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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Blog

Advancing Life Sciences with expertise across healthcare

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Your organization’s success relies on understanding evolving market dynamics and navigating a complex statutory and regulatory environment. Drug, device, and diagnostic firms, from established to start-up, come to HMA when they want experienced partners who can help with regulatory strategy, coding, coverage, and payment solutions, investment strategy, navigating the complexities of federal and state law, or even creating new policy. HMA, working with our partner companies, provides consulting with depth and breadth throughout the life sciences sector and the broader healthcare industry.

We work with drug, device, and diagnostic companies and their trade associations, pharmacies, physician specialty societies, hospitals, health systems, and community health centers, as well as investment firms and their portfolio companies.

Before joining HMA, our team spent years as senior officials in Medicare and Medicaid; cabinet-level health secretaries; and policy advisors to governors and other elected officials. They also served as directors of large nonprofit and social services organizations, top-level advisors, and C-level executives. Our team is expert in federal and state policy, reimbursement, actuarial consulting, medical coding support, public affairs, and corporate development.

Our Life Sciences team, comprised of experts across our firm, can help with:

We help you navigate the complexities of FDA regulation to help with product development and marketing authorization strategies and regulation throughout the product lifecycle. 

Regulatory policy counseling

Product development and target product profile

FDA authorization strategy

Post-approval compliance  

Contact our FDA Experts:

Clay Alspach, Principal, Leavitt Partners
Eric Marshall, Principal, Leavitt Partners

We help your organization understand the commercial market for life sciences products and develop strategies to support patient access, product launches and growth, and value.

Market intelligence, including market, customer, and stakeholder analysis

Strategic planning, considering risk-based contracting, value-based care, and population health

Business development and strategy

Formulary and market access insights

Go-to-market and launch strategies

Contact our Commercial Experts:

David Kulick, Managing Director, HMA
Spencer Morrison, Associate Principal, Leavitt Partners
Rebecca Nielsen, Managing Director, Leavitt Partners
Alex Rich, Managing Director, HMA

Experts in Medicare, Medicaid, and the commercial market, we help you understand and navigate the complexities of coding, coverage, and payment for approved products and develop and execute strategies to support product access and value.

Code assessment and recommendation

Coverage mapping and guidance

Payment strategy across settings

CMS engagement

Emerging technology strategies

Alternative payment model (APM) development

Payment change impact modeling

Contact our Reimbursement Experts:

Amy Bassano, Managing Director, Medicare, HMA
Mark Desmarais, Principal, HMA
Zach Gaumer, Principal, HMA
Kevin Kirby, Managing Director, HMA
Rachel Kramer, Principal, HMA
Clare Mamerow, Principal, HMA

We help you understand how evolving Federal policy impacts your business and develop strategies for creating and advancing Federal policy that advances value and your business.

Congressional and Administration intelligence and strategy

Policy development and strategy

Multi-sector alliances to create and advance new policy

Policy modeling and CBO scoring projections

Contact our Federal Experts:

Clay Alspach, Principal, Leavitt Partners
Amy Bassano, Managing Director, Medicare, HMA
Mark Desmarais, Principal, HMA
Zach Gaumer, Principal, HMA
Kevin Kirby, Managing Director, HMA
Rachel Kramer, Principal, HMA
Clare Mamerow, Principal, HMA
Eric Marshall, Principal, Leavitt Partners
Sara Singleton, Principal, Leavitt Partners
Josh Trent, CEO, Leavitt Partners
Liz Wroe, Principal, Leavitt Partners

We help you understand how evolving State policy impacts your business and develop strategies to support product access and value in Medicaid programs.

State-related access issues

State policy impact modeling

State research support

Contact our State Experts:

Clay Alspach, Principal, Leavitt Partners
Stephen Palmer, Managing Principal, HMA
Matt Powers, Managing Director, HMA
Josh Trent, CEO, Leavitt Partners

We work with investment firms and their portfolio companies to provide insight that helps you invest wisely in the rapidly evolving healthcare marketplace.

Comprehensive due diligence studies

In-depth research projects

Billing and compliance reviews

Identification, analysis, and outlook on federal, state, and local reimbursement/regulatory issues

Contact our Investment Strategy Experts:

David Kulick, Managing Director, HMA
Alex Rich, Managing Director, HMA

Project Spotlight

Pipeline research and policy recommendations to address new innovative therapies

A large national pharmaceutical manufacturer hired HMA, The Moran Company, and Leavitt Partners, both HMA subsidiaries, to assess the current pipeline of innovative therapies, examine current reimbursement policies to assess long-term compatibility with the adoption of innovative therapies and novel delivery mechanisms, and make policy recommendations to address any challenges identified through the process.

Brief & Report

23rd annual Kaiser Family Foundation state Medicaid budget survey released

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The 23rd annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA) was released on November 14, 2023 in the report: Amid Unwinding of Pandemic-Era Policies, Medicaid Programs Continue to Focus on Delivery Systems, Benefits, and Reimbursement Rates”.

Survey results show that states expect a sharp increase in Medicaid spending that is a direct result of lower federal spending as Covid relief and enhanced matching declines. This budget pressure is compounded by increasing provider rates, workforce recruitment and compensation challenges, increased spending on behavioral health and maternity care, and spending on programs that improve health related social needs. These budget pressures will create a very challenging environment for state policy makers in the coming years.

The report was prepared by Kathleen Gifford, Aimee Lashbrook, Caprice Knapp, Beth Kidder from HMA and Leavitt Partner’s Bill Snyder; and by Elizabeth HintonElizabeth WilliamsJada RaphaelAnna MudumalaRobin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors (NAMD).

Blog

Health Management Associates selected as CalAIM Technical Assistance vendor

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One of only two firms selected in all seven domains out of 46 vendors.

The California Department of Health Care Services (DHCS) has developed a multi-year initiative whose goal is to improve health outcomes and health care quality through broad delivery, payment, and program reforms known as California Advancing and Innovating Medi-Cal (CalAIM). This includes the introduction of new programs and changes to existing programs that will occur over the span of five years. CalAIM further expands upon prior initiatives, such as Whole Person Care, the Health Homes Program, and the Coordinated Care Initiative, and strives to integrate California’s delivery systems to better facilitate the overall Medi-Cal program.

Source: https://www.dhcs.ca.gov/calaim

With the rollout of these programs and the vast requirements associated with them, DHCS and California’s Medi-Cal managed care health plans are now tasked with the challenge of implementing CalAIM and enabling the participation of community providers and partners in these opportunities. To support these partners, DHCS developed a funding initiative, known as Providing Access and Transforming Health (PATH) to aid in strengthening capacity and infrastructure of Community Based Organizations, public hospitals, county agencies, and others to stand up CalAIM. This five-year, $1.85 billion initiative includes the creation of a virtual Technical Assistance (TA) Vendor Marketplace that organizations can use to request resources and support from approved vendors through services that are fully paid for by the State.

Health Management Associates (HMA) is recognized as a valued partner to Payers, Community Based Organizations, public hospitals, and county agencies and has deep expertise in CalAIM policy, operations and implementation. Recognized for our extensive capabilities in the field, HMA is one of only two firms out of 46 vendors that received State approval to serve as a technical assistance vendor on the PATH Technical Assistance (TA) Marketplace for all seven domains:

  • Domain 1: Building Data Capacity: Data Collection, Management, Sharing, and Use
  • Domain 2: Community Supports: Strengthening Services that Address the Social Drivers of Health
  • Domain 3: Engaging in CalAIM Through Medi-Cal Managed Care
  • Domain 4: Enhanced Care Management (ECM): Strengthening Care for ECM Population of Focus
  • Domain 5: Promoting Health Equity
  • Domain 6: Supporting Cross-Sector Partnerships
  • Domain 7: Workforce

HMA also has expertise in and hands-on experience with addressing the unique challenges experienced by providers and partner agencies serving rural communities. Please visit the PATH Technical Assistance (TA) Marketplace to access TA resources that can help strengthen capacity to provide high quality Enhanced Care Management (ECM) and Community Supports services for Medi-Cal members.

Blog

Digital innovation to be a featured topic at 2023 HMA fall conference

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Advancements in digital health and data technology have made for rapid and remarkable transformation of the healthcare landscape. From wearable devices to mobile health apps to telemedicine platforms, the integration of digital solutions and patient data is disrupting every facet of healthcare – to say nothing of the AI revolution that has only just begun. While this innovation is exciting and meaningful, it still has runway to truly deliver “better, cheaper, faster” for patients. These innovations and others will be featured at Health Management Associates annual fall conference, being held October 30-31, 2023.

Digital innovation has graduated from its “experimentation/compliance” phase and is now in its “expectation of results” phase. Healthcare payers and providers should incorporate digital into core payment and delivery strategies to deliver better outcomes and a better care experience at a most efficient cost. Health data management is creating more efficient platforms to provide the right care at the right time to the right patient. Federal policy programs like the 21st Century Cures Act, and CMS Interoperability and Patient Access rule have opened the door for providers, payers, and applications to make better use of health information, with patients more in control. 

While this level of innovation is exciting anywhere, it is particularly exciting to see how it is enabling improvements in publicly funded healthcare programs to deliver more effective care. HMA consultants are leading conversations and presentations on how digital innovation is driving change in Medicare, Medicaid, and state marketplaces. 

Key Sessions (full agenda and panelists here)

The Dynamic World of Publicly Sponsored Health Care: Trends and Innovations: Learn about new payment models, quality and equity initiatives, new products and services, workforce, likely policy initiatives, and new ways of reaching and serving members. (Monday 9:15-10:30am plenary session)

Digital Health, Interoperability, and Information Sharing: From Compliance to Innovation: Discover how early adopters will show how they have moved from compliance to innovation by embracing data sharing, FHIR APIs, and third-party applications using real-time data. (Monday 1:30-3:00pm breakout session)

The Pitch: Innovative and Potentially Disruptive Models in Care DeliveryHear the latest innovations in care delivery models and will also gain an understanding of how to best approach managed care partners when considering value-based contracting or other network arrangements. (Monday 3:30-5:00pm breakout session)

Behavioral Health System Redesign: Learn why federal and state governments and the healthcare delivery system must collaborate in new and innovative ways to meet the rapidly growing demand for a more integrated behavioral health system (Sunday preconference, this session and others running 1pm – 5pm)

To learn more about HMA’s work in the digital innovation space or digital health work, please contact our experts below.

Blog

Learning the invaluable lessons of value-based care at 2023 HMA conference

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If you search the term “value-based care” on the internet you will find over 2.5 million hits on that term alone. No one would disagree with the need to provide value to patients and purchasers, but how we define value differs based on where we sit. Value is paying for outcomes, not volume of services. Value is ensuring that patients get the right care at the right time. Value is ensuring that purchasers pay a reasonable cost for the highest possible quality. Value is ensuring that healthcare is provided equitably and sustainably. Implementing value is even trickier than defining it, given the complexity of who pays for care and the challenges of measuring the outcomes we seek to reward.  

From the top office of HHS to the back office of a health center and everywhere in between, HMA leaders have been part of our collective journey to value: advancing policy and regulatory change, calculating risk and setting prices, crafting alternative payment models, integrating social services and behavioral health, and coaching industry leaders to make important changes to their business models to adapt to a more sustainable approach to American healthcare. These experiences – both successes and challenges – provide a unique perspective from which to advise clients on transformation of healthcare.  

The HMA 2023 fall conference, scheduled for October 30-31, 2023, has thoughtfully curated several discussions to educate, enlighten and motivate attendees on industry standards and navigating the practicality of providing value in care, coverage, and patient experience in publicly funded healthcare:  

Leading the Charge on Value, Equity and Growth: The Future of Publicly Sponsored Healthcare: Discuss how these public programs came to be the industry standard bearers and what this shift means for outcomes, affordability, policy, and the overall direction of U.S. healthcare.  

Positive Change and the Growing Importance of Managed Care in Publicly Sponsored Healthcare: Discuss the future of publicly sponsored healthcare, outline promising initiatives aimed at improving coverage and care, and address key concerns over funding, policy, equity, and coordination between government, plans, providers, and members.  

The Future of Delivery Systems: Achieving Operational and Financial Sustainability: Discuss a wide range of practical approaches to prepare for the future, including managing cash flow, optimizing the workforce, developing long-term reimbursement plans, improving operational efficiency, and addressing changes in government policy.   

Real Talk from the Trenches of Value-based Payments: Learn about the advantages and pitfalls of value-based payments, with important insights from organizations that have made it work.  

Navigating Change in Medicare Advantage: A Roadmap for Success: Discuss what Medicare Advantage plans must do to meet the demanding, new requirements – all against a backdrop of continued efforts to improve equity, access, outcomes, and cost.   

In addition, a pre-conference workshop on behavioral health will be held the afternoon of October 29th, prior to the official start of the conference. This workshop will highlight the integral role of behavioral healthcare in improving patient outcomes across the continuum of publicly sponsored healthcare programs.  

We are excited to engage with industry experts throughout these discussions about value-based care and forge a better path forward toward a more sustainable and equitable system of care.  

Blog

What does passage of the “debt ceiling” bill mean for the healthcare workforce?

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On May 31, the House passed H.R. 3746 – the Fiscal Responsibility Act of 2023, otherwise known as the “debt ceiling” bill, which increased the federal debt limit, established new discretionary spending limits, rescinded unused funds, and expanded work requirements for federal programs. It was passed by the Senate on June 1 and will soon be signed into law.  What does all this have to do with healthcare workforce? Well, part of the rescindment plan comes from $28 billion in unused pandemic funding, with a substantial portion of those funds that were allocated for healthcare workforce efforts. This includes funds set to be used for mental health and substance use disorder training, grants to improve mental health and burnout in the healthcare workforce, and additional educational and training grants for promoting future workforce. Overall, part of $28 billion specifically includes removal of $1.7 billion from the Centers for Disease Control and Prevention (CDC) and $13.4 billion from the Department of Health and Human Services (DHHS), including $10.4 billion from public health and social services emergency funds.

Washington DC Capitol dome detail with waving american flag

So, what does this mean for the healthcare workforce? It means healthcare organizations will need to continue to optimize their current and future workforce plans, without additional funding that could provide some relief.

At Health Management Associates (HMA), our healthcare workforce experts have not only partnered with health system leaders to identify real-world solutions, we have directly experienced the same challenges, because our team includes physicians, nurses, advanced practice providers, and former health system operations and financial executives who share the same lived experiences.

HMA offers a number of workforce solutions to healthcare communities across the spectrum. We cannot fill all your staffing gaps tomorrow; however, we can give you an innovative, model-of-care plan designed to lower costs, increase revenue, and position organizations for long-term financial success and operational sustainability.

With HMA’s Delivery System Optimization Team, organizations will benefit from:

  • An experienced team of health system leaders, bedside clinicians, and workforce subject matter experts with real-world experience and modern health care delivery solutions
  • A thorough quantitative and qualitative assessment including:
    • Workforce capacity, needs, and gap analysis.
    • Leadership and governance structure evaluation.
    • Key regulatory and policy gap analysis.
    • Compensation and benefits review.
    • Clinical and/or non-clinical workflow evaluation.
    • Provider billing practices and quality metric capture.
    • Provider and staff utilization analysis.

What organizations receive is:

  • A customized, comprehensive phased implementation plan that:
    • Improves cash flow and maximizes revenue.
    • Reduces turnover, increases retention, and improves health system culture.
    • Optimizes the ‘Model of Care’ delivery while still maintaining quality and safety.
    • Provides solutions for long-term financial success and operational sustainability.
    • Offers on-going executive and leader coaching services to help provide support through the change management process.

Today’s healthcare workforce challenges are unwavering, especially given the recent passage of the “debt ceiling” bill. From significant workforce shortages, to rising costs and competition, to decreasing employee engagement and burnout, today’s health systems face tremendous challenges. But by understanding workforce and health system needs and identifying gaps and inefficiencies, employers can fully utilize the employees they have to their highest potential and deliver care more effectively and efficiently.  Here at HMA, our delivery system optimization team can help health care communities struggling with workforce challenges do just that.

Contact our healthcare delivery system experts, who can partner with your organization to design a custom workforce solution for you.

Blog

HMA annual conference on innovations in publicly sponsored healthcare

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Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth

Pre-Conference Workshop: October 29, 2023
Conference: October 30−31, 2023
Location: Fairmont Chicago, Millennium Park

Health Management Associates has announced the preliminary lineup of speakers for its sixth annual conference, Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth.

Hundreds of executives from health plans, providers, state and federal government, investment firms, and community-based organizations will convene to enjoy top-notch content, make new connections, and garner fresh ideas and best practices.

A pre-conference workshop, Behavioral Health at the Intersection of General Health and Human Services, will take place Sunday, October 29.

Confirmed speakers to date include (in alphabetical order):

  • Jacey Cooper, State Medicaid Director, Chief Deputy Director, California Department of Health Care Services
  • Kelly Cunningham, Administrator, Division of Medical Programs, Illinois Department of Healthcare and Family Services
  • Karen Dale, Chief Diversity, Equity, and Inclusion Officer, AmeriHealth Caritas
  • Mitchell Evans, Market Vice-President, Policy & Strategy, Medicaid & Dual Eligibles, Humana
  • Peter Lee, Health Care Policy Catalyst and former Executive Director, Covered California
  • John Lovelace, President, Government Programs, Individual Advantage, UPMC Health Plan
  • Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation
  • Anne Rote, President, Medicaid, Health Care Service Corp.
  • Drew Snyder, Executive Director, Mississippi Division of Medicaid
  • Tim Spilker, CEO, UnitedHealthcare Community & State
  • Stacie Weeks, Administrator/Medicaid Director, Division of Health Care Financing and Policy, Nevada Department of Health and Human Services
  • Lisa Wright, President and CEO, Community Health Choice

Publicly sponsored programs like Medicare, Medicaid, and the Marketplaces are leading the charge in driving value, equity, and growth in the U.S. healthcare system. This year’s event will highlight the innovations, initiatives, emerging models, and growth strategies designed to drive improved patient outcomes, increased affordability, and expanded access.

Early bird registration ends July 31. Group rates, government discounts, and sponsorships are available.

Blog

New experts join HMA in April 2023

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HMA is pleased to welcome new experts to our family of companies in April 2023. This diverse team brings significant expertise in Medicare, Medicaid, regulatory strategies, and managed care, strengthening HMA’s capabilities in healthcare consulting across areas like actuarial support, regulatory compliance, and strategic leadership in Medicare Advantage and Medicaid programs.

Headshot of Jed Abell

Jed Abell

Consulting Actuary I

Headshot of Surah Alsawaf

Surah Alsawaf

Senior Consultant

Headshot of Elrycc Berkman

Elrycc Berkman

Senior Consulting Actuary I

Headshot of Monica Bonds

Monica Bonds

Associate Principal

Headshot of Yucheng Feng

Yucheng Feng

Senior Consulting Actuary I

Headshot of Melanie Hobbs

Melanie Hobbs

Associate Principal

Headshot of Ryan McEntee

Ryan McEntee

Senior Consultant II

HMA News

Health Management Associates Acquires Crestline Advisors

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Jay Rosen, founder, president, and co-chairman of Health Management Associates (HMA), today announced the firm’s acquisition of Crestline Advisors, an Arizona based healthcare consulting firm.

Founded in 2013, Crestline Advisors supports health plans, provider organizations, and state agencies with an array of services designed to help them navigate the changing healthcare landscape. The company’s team of independent consultants has an extensive track record of developing successful RFP responses, provider networks, and business development strategies to fuel client success.

“Crestline Advisors brings an impressive mix of expertise and relentless client focus – that delivers results – to HMA,” Rosen said. “Their ability to consistently develop winning proposal responses for Medicaid managed care organizations (MCO) complements our extensive MCO supports as we continue to expand the ways in which we serve our clients.”

In addition to Crestline’s proposal response development and MCO network management and operations support services, the company also assists clients with regulatory and contract compliance, accreditation, and strategic planning for business development.

“Crestline has demonstrated a commitment to supporting health plans, providers, and states to improve healthcare for Medicaid beneficiaries,” said Crestline CEO Susan Dess. “We firmly believe that as part of the HMA family of companies we will bring even more success to our clients and drive continued growth and development in Medicaid healthcare delivery.”

Dess and Tim Mechlinski will continue to lead Crestline Advisors, an HMA Company, as managing directors. Terms of the transaction were not disclosed.

About HMA

Founded in 1985, HMA is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, HMA’s expertise, services, and team are always within client reach. Learn more about HMA at healthmanagement.com, or on LinkedIn and Twitter.

About Crestline Advisors

Established in 2013, Crestline Advisors, LLC is a consulting company designed to support the needs of health plans, provider organizations, and state agencies. Crestline specializes in helping large and small organizations operate successfully and grow despite the constant operational, financial, and political challenges they face. Crestline uses its current understanding of industry drivers to strategize with our clients so they can respond timely and effectively to small, large, or enormous market-place changes. Learn more about Crestline Advisors at crestlineadvisors.com.

HMA News

Health Management Associates acquires Lovell Communications and establishes Nashville office

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Jay Rosen, founder, president, and co-chairman of Health Management Associates (HMA), today announced the firm’s acquisition of Lovell Communications, a leading strategic communications and change management firm that exclusively serves the healthcare industry.

Founded in 1988 and based in Nashville, Tenn., award-winning Lovell Communications provides communication solutions and strategies for healthcare organizations across the country. Lovell has helped clients of all size manage crises, navigate change, maximize brand potential, and grow business. Services include creation of corporate communication programs, marketing and media strategies, transaction support, and helping clients navigate complex operational, reputational and regulatory issues.

“Lovell’s strategists have an impressive track record of helping healthcare clients overcome challenges and seize opportunities,” Rosen said. “They are a natural addition to our company as we open a Nashville office and continue to expand the depth and breadth of services we offer our clients and partners.”

Lovell CEO Rosemary Plorin will continue to lead the firm, which will operate as Lovell Communications, an HMA Company. In addition to serving integrated health systems, hospitals and providers across the country, Lovell’s clients include healthcare suppliers, consultants, associations and innovators throughout the industry.

“As the pace of transformation in healthcare continuously increases, the need for effective, strategic communications has never been greater,” Plorin said. “We are honored to offer our expertise in support of HMA’s clients and look forward to what we will accomplish together as we pursue a shared commitment to making healthcare more accessible, equitable and effective.”

HMA’s new Nashville office is co-located with the Lovell office in the Westpark Building at 3212 West End Ave.

About HMA

Founded in 1985, HMA is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, HMA’s expertise, services, and team are always within client reach.

About Lovell Communications

For 35 years Lovell Communications has served as strategic counsel and trusted partner to health care providers and suppliers across the country. Publicly traded companies, not-for-profit systems, early stage and mature companies draw upon the firm’s vast communications expertise to support them through phases – or just moments – when it is crucial to persuade audiences or influence decision makers. Learn more about the firm at Lovell.com, or on Twitter, Facebook or the company blog.

HMA: https://www.healthmanagement.com/

Lovell Communications: https://www.lovell.com/

Blog

Lee Fleisher of CMS to keynote HMA national quality conference

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Join us on Monday, March 6, 2023, at the Fairmont Chicago, Millennium Park, for “Healthcare Quality Conference: A Deep Dive on What’s Next for Providers, Payers, and Policymakers,” where Lee Fleisher, MD, chief medical officer and director of CMS’ Center for Clinical Standards and Quality, will deliver the keynote titled A Vision for Healthcare Quality: How Policy Can Drive Improved Outcomes.

HMA’s first annual quality conference will provide organizations the opportunity to “Focus on Quality to Improve Patients’ Lives.” Attendees will hear from industry leaders and policy makers about evolving health care quality initiatives and participate in substantive workshops where they will learn about and discuss solutions that are using quality frameworks to create a more equitable health system.

In addition to Fleisher, featured speakers will executives from ANCOR, CareOregon, Commonwealth Care Alliance, Council on Quality and Leadership, Intermountain Healthcare, NCQA, Reema Health, Kaiser Permanente, United Hospital Fund, and others.

Working sessions will provide expert-led discussions about how quality is driving federal and state policy, behavioral health integration, approaches to improving equity and measuring the social determinants of health, integration of disability support services, stronger Medicaid core measures, strategies for Medicare Star Ratings, value-based payments, and digital measures and measurement tools. Speakers will provide case studies and innovative approaches to ensuring quality efforts result in lasting improvements in health outcomes.

“What’s different about this conference is that participants will engage in working sessions that provide healthcare executives tools and models for directly impacting quality at their organizations,” said Carl Mercurio, Principal and Publisher, HMA Information Services. 

View the Full Agenda

Early Bird registration ends January 30. Visit the conference website for complete details. Group rates and sponsorships are available.

Blog

2022 Yearly Roundup: a year of successful partnerships

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The holiday season is grounded in gratitude. At HMA, we are grateful for successful partnerships that have fueled change to improve lives.

We are proud to be trusted advisors to our clients and partners. Their success is our success. In 2022 our clients and partners made significant strides tackling the biggest healthcare challenges, seizing opportunities for growth and innovation, and shaping the healthcare landscape in a way that improves the health and wellness of individuals and communities.

Reforming Colorado’s Behavioral Health System

HMA partnered with the Colorado Department of Human Services to support the planning and implementation of a new Behavioral Health Administration (BHA). HMA provided technical research and extensive stakeholder engagement, drafted models for forming and implementing the BHA, employed an extensive change management approach, and created a detailed implementation plan with ongoing support. Today the BHA is a cabinet member-led agency that collaborates across agencies and sectors to drive a comprehensive and coordinated strategic approach to behavioral health.

From Bid to Trusted Advisor

Wakely Consulting Group, an HMA Company, was engaged to support the launch of a Medicare Advantage (MA) joint venture partnership between a health plan and a provider system. Wakely was responsible for preparing and certifying MA and Medicare Part D (PD) bids, a highly complex, exacting, and iterative effort. The Wakely team quickly became a trusted advisor and go-to resource for the joint venture decision makers. The joint venture has driven significant market growth over its initial years, fueled by a competitive benefit package determined by the client product team.

Laying the Foundation for Modernizing Indiana’s Public Health System

In 2021 Indiana Governor Eric Holcomb appointed a 15-member commission to assess Indiana’s public health system and make recommendations for improvements. The Indiana Department of Health (IDOH) engaged HMA to provide extensive project management and support for six workstreams. HMA prepared a draft report summarizing public input as well as research findings and recommendations. The commission’s final report will form the basis of proposed 2023 legislation, including proposals to substantially increase public health service and funding across the state.

Multiple Clients Accepted into ACO REACH Model

In early 2022 HMA and Wakely Consulting Group, an HMA Company, assisted multiple clients with their applications to participate in the new CMS ACO REACH model. The purpose of this model is to improve quality of care for Medicare beneficiaries through better care coordination and increased engagement between providers and patients including those who are underserved. The team tailored their support depending on each client’s needs. The application selection process was highly competitive. Of the 271 applications received, CMS accepted just under 50 percent. Notably, nine out of the 10 organizations HMA and Wakely supported were accepted into the model.

Pipeline Research and Policy Recommendations to Address New Innovative Therapies

HMA, and subsidiaries The Moran Company and Leavitt Partners, were selected by a large pharmaceutical manufacturer to analyze the current pipeline of innovative therapies, examine reimbursement policies to assess long-term compatibility with the adoption of innovative therapies and novel delivery mechanisms, and make policy recommendations to address any challenges identified through the process. The project equipped the client with a holistic understanding of future potential impacts and actions to address challenges in a detailed pipeline analysis of innovative therapies.

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