Insights

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.

Quarterly Medicaid Managed Care Enrollment Update – Q1 2017

This week, we reviewed recent Medicaid enrollment trends in capitated, risk-based managed care in 25 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 25 states have released monthly Medicaid managed care enrollment data through the first quarter (Q1) of 2017. This report reflects the most recent data posted.

Alabama, Ohio Provide Details on Medicaid MLTSS Program Designs

This week, we reviewed two proposed statewide Medicaid managed long-term services and supports (MLTSS) program designs. Alabama is currently accepting public comments on a plan to implement provider-driven Integrated Care Networks (ICNs) to provide MLTSS statewide to roughly 25,000 beneficiaries who are residing in nursing facilities or receiving home and community based services (HCBS) through three of the state’s Medicaid HCBS waiver programs. Meanwhile, Ohio Governor John Kasich proposed in his upcoming state budget to implement a statewide MLTSS program for more than 100,000 beneficiaries in the state. We review both states’ plans for MLTSS, including market sizes, implementation timing, and existing Medicaid managed care plans in the states.

Relationship-Centered Care: Empathy and Healing

This blog post was authored by HMA clinicians
Margaret Kirkegaard, MD, MPH, and Jeffrey Ring, PhD.

Patient: I am anxious about my results, Doctor.

Doctor: Let’s take a look … Yes, you do indeed have cancer. I will refer you to the surgeon for an evaluation as fast as possible. You must have questions.

Patient: (Silent, in shock)

Doctor: OK, well hang out here for a few minutes, and our medical assistant will bring you contact information for the surgeon. We are backed up with patients today, so this may take a short while.

This brief exchange illustrates missed opportunities for healthcare clinicians to provide empathic relationship-centered care.

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