Insights

Chronicle of a Death Foretold: ACA Repeal and Replace Stalls in Senate

This In Focus article, authored by HMA Managing Principal Greg Nersessian, CFA and Research Assistant Anh Pham, was originally published in the August 2, 2017 HMA Weekly Roundup.

In deference to Miracle Max, after last week’s failed votes on “Repeal and Replace,” “Straight Repeal,” and “Skinny Repeal,” the GOP’s efforts to undo the Affordable Care Act (ACA) through budget reconciliation appear to be at least “mostly dead.” While it is possible strictly partisan discussions will reaccelerate at some point, it appears that Congress is, for the first time, considering bipartisan proposals for shoring up the underwriting challenges in the individual market. In light of this change in direction, we are using this week’s In Focus section to chronicle the events that transpired over the last five months leading to last week’s historic vote. Our objective here is to create a reference piece for our readers so that the next time Congress revisits major healthcare legislation we can look back on the strategies and approaches that led to last week’s result. Many times over the last eight months, we have reflected on the key dynamics surrounding the passage of the ACA in 2010 as a guide for what factors to watch in the efforts to repeal the ACA – budget reconciliation issues, Congressional Budget Office (CBO) scoring, key proposals to win over recalcitrant legislators, the President’s role in pushing the agenda – but our memories were not always up to the task. So in the spirit of having a reference document for future reflection, we record below the key events associated with this effort.

HMA Principal to Speak about Role Public Health Plays in Implementing Retail Marijuana Legalization at National Cannabis Summit

The 2017 National Cannabis Summit will feature the workshop, Implementing Retail Marijuana Legalization: Public Health’s Role in Implementation of Prevention and Education Efforts Following Legalization of Retail Marijuana. During this workshop, HMA Principal Shannon Breitzman will share her unique expertise on how state agencies begin the complex implementation process of regulatory and programmatic needs after retail marijuana is legalized.

Virginia Releases Medallion 4.0 Medicaid Managed Care RFP

This week, our In Focus section reviews the request for proposals (RFP) issued by the Virginia Department of Medical Assistance Services (DMAS) for the Medallion 4.0 Medicaid managed care program. Medallion 4.0 will serve roughly 740,000 children, including those with special health care needs, families, and individuals in foster care and adoption assistance programs, with annual Medicaid managed care spending of more than $3 billion when fully implemented by the end of 2018. Proposals are due to DMAS on September 8, 2017.

Quarterly Medicaid Managed Care Enrollment Update – Q2 2017

This In Focus article was originally published in the July 12, 2017 HMA Weekly Roundup.

This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states.[1] Many state Medicaid agencies elect to 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. Nearly all 27 states have released monthly Medicaid managed care enrollment data through the second quarter (Q2) of 2017. This report reflects the most recent data posted.

Highlights from NASBO Spring 2017 Fiscal Survey of States

This In Focus article was originally published in the June 21, 2017 HMA Weekly Roundup.

This week, our In Focus section highlights some of the key findings of the Fiscal Survey of the States Spring 2017, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget officers in all 50 states in February through April 2017. The findings in the report focus on the key determinants of state fiscal health, highlighting data and state-by-state budget actions by area of spending. Below we summarize the major takeaway points from the report, as well as highlight key findings on Medicaid-specific and other health care budget items.

Register Now: 30-plus Speakers Slated for HMA Conference

The Future of Medicaid is Here: Implications for Payers, Providers and States is a two-day event organized by Health Management Associates (HMA). Confirmed speakers include industry executives from Medicaid plans across the nation as well as Medicaid directors from California, Florida, Kansas, Hawaii, Michigan, Tennessee, Texas, and Washington.

It Takes a Community to Divert Populations with Behavioral Health Needs from Jail

This blog post was authored by HMA Principal Bren Manaugh, LCSW-S, CPHQ and Senior Consultant Laquisha Grant, MPA.

We have all seen the headlines about jails and prisons becoming the largest de facto mental healthcare providers in the country. Nationally, 14 to 17 percent of inmates have a serious mental illness, 53 to 68 percent have a substance use disorder^[1], and up to 72 percent of jail inmates have both a mental illness and substance use disorder. The overrepresentation of individuals with mental illness and substance use disorder did not happen overnight — and it is not a result of one system or issue.

Texas Budget and Health Care Legislation Summary – 2017

This week, our In Focus section comes to us from HMA Principal Dianne Longley, of our Austin, Texas, office. Dianne provides an update on and summary of the Texas Legislature’s adoption of a state fiscal year (SFY) 2018-2019 budget, as well as a review of health care legislation passed by the Legislature this session.

HMA Conference to Feature Insights from Health Plan CEOs, State Medicaid Directors

Dates: September 11-12, 2017
Location: Renaissance Chicago Downtown Hotel

Waivers, block grants and per capita caps, member premiums and copays, health savings accounts, expansion, and new benefit design and funding models will take center stage as 35 speakers from leading health plans, states and providers join Health Management Associates for the high-level, two-day conference The Future of Medicaid is Here: Implications for Payers, Providers and States.

HMA’s Raney, Lasky Edit Book that Serves as Guide for Implementing Integrated Care

Integrated Care: A Guide for Effective Implementation is co-edited by HMA’s Lori Raney, MD and Gina Lasky, PhD, MAPL and Collaborative Care Consulting’s Clare Scott, LCSW. The book provides a detailed, thoughtful, and experience-based guide to effective implementation of integrated behavioral healthcare. Using evidence and on the ground experience, the authors share practical and actionable advice for a complex model of care.

States Receive More Time to Bring HCBS Settings into Compliance

Here is an update on The Centers for Medicare & Medicaid Services (CMS) extending the timeline for states to comply with a 2014 rule defining the settings for Medicaid home and community-based services (HCBS). On May 9, 2017, the CMS Center for Medicaid and CHIP Services issued an Informational Bulletin extending the deadline for states to demonstrate compliance with the settings criteria by three years, to March 17, 2022. It does not extend the deadline for final CMS approval of Statewide Transition Plans, which must still be approved by March 17, 2019. The bulletin makes no changes to the underlying rule, nor indicates plans to do so.

Depression Mapping and “Hot-Spotting” Reveals Potential Best Practices

This topic comes to us from HMA’s Anissa Lambertino, PhD, of our Chicago office, and Lori Raney, MD, of our Denver office, and Sarah Arvey, PhD, of our Austin office. May is Mental Health Month, and the first week in May is recognized as National Anxiety and Depression Awareness week. Anissa, Lori, and Sarah’s work, highlighted below, utilized geospatial mapping of prevalence of depression among Medicaid beneficiaries and treatment with FQHC locations in rural southeastern Ohio, revealing potential best practices.

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