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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

Medicaid and Health Policy Highlights from Governors’ Proposed Budgets

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Governor’s Proposed Budgets for FY 2018: Focus on Medicaid and Other Health Priorities

This issue brief, authored by the Kaiser Family Foundation and Health Management Associates (HMA), analyzes governors’ proposed budgets for state fiscal year (FY) 2018.

Despite nearly half of the states facing budget challenges for FY 2018, many governors are recommending enhancements to Medicaid and increasing the use of managed care and community-based long-term services and supports. With ongoing debate of the Affordable Care Act at the federal level, several governors still view Medicaid expansion as a solution to addressing top health priorities, including the opioid epidemic and healthcare for those involved with the criminal justice system.

This issue brief reviews 48 proposed state budgets. Key findings are presented in the areas of:

• Provider payment rates and taxes
• Eligibility changes
• Benefits, premiums and cost-sharing
• Delivery system and managed care reforms
• Community-based long-term services and supports
• Medicaid administration
• Initiatives to fight the opioid epidemic
• Initiatives to enhance behavioral health services
• Health-related corrections and criminal justice initiatives

HMA’s Kathleen Gifford and Nicole McMahon co-authored the issue brief along with Larisa Antonisse, Elizabeth Hinton and Robin Rudowitz of the Kaiser Family Foundation.

Blog

Medicaid and Exchange Enrollment Update – December 2016/January 2017

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This week, we reviewed updated reports issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “December 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on February 28, 2017. Additionally, we review 2017 Exchange enrollment data from the “Health Insurance Marketplaces 2017 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on March 15, 2017. Combined, these reports present a picture of Medicaid and Exchange enrollment at the beginning of 2017, representing more than 74 million Medicaid and CHIP enrollees and more than 12 million Exchange enrollees.

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HMA News

Health Management Associates to Acquire Firm Founded by Seema Verma

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WASHINGTON, D.C. – Today, Jay Rosen, founder and president of Health Management Associates (HMA), announced the signing of an agreement by which HMA will acquire SVC, a consulting firm which is owned by Seema Verma, founder and president, and recently confirmed Administrator of the Centers for Medicare & Medicaid Services (CMS).

SVC will become HMA Medicaid Market Solutions, a new subsidiary of HMA.

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Blog

New Jersey Health Care Quality Institute Issues “Medicaid 2.0 Blueprint for the Future”

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This week’s review comes to us from HMA Principal Karen Brodsky and Research Assistant Anh Pham, both of our New York City office. Anh and Karen provide a review of the “Medicaid 2.0 Blueprint for the Future” issued by the New Jersey Health Care Quality Institute (Quality Institute). Funded by The Nicholson Foundation, the Quality Institute embarked on a year-long project convening a wide variety of stakeholders in New Jersey with the goal of redesigning and modernizing the State’s Medicaid program. The report is a culmination of 24 recommendations to promote the efficient delivery of quality healthcare services to New Jersey’s most vulnerable populations.

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Brief & Report

Linking Medicaid and Supportive Housing: Opportunities and On-the-Ground Examples

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Research suggests that a broad range of social factors affect individual and population health. Indeed, acknowledging the role of social factors in determining health, the U.S. Department of Health and Human Services’ Healthy People 2020 report included as one its four overarching goals for the 2010-2020 decade: “Create social and physical environments that promote good health for all.”1 Housing has been identified as one such social determinant of health, as individuals experiencing homelessness or unstable housing situations face significant challenges in obtaining care and managing chronic conditions, and lack of housing and poor housing conditions can themselves adversely affect health. There is growing evidence that supportive housing can contribute to improved health outcomes for individuals experiencing homelessness or at risk of homelessness.2 Supportive housing can also promote the goal of community integration of individuals with disabilities and elders who need long-term services and supports (LTSS).

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Blog

Mississippi Division of Medicaid Issues RFP to Rebid MississippiCAN Program

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This week, we reviewed the request for proposals (RFP) issued by the Mississippi Division of Medicaid (DOM) for the reprocurement of Mississippi Coordinated Access Network (MississippiCAN) Medicaid managed care plans. Under the RFP, the DOM is adding 1915(i) Intellectual/Developmental Disabilities Community Support Program (IDD CSP) and Mississippi Youth Programs Around the Clock (MYPAC) services to the MississippiCAN benefit package. As of February 2017, MississippiCAN enrolls roughly 490,000 Medicaid members across all 82 counties in the state, with annual spending of more than $2.7 billion.

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Blog

HIP 2.0 Waiver Renewal Summary

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This week’s review comes to us from HMA Principal Sarah Jagger, of our Indianapolis, Indiana office. Sarah provides an overview of the Healthy Indiana Plan (HIP) and the proposed changes under the HIP 2.0 waiver renewal request, submitted to the Centers for Medicare & Medicaid Services (CMS) for approval on January 31, 2017.

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Blog

Medicaid Managed Care Spending in 2016

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This week, Andrew Fairgrieve and Greg Nersessian reviewed Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. In federal fiscal year (FFY) 2016, Medicaid expenditures across all 50 states and 6 territories exceeded $548 billion, with nearly half of all spending now flowing through Medicaid managed care programs.

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Blog

Reviewing Oregon’s Medicaid Expenditure Cap Waiver

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This week, our In Focus article provides an overview of Oregon’s Medicaid waiver program, under which the state implemented integrated managed care entities and committed to a per capita reduction on the rate of Medicaid cost growth. The model, viewed widely as a success, may be of interest to states as discussions at the federal level around restraining spending growth in Medicaid develop under the incoming administration.

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Blog

Medicaid Managed Care Procurement Updates in DC, Massachusetts, and Texas

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This week we reviewed two active Medicaid managed care procurements – in the District of Columbia and Massachusetts – and a Medicaid managed care request for information issued by Texas. On December 22, 2016, the District of Columbia issued a request for proposals (RFP) to rebid Medicaid managed care organization (MCO) contracts for the DC Healthy Families and Alliance programs. One day prior, on December 21, 2016, Massachusetts issued a request for responses (RFR) from MCOs interested in participating in the MassHealth managed care program, with a focus on preparing for Medicaid ACO implementation, as well as the planned carve-in of managed long-term services and supports (MLTSS). Finally, also on December 22, 2016, Texas issued a request for information (RFI) ahead of an upcoming statewide reprocurement of the STAR+PLUS Medicaid managed care program.

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Blog

Medicaid and Exchange Enrollment Update

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This week, we reviewed updated reports issued by the Department of Health & Human Services (HHS) on Medicaid expansion enrollment from the “September 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on December 1, 2016. Additionally, we review 2016 Exchange enrollment data from the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) Issue Brief, “Health Insurance Marketplace 2016 Open Enrollment Period: February 2016 Enrollment Report,” and 2017 enrollment snapshot data through December 19, 2016, from the Centers for Medicare & Medicaid Services (CMS). Combined, these reports present a picture of Medicaid and Exchange enrollment at the end of 2016, with a look at progress towards 2017 Exchange enrollment.

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