state financial and programmatic goals. This paper offers a timely examination of this topic as state Medicaid programs emerge from the COVID-19 public health emergency (PHE) and navigate the unwinding of Medicaid continuous coverage. This paper also builds upon the Health Management Associates May 2021 white paper, Moving Beyond COVID-19 Public Health Emergency Risk Corridors, which more narrowly focused on appropriate and inappropriate use of risk corridors.

Brief & Report

HMA Community Strategies conducts evaluation for the city of Los Angeles FamilySource System

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Systemic health disparities have exposed Los Angeles’ racially and ethnically diverse populations to increased risks of economic hardship, educational underachievement, and housing instability. To better understand this imbalance and drive toward change, the City of Los Angeles (the City), through Community Development Block Grants (CDBG), Community Service Block Grants (CSBG) and General Funds established the FamilySource System (FSS), a place-based program, to address disparities, prevent and alleviate poverty, increase equity, and better coordinate support for these communities. The purpose of the FSS is to provide a myriad of braided social, educational, work and family support services designed to assist low-income families to become more self-sufficient by increasing family income and academic achievement for youth and adults.

HMA Community Strategies conducted this evaluation of the FamilySource System and economic impact study to identify key trends, barriers, and interventions that could better illuminate disparities in Los Angeles and move to greater income, education, and housing equity.

Contributions to this report were made by Charles Robbins, MBA (project director), Megan Beers, PhD, Ryan Maganini, Matthew Ward, and Yamini Narayan.

Brief & Report

New report highlights hybrid (in-person & virtual visits) as the future of child welfare service delivery

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During the COVID-19 public health emergency (PHE), the federal government waived the requirement for “once every 30 days” in-person visits by caseworkers for children in foster care, allowing these visits to occur virtually. In 2021, Casey Family Programs (CFP) commissioned Health Management Associates (HMA) to evaluate the delivery of virtual child welfare services and outline the implications of the COVID-19 PHE on the child welfare system.  The report “Evaluating the Delivery of Virtual Child Welfare Services” is now available. It summarizes HMA’s findings and elevates the voices of staff in public and private child welfare agencies, and of youth and families with lived experiences, and examines their perspectives on how well virtual services have worked. It also details the implications of the COVID-19 PHE, the response from public child welfare agencies, and offers guidance on a hybrid (part in-person, part virtual) service model, which we believe will continue to be a factor in the future delivery of child welfare services.

As the COVID-19 PHE accelerated the spread and scale of telehealth adoption in health care, we surmised that the experience offered valuable opportunities to learn more about how the health care sector’s adoption of telehealth services could be applied in the child welfare community. While cognizant of the unique considerations for child welfare, this disruption also represents a substantial opportunity to rethink the child welfare system and advance both the use of technology as well as a more prevention- and strengths-based approach to child welfare.

The report highlights innovative approaches in the field, offers questions to frame a jurisdiction’s decision-making process, and provides a tool to facilitate an informed decision on the hybrid model. The report also offers a broader value proposition that outlines policy, practice, workforce, and technology imperatives to develop a hybrid approach to the delivery of child welfare services.

Please complete the form in this link to access a copy of the report and the tools and recommendations offered.

Brief & Report

HMA conducts assessment of unmet mental health needs of people living with HIV in Los Angeles County

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HMA Community Strategies conducted an assessment of unmet mental health needs of people living with HIV in Los Angeles County. The study aimed to understand behavioral health service utilization and the role that facility staff and institutional structures play in charting the trajectory of clients. The assessment includes the breadth of experiences and perspectives represented by each facet of the delivery system to inform stakeholders and funders of the best approach for future success.

Brief & Report

The 22nd annual Medicaid budget survey released: pandemic continues to shape priorities

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The 22nd annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA) was released on October 25, 2022, in the report: How the Pandemic Continues to Shape Medicaid Priorities: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2022 and 2023.

The report was prepared by Kathleen Giff­ordAimee Lashbrook, and Matt Wimmer from HMA; Mike Nardone; and by Elizabeth Hinton, Madeline Guth, Jada Raphael, Sweta Haldar, and Robin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors (NAMD).

Brief & Report

System integration across child welfare, behavioral health, and Medicaid

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Children and families involved in the behavioral health and child welfare systems are often the most vulnerable and in need of intensive supports. Fragmented systems of care across child welfare, behavioral health, and Medicaid often cause families “to fall through the cracks,” leading to increased use of high-cost services that separate families and results in poorer outcomes.  These siloed approaches perpetuate and exacerbate trauma to children and families. In the second in a series of briefs focused on enhancing the youth behavioral health system, the HMA team of Uma Ahluwalia, Caitlin Thomas-Henkel, Roxanne Kennedy, and Courtney Thompson propose four core design elements – and related KPIs – for establishing a high-functioning integrated system of care for children, youth, and their families, child welfare, Medicaid, and behavioral health systems.

Brief & Report

HMA consultants author Well Being Trust brief, “Naloxone for Overdose Reversal: Challenges and Opportunities”

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Efforts to reduce America’s opioid-related overdose deaths are being hampered by glaring inconsistencies in U.S. policies and practices from one region, health system, and community to another. So states a new Well Being Trust brief, “Naloxone for Overdose Reversal: Challenges and Opportunities,” written by HMA consultants Barry Jacobs and Helena Whitney, released September 15, 2022. The 10-page, intensively researched report also makes four policy recommendations calling for easier access to naloxone for providers and consumers, as well as more consistent naloxone prescribing and community distribution practices throughout the country.

Brief & Report

Bolstering the youth behavioral health system: innovative state policies to address access & parity

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With 1 in 5 children experiencing a mental health condition every year and only 54 percent of non-institutionalized youth enrolled in Medicaid or CHIP receiving mental health treatment, the HMA team of Caitlin Thomas-Henkel, Uma Ahluwalia, Devon Schechingerand Debbi Witham have authored the first in a series of briefs focused on enhancing the youth behavioral health system. This brief, Bolstering the Youth Behavioral Health System: Innovative State Policies to Address Access & Parity, explores state policy levers to advance access and availability of behavioral health services (encompassing mental health and substance use disorders) for youth.

Brief & Report

HMA series of issue briefs outline Medicare savings proposals

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In a series of issue briefs outlining Medicare savings proposals, Jennifer Podulka examines federal budget pressures and impending insolvency of the Medicare Trust Fund that will require Congress to choose between reducing provider or Medicare Advantage plan payments, increasing dedicated income, modifying beneficiary cost sharing, or some combination of these options.

Successful Centers for Medicare & Medicaid Services Innovation Center models, temporary regulatory flexibilities implemented in response to the COVID-19 public health emergency, and other recent Medicare policy changes inform new savings options for policymakers to consider.

The issue briefs were prepared for Arnold Ventures and will be used to drive discussion and planning.  Five novel Medicare savings proposals include:

Expand the Successful Home Health Value-Based Purchasing Model to Providers that Report Similar Quality Measures 

Medicare Coverage of Drugs That Receive FDA Accelerated Approval 

Ensure that Medicare Beneficiaries have Access to the Successful Diabetes Prevention Program 

Options for Adjusting Medicare Advantage Benchmarks and Quality Bonuses to Achieve Program Savings 

Addressing Medicare Trust Fund Solvency