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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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Brief & Report

HMA brief examines options for CMMI to refine approach for testing Medicare program improvements

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A recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, revisits questions raised in a previous HMA report and offers potential answers to guide progress and changes for demonstrations within the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (CMMI) or the Innovation Center.

The brief examines options for how CMMI could refine their approach to testing ideas for improving the Medicare program. HMA colleagues Jennifer Podulka, Yamini Narayan, and Lynea Holmes wrote the brief which was supported by Arnold Ventures.

HMA’s earlier brief examined the progress the Innovation Center has made in learning from Medicare-focused models during its first decade and raised questions to guide policymakers as they plan for the next phase of the Innovation Center’s work. In the new report, the team returns to those questions and offers potential answers.

The brief outlines seven pairs of competing goals and offers four recommendations that may, in part, help to balance these competing goals, as they are designed to increase the transparency of Innovation Center efforts and improve the likelihood that more models succeed in decreasing spending or improving quality. The recommendations include:

  • The Department of Health and Human Services (HHS) should establish a National Healthcare Transformation Strategy
  • CMMI should articulate a vision for how different models work together
  • CMMI should tailor models to test ideas that address the largest areas of spending growth and key areas of quality concerns, including
    • Include Part D in models
    • Include Part C in models
    • Promote primary care as a counterbalance to excessive low-value care
    • Address social determinants of health and other drivers of quality and access disparities
  • Congress and HHS should revisit the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
Brief & Report

Strategic approaches to utilize ARPA funds to support older adults issue brief authored by HMA

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A new issue brief, authored by Madeline Shea and Aaron Tripp, provides an overview of key provisions of the American Rescue Plan Act (ARPA) of 2021 which offer the potential to make communities better places to grow older. ARPA provides an opportunity for states to build sustainable, person-centered systems and infrastructure for older Americans. These provisions aim to allow older Americans to age in their home and communities.

The provisions examined in the issue brief include addressing both long-standing and emerging needs of older adults for state government officials, including staff of Medicaid, aging, and housing and community development agencies; state legislators and their staff; and advisors to governors.

The ARPA funds are now available to states and local governments and will allow the development of better systems for older Americans. Key areas of opportunity outlined in the brief include

  • Building integrated data systems
  • Expanding affordable housing with services
  • Enhancing quality measurement and value-based purchasing models
  • Developing workforce recruitment and retention strategies
  • Ensuring access to internet services and assistive technology
  • Aligning Medicaid and Medicare services and payments
  • Creating ongoing structures to engage stakeholders in designing innovative and integrative approaches to meet community needs and monitoring their effectiveness over time
Blog

Medicaid Managed Care Enrollment Update – Q2 2021

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This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 states.[1] Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. All 33 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2020. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):

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Webinar

Webinar Replay: Continuing the Path to Medicare-Medicaid Integration

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This webinar was held on October 4, 2021.

Federal and state policy makers have long been working to expand enrollment in Medicare-Medicaid integrated care programs (ICPs). ICPs can advance independent living and health equity for individuals who are dually eligible for both programs. However, approximately only one in 10 dually eligible individuals was enrolled in an ICP as of 2019. To encourage ICP enrollment and retention, HMA identified 10 essential elements of ICPs centered around, informed by, and made available to dually eligible individuals. (See HMA Brief #3 and the brief fact sheet.)

During this webinar, HMA shared these 10 essential elements for establishing and simplifying ICPs specifically tailored to diverse individuals’ needs and preferences. Panelists involved in health justice and community-based healthcare offered practical next steps for advancing ICPs.

Learning Objectives

  • Hear about the 10 essential elements for ICPs identified through interviews with diverse stakeholders
  • Engage panelists to share their views on how to advance ICPs tailored around members’ needs
  • Consider the types and level of investment required to advance the essential elements for ICPs

Speakers

  • Arielle Mir, MPA, Vice President of Health Care, Arnold Ventures, Washington, DC
  • Sarah Barth, JD, Principal, HMA, New York, NY
  • Ellen Breslin, MPP, Principal, HMA, Boston, MA
  • Dennis Heaphy, M.Div., M.Ed., MPH, Health Justice Policy Analyst, Disability Policy Consortium, Malden, MA
  • Linda Little, MBA, RN, CCM, President and CEO, Neighborhood Service Organization (NSO), Detroit, MI
HMA News

Health Management Associates Acquires Wilson Strategic

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State of Reform™ to Continue Independent Convening of Healthcare and Health Policy Leaders

Today, Jay Rosen, founder, president, and co-chairman of Health Management Associates (HMA), announced the firm’s acquisition of Wilson Strategic, a Washington state-based company that operates State of Reform™ health policy conferences.

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