This week, our In Focus section reviews the bill put forward last week by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) to repeal and replace the Affordable Care Act (ACA). General consensus, the HMA Roundup included, viewed ACA repeal-and-replace efforts as largely defeated at the end of July, with the Senate’s failure to pass the Better Care Reconciliation Act. There is, however, an emerging view, which was shared by several speakers at last week’s HMA conference, that the Graham-Cassidy bill has a real chance of passing the Senate ahead of the September 30 deadline, at which point the reconciliation process expires and a bill would require 60 votes to pass the Senate. Below, we highlight key provisions of the Graham-Cassidy bill that impact federal funding to states, state Medicaid programs, and the Exchange and individual insurance markets, including both a block grant program targeted at higher-income and Medicaid expansion populations and a Medicaid per capita cap funding structure.
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Highlights from HMA Conference on Future of Medicaid
Last week, our In Focus section provided a recap of the second annual HMA Conference, The Future of Medicaid is Here: Implications for Payers, Providers, and States, held Monday, September 11, and Tuesday, September 12, in Chicago, Illinois. More than 300 leading executives from health plans, providers, state and federal government, community-based organizations, and others in the health care field gathered to address the challenges and opportunities for organizations serving Medicaid and other vulnerable populations given the priorities of the new Administration and Congress.
New Mexico Issues Centennial Care 2.0 Medicaid Managed Care RFP
This week, our In Focus section reviews the request for proposals (RFP) released by the New Mexico Human Services Department (HSD) to reprocure contracts for the state’s Medicaid managed care program in its second phase, Centennial Care 2.0. Centennial Care provides integrated Medicaid managed care coverage, including long-term services and supports (LTSS) and behavioral health, to nearly 700,000 Medicaid beneficiaries in the state, with annual spending of roughly $4.5 billion.
Medicaid and Exchange Enrollment Update – May 2017
This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “May 2017 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on July 21, 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 in the first half of 2017, representing nearly 75 million Medicaid and CHIP enrollees and more than 12 million Exchange enrollees.
North Carolina Outlines Proposed Design for Medicaid Managed Care
This week, our In Focus section reviews “North Carolina’s Proposed Program Design for Medicaid Managed Care,” a draft proposal published this week for public comment, which provides a detailed overview of the planned statewide Medicaid managed care program to be launched in 2019. By 2023, North Carolina estimates it will have transitioned roughly 1.8 million Medicaid beneficiaries in the state to managed care. North Carolina’s Department of Health and Human Services (DHHS) is encouraging public comment on the program design proposal through September 8, 2017, ahead of a planned request for information (RFI) release later this year.
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.