Medi-Cal experts, including HMA’s Margaret Tatar, provided an overview of the program during a presentation in Sacramento, and via webcast, on Feb. 25. The event was sponsored by the California HealthCare Foundation (CHCF).
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Medicaid Plan PMPM Rates Rise 0.3 Percent in 2018 for TANF/CHIP In 19 States, 4 Percent for Expansion, HMAIS Analysis Shows
This week, our In Focus summarizes the findings of an HMA Information Services (HMAIS) analysis of Medicaid managed care rates in 2018 versus 2017. The analysis represents HMAIS’ first attempt at what will be an annual tracking of Medicaid managed care rate increases, which we will expand upon and refine over time with input from our readers and the Medicaid community. Complete results, including spreadsheets showing underlying analysis, will be made available to HMAIS subscribers. For information on how to subscribe, contact Carl Mercurio.
MA Releases One Care Dual Demonstration 2.0 Request for Responses
This week, our In Focus reviews the Massachusetts One Care Dual Demonstration 2.0 request for responses (RFR), released by the Massachusetts Executive Office of Health and Human Services (EOHHS). One Care will cover Medicare and Medicaid dual eligible adults with disabilities ages 21 through 64 and includes medical, behavioral, Long-term Services and Supports (LTSS), community supports, and care management services statewide.
Evolving Integrated Managed Care Models for Medicare-Medicaid Dual Eligible Beneficiaries: Key Considerations for Health Plans
This week we are providing a brief recap of our January 8th webinar Evolving Integrated Managed Care Models for Medicare-Medicaid Dual Eligible Beneficiaries: Key Considerations for Health Plans presented by Principals Sarah Barth, JD and Ellen Breslin, MPP.
HMA Colleagues Played Pivotal Role in Launching Forum for the Brooklyn Perinatal Network
HMA New York colleagues Heidi Arthur and Annalisa Baker played a pivotal role in launching a forum for the Brooklyn Perinatal Network on Jan. 11.
The forum, entitled, “A Community Response to Addressing Maternal Morbidity and Mortality,” was a collaboration between a network of community-based organizations (CBOs) making up the Brooklyn Coalition for the Health Equity for Women and Families Coalition Leadership Team.
Oregon Releases Medicaid Coordinated Care Organizations 2.0 RFA
This week, our In Focus reviews the Oregon Health Plan’s Coordinated Care Organizations (CCO) 2.0 request for applications (RFA), released by the Oregon Health Authority (OHA) on January 25, 2019. Under CCO 2.0, the CCOs will provide full-risk coordinated care for approximately 840,000 Medicaid members.
Medicaid Managed Care Enrollment Update – Q4 2018
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 29 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 29 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2018. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):
Report conducted by HMA addresses alarming youth suicide trends across Colorado
On January 3, 2019, Colorado Attorney General Cynthia H. Coffman released the study, Community Conversations to Inform Youth Suicide Prevention. The multi-layered study, conducted by HMA, focused on the four Colorado counties with the highest youth suicide rate.
HMA designed a multi-pronged strategy to the study with the goal of learning about opportunities and approaches to youth suicide prevention in each of the four counties, and across Colorado. The team conducted 42 stakeholder interviews and also facilitated 34 focus groups with adults and youth from various communities and sectors. For comparison, focus groups were also conducted with school staff and parents in two counties, where youth suicide rates were lower and/or there had not been recent suicide clusters.
HMA also reviewed information about current suicide prevention activities and resources, traditional and social media coverage related to suicide, and publicly available information on school policies and procedures related to suicide prevention and postvention in the aftermath of a student suicide or suicide attempt.
Key findings:
Risk factors attributing to youth suicide:
- Pressure and anxiety about failing
- Social media and cyber bullying
- Lack of pro-social activities
- Lack of connection to a caring adult
- Judgement and lack of acceptance in the community.
- Substance use, mental health disorders and trauma history
- Adult suicides in the community
Barriers to suicide prevention:
- Not enough resources to effectively implement youth suicide prevention, intervention and postvention activities
- Each county faces lack of resources and funding for public health and social services programs
- Lack of equitable distribution of resources across agencies
- Lack of mental health providers in these communities who accept Medicaid
- Communities with more mental health resources have few providers who are trained to work with youth or the providers only accept adults
- Stigma associated with seeking help
- Stigma against LGBTQ+ individuals limits the places and resources from which those individuals seek help
HMA Experts Contribute to Report on Health Disparities in Minnesota’s Medicaid Population
Editors Note: This post was authored by HMA Principal Ellen Breslin, MPP.
The Minnesota Department of Human Services (DHS) recently submitted a report to the Minnesota Legislature, called Accounting for Social Risk Factors in Minnesota Health Care Program Payments. This report represents a multi-year effort on the part of DHS, and a real step forward in moving from social risk as a concept to a quantifiable methodology to explain its impact on health. The report delivers DHS recommendations to reduce health disparities among Medicaid and other DHS program participants.
Medicaid Expansion Considerations For Non-Expansion States
This week, our In Focus section is led by Matt Powers, a Principal in our Chicago office, who worked with HMA colleagues to summarize the factors that non-expansion states weigh when considering whether or not to expand Medicaid under the Affordable Care Act. Including the states where Medicaid expansion ballot initiatives passed, 37 states have chosen Medicaid expansion or are moving toward Medicaid expansion. More than 12 million newly eligible individuals are insured by state Medicaid programs through the expansion. Comments on recent ACA Court Ruling:
Medicaid and Exchange Enrollment Update – September 2018
This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “September 2018 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on November 30, 2018. Additionally, we review 2018 Exchange enrollment data from the “Health Insurance Marketplaces 2018 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on April 3, 2018. Combined, these reports present a picture of Medicaid and Exchange enrollment in 2018, representing 73 million Medicaid and CHIP enrollees and nearly 12 million Exchange enrollees.
Premium Assistance Programs for the Working Adult Population in Medicaid Expansion States
This week, our In Focus section comes to us from HMA Senior Consultant Erin Mathies (Indianapolis), who reviews the premium assistance programs for the working adult population in Medicaid expansion states. Medicaid programs that pay for premiums in commercial insurance for individuals eligible for Medicaid have been part of state Medicaid programs since the 1990s. Under a premium assistance program, the employer or individual market coverage is the primary plan and Medicaid supports the cost of the premium, pays for cost sharing, and provides any wrapped benefits. These programs can save money for state Medicaid agencies by leveraging the employer contribution towards premiums and holding expenditures per member to the annual out of pocket maximum amounts. Existing Health Insurance Premium Payment (HIPP) programs traditionally cover children and populations with disabilities. Individuals eligible under the Medicaid Expansions may be more likely to have access to employer sponsored-insurance (ESI) and leveraging premium assistance options for these populations represents an unrealized opportunity for many state Medicaid agencies.