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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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1426 Results found.

Blog

GAO 50-State Medicaid Survey on Federal Policy Challenges

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This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia to identify challenges related to federal Medicaid policies.  

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Webinar

Webinar Replay: Nursing Home Revenue Diversification and Care Options Series: Exploring Medicare Advantage as an Alternative Revenue Source for Post-Acute Providers

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This webinar was held on July 17, 2020.

Even before COVID-19, post-acute providers such as nursing homes struggled with inadequate reimbursement rates and declining occupancy rates. This, along with additional stressors brought on by the pandemic, has led many nursing homes to consider revenue diversification and service expansion strategies. During this webinar (the first in a series), HMA Medicare Advantage and long-term care experts addressed two such options for nursing homes: Medicare Advantage Institutional Special Needs Plans (I-SNP) and Institutional-Equivalent Special Needs Plans (IE-SNP).

Learning Objectives

  • Understand Medicare Advantage, its significance and its growth
  • Identify types of Medicare Advantage options for residents and community-based beneficiaries
  • Explore how Medicare Advantage can serve as a potential revenue diversification strategy
  • Learn about the benefits and risks of   Medicare Advantage, in particular for I-SNPs
  • Identify how to assess if an I-SNP or an IE-SNP is the right opportunity for your organization

HMA Speakers

Mary Hsieh, Managing Principal, Atlanta, GA
Susan Tucker, Principal, Tallahassee, FL

Blog

CMS Medicare Advantage and Section 1876 Cost Plan Network Adequacy Update

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This week, our In Focus section examines new guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Advantage (MA) plan network adequacy requirements. On June 17, 2020, CMS released updated Medicare Advantage and 1876 Cost Plan Network Adequacy Guidance for Medicare Advantage (MA) health plans to use now for Contract Year 2021 network submission. 

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Webinar

Webinar Replay: HMA Community Health Worker Webinar Series Part 1: Health and Human Services Workforce Needs in the Context of COVID-19

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This webinar was held on June 30, 2020.

In the midst of the COVID-19 pandemic, state and local governments and safety net providers are faced with a clear indication of disparities in population health outcomes and looming budgetary challenges across the nation. These entities are committed to their residents and are looking for creative strategies to mitigate health risks and deliver responsive health and human services despite budgetary challenges. As such, the role of the community health worker or the navigator rises to the top. Engaging and integrating trusted community health workers and other paraprofessionals is a promising, cost-effective and trust-building practice that can support the seamless dissemination of these essential services in these unprecedented times.

This webinar was the first in HMA’s Community Health Worker Series. During this webinar, HMA experts put forth a value proposition for the timely engagement and integration of community health workers/navigators/peer support specialists in the delivery of health and human services. Presenters provided several compelling case studies and three successful implementation models for integrating paraprofessionals into the delivery system. Participants learned how community health workers are poised to support the unique needs of residents in urban, suburban, rural, and public health and human services settings. Finally, respondents reflected on the paraprofessional role from a social determinants of health standpoint and from the perspective of minority populations and their communities.

Learning Objectives: 

  • Understand the role community health workers and other paraprofessionals can play in the health and human services workforce in the COVID-19 era.
  • Learn how select states explored the certification, education, financing and roles of community health workers and other paraprofessionals when integrated into specific health and human services.
  • Find out how to build trust in minority communities, incorporating social determinants of health in the COVID-19 recovery response at the crossroads of health disparities and racial inequities.

HMA Speakers

Uma Ahluwalia, Principal, Washington, DC
Heidi Arthur, Principal, New York, NY
Stephanie Denning, Principal, Denver, CO
Julia Elitzer, Senior Consultant, San Francisco, CA
Iliana Gilman, Principal, Austin, TX
Catherine Guerrero, Principal, Denver, CO
Lori Weiselberg, Managing Principal, Chicago, IL

Reference Materials:

The National Academy of State Health Policy (NASHP) has a great website of state CHW models:  https://www.nashp.org/state-community-health-worker-models/

The Association of State and Territorial Health Officials (ASTHO) features tools and information about CHWs at: https://www.astho.org/Community-Health-Workers/

There is also a helpful image describing the ever-changing picture of state approaches to CHW certification as well: https://www.astho.org/Programs/Clinical-to-Community-Connections/Documents/Map-of-State-Approaches-to-CHW-Certification/

Multnomah County training: https://multco.us/health/community-health/community-health-worker-training

SAMHSA has great resources: https://www.samhsa.gov/brss-tacs/recovery-support-tools/youth-young-adults

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703286/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343233/

The VT interview is the March 4, 2020 podcast.  https://www.aha.org/advocacy/small-or-rural/rural-report-podcast-series

Brief & Report

Inland Empire Health Plan releases health homes program year one implementation report

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A new report has been released outlining Inland Empire Health Plan’s (IEHP) efforts to establish 50 care teams to support the delivery of core Health Homes Program services for IEHP’s most vulnerable members with complex health conditions.

HMA contributed to the new report and has supported implementation of IEHP’s Health Homes Program since 2018, providing consultation in the development and implementation of a clinical model of care, the design and deployment of a population health management tool, the creation and delivery of a multi-modal training program, and the provision of practice coaching to over 50 care teams.

HMA colleagues Liz Arjun, Marc Avery, Emily Brandenfels, Leslie Brooks, Nancy Jaeckels Kamp, and Jeffrey Ring contribute to this project, which is led by Betsy Jones. Former HMA colleagues Lynn Dierker and Michael Mabanglo also contributed.

Blog

Inland Empire Health Plan Releases Health Homes Program Year One Implementation Report

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A new report has been released outlining Inland Empire Health Plan’s (IEHP) efforts to establish 50 care teams to support the delivery of core Health Homes Program services for IEHP’s most vulnerable members with complex health conditions.

HMA contributed to the new report and has supported implementation of IEHP’s Health Homes Program since 2018, providing consultation in the development and implementation of a clinical model of care, the design and deployment of a population health management tool, the creation and delivery of a multi-modal training program, and the provision of practice coaching to over 50 care teams.

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Blog

Impact of COVID-19 Federal Policy on Medicare Advantage

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This week, our In Focus section examines the operational impacts of federal Medicare Advantage policy changes in response to the COVID-19 pandemic. On January 31, 2020, the Secretary of Health and Human Services declared a public health emergency. This was followed by a national emergency declared by President Trump on March 13, 2020. These declarations provide the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) authority to waive certain Medicare and Medicaid regulatory requirements to help health plans, providers, and other stakeholders respond to immediate needs of their members and communities. These waiver flexibilities, when combined with other legislative and regulatory changes issued by Congress and CMS have resulted in over 200 policy changes to Medicare alone. Many of these affect Medicare Advantage sponsors and have direct implications to current and future operations of plan responsibilities. We examine eight categories of requirements and flexibilities that have significant business relevance and exposure for Medicare Advantage plan sponsors:

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