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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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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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Webinar

Webinar Replay: Federal COVID-19 Response: Medicare Advantage Policy Changes and Impacts

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This webinar was held on June 11, 2020.

In response to the rapid spread of the COVID-19 virus, Congress and the Centers for Medicare & Medicaid Services (CMS) have made significant policy changes to Medicare Advantage regulations, allowing for expanded benefits and other flexibilities designed to better serve the Medicare population.

During this webinar, HMA experts addressed the impact of these changes, including a look at policies affecting cost sharing, telehealth, Star Ratings, prescription drugs, provider funding, appeals, and Special Needs Plans (SNP). Speakers also addressed the likelihood that these policies remain in place even after the COVID-19 emergency ends.

Learning Objectives: 

  • Learn about changes in federal Medicare Advantage policies in response to COVID-19.
  • Understand how Medicare Advantage plans, including Special Needs Plans, are adjusting to the new rules, including the impact on benefit design, care delivery, payment models, and quality.
  • Identify operational implications of Medicare Advantage policy changes to ensure continued delivery of high-quality care to beneficiaries.

HMA Speakers:

  • Julie Faulhaber, MBA, Principal, Chicago
  • Mary Hsieh, PharmD, MPH, Managing Principal, Atlanta
  • Narda Ipakchi, MBA, Senior Consultant, Washington, DC
  • Sarah Owens, Principal, Philadelphia
  • Danielle Pavliv, MPH, PMP, Senior Consultant, Atlanta
Webinar

Webinar Replay: Tracking State Responses to COVID-19 for Home Health and Home Care Providers: Survey Results and Provider Perspectives

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This webinar was held on June 9, 2020. 

With most federal COVID-19 funding going to hospitals and nursing homes, states are implementing various Medicaid authorities, legislation, and policies of their own to improve access to long-term services and supports, including home and community-based services. HMA home care experts have tracked these state efforts and presented the results during this informational session. They were joined by home health and home care industry leaders, who offered important perspectives on state actions as well as thoughts on additional steps that will be necessary over the long term.

Learning Objectives:

  • Understand state COVID-19 legislation, executive orders, and policy guidance and how it affects home health and home care providers.
  • Gain perspective from home health and home care providers on how state COVID-19 efforts are playing out.
  • Understand the immediate and long-term challenges and opportunities home health and home care providers are likely to face as they respond to COVID-19.

Speakers

Karen Brodsky, Principal, HMA
Pat Kelleher, Executive Director, Home Care Alliance of Massachusetts
Linda Mintz, Co-Chair, CareFinders Total Care
Susan Tucker, Principal, HMA

Blog

Medicare FY 2021 Hospital Inpatient Proposed Rule, Federal Flexibilities for COVID-19

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This week, our In Focus section reviews recent announcements and actions by Congress and the Centers for Medicare & Medicaid Services (CMS) that have significant financial and operational implications for the hospital industry. This brief begins with the most recent of these actions by providing a summary of the key provisions of the CMS Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (CMS-1735-P), which includes Medicare payment updates and policy changes for the upcoming FY, with a comment deadline of July 10, 2020.  Although somewhat limited in scope compared to previous proposals, this year’s proposed rule includes several disruptive proposals that the hospital industry should carefully consider.

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Webinar

Webinar Replay: Supporting the Behavioral Health Workforce During the COVID-19 Response: Strategies for Providers to Sustain and Strengthen the Behavioral Health System

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This webinar was held on May 18, 2020.

Even as behavioral health providers work tirelessly to respond to COVID-19, the most forward-looking organizations also recognize that the pandemic has laid bare the need to develop a wide variety of short- and long-term solutions to ongoing and emergent needs. The most pressing of these needs concern strategies to support and strengthen the behavioral health system workforce.

During this webinar, HMA experts showed how leading behavioral health providers are using new regulatory flexibilities, emerging staffing models, and new delivery formats to develop and implement organizational changes and innovations that sustain workforce excellence.

Learning Objectives:

  • Hear how behavioral health providers around the country are supporting their workforce and continuing to meet ongoing and emergent behavioral health needs.
  • Learn how collaborative efforts among states and providers can lead to meaningful changes in rules, roles, tools, and approaches to delivering behavioral healthcare.
  • Obtain cross-cutting strategies for management and leadership during a crisis.
  • Find out how to ensure organizational structures are in place to help staff adjust to change, foster resilience, and provide bereavement support when appropriate.
  • Understand the available resources and emerging practices for workforce support, including training, technology, and strategies for enhancing the ability of the behavioral health workforce to meet the needs of special populations.

HMA Speakers

Barry Jacobs, PsyD, Principal, Philadelphia, Pennsylvania
Gina Lasky, PsyD, Principal, Denver, Colorado
Shannon Mong, PsyD, Principal, San Francisco, California
Lori Raney, MD, Principal, Denver, Colorado
Meggan Schilkie, MBA, Managing Principal, New York
Tim Sheehan, MSW, Principal, Chicago, Illinois

Brief & Report

HMA report examines COVID-19 toll on Pennsylvania hospitals

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A report completed by HMA colleagues estimated the potential financial impact on hospitals and health systems of the current COVID-19 pandemic in the Commonwealth of Pennsylvania.

The analysis, completed in mid-April, concluded that Pennsylvania hospitals and health systems are likely to experience losses in excess of $7 billion for the final 10 months of 2020 after accounting for federal disaster relief payments, based on emergency relief legislation that had been passed at the time. HMA Principal Tom Marks and Senior Consultant Mary Goddeeris completed the report, Analysis of the Financial Impact of COVID-19 on Pennsylvania Hospitals, on behalf of the Hospital and Healthsystem Association of Pennsylvania (HAP). HMA conducted interviews and collected data from finance officials at a sample of health systems and projected the findings across the population of Pennsylvania hospitals and health systems. The interviews and analysis were completed in mid-April, well before the full effect of the pandemic could be measured. Financial leaders consistently reported enormous declines in patient service from mid-March to mid-April due to the cancellation and deferral of non-emergency services. While there are varying assumptions about the return of pre-pandemic patient service volumes, all leaders projected a bleak forecast for the second quarter and continued negative impact of service disruption for the rest of 2020.

Learn more about HMA’s multi-faceted COVID-19 response.

Webinar

Webinar Replay: Health Equity and Enlightened Leadership in the Shadows of COVID-19: A Conversation with Jay Bhatt, D.O.

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This webinar was held on April 30, 2020.

True health system innovation and transformation requires the type of enlightened leadership that understands the nature and role of health equity and social justice. That’s especially true in the shadows of COVID-19, when disparities are heightened, and a strong vision is needed to progress toward the elimination of health inequities.

During this webinar, Jay Bhatt, D.O., a practicing internist and past chief medical officer of the American Hospital Association, engaged in a spirited conversation with HMA health system transformation and leadership expert Jeffrey Ring about the role of strong leadership in health system transformation and healthcare justice.

 Learning Objectives

  • Explore the concept of health equity, including a look at how inequities are heightened in the era of COVID-19.
  • Understand the concept of enlightened leadership and its role in achieving optimal healthcare delivery.
  • Gain insight into how the fallout from COVID-19 will impact our understanding of healthcare justice.

Speakers

Jay Bhatt, D.O., practicing internist; Past SVP, and Chief Medical Officer, American Hospital Association; Past President, Health Research and Educational Trust
Jeffrey Ring, PhD, Principal and Health Psychologist, Health Management Associates

Blog

COVID-19 Education, Contact Tracing, and Care Connections: Community Health Workers Can Be Activated for Sustainable Public Health Response to Local Needs

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As reported by the New York Times (An Army of Virus Tracers Takes Shape in Massachusetts, April 17), Massachusetts has hired 1,000 public health contact tracers to speed containment of COVID-19 during its surge in infections. Contact tracers are reaching out to those who have tested positive, providing information, and talking them through their recent movements and connections, using cell phones and triangulation data. They then, in turn, reach out to inform and educate those contacts.

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Blog

Medicare and Medicaid Telehealth Coverage in Response to COVID-19

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Telehealth service expansions by Medicare and most Medicaid programs aim to rapidly increase access to care and reduce transmission, but also provide a natural experiment for policymakers.

This week, our In Focus section examines the extensive scope of flexibilities Federal and State governments have made to Medicare and Medicaid telehealth coverage in response to the COVID-19 national emergency. In March and April 2020, federal and state policymakers responded to the COVID-19 emergency by temporarily and aggressively expanding the definition of and reimbursement for telehealth services—moves intended to improve access to care and reduce virus transmission. Under the Medicare and Medicaid programs, these temporary expansions have been rapid and historic in scope, and will have substantial implications for patients, providers, payers, and federal/state financing. For policymakers, this temporary expansion may serve as a natural experiment for assessing which forms of telehealth services successfully expand access to care and should become permanent healthcare policy.

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Webinar

Webinar Replay: Reflecting on HCBS Policies and Practices in Response to COVID-19

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This webinar was held on April 17, 2020.

Medicaid-covered home and community-based services (HCBS) are critical to the health and well-being of millions of individuals with intellectual or developmental disabilities, physical disabilities, and/or behavioral health conditions.

In response to COVID-19, the Centers for Medicare and Medicaid Services (CMS) has provided state Medicaid programs with increased flexibility to modify HCBS programs to continue to provide timely high-quality care. State Medicaid programs have secured approval for new initiatives through a combination of Section 1135 Waivers, 1115 Emergency Amendments, Emergency State Plan Amendments, and Appendix K amendments to HCBS 1915(c) waivers.

During this webinar, our HMA experts outlined what these changes mean for states, providers, and individuals who rely on HCBS. Speakers provided an overview of key flexibilities, offered examples of promising practices, and shared insights about the present and the future of HCBS as reshaped by COVID-19.

Learning Objectives 

  • Learn how state Medicaid programs have used CMS-approved waivers and amendments to temporarily modify HCBS policies and practices to protect people during the COVID-19 pandemic.
  • Understand how new HCBS flexibilities impact HCBS providers on-the-ground.
  • Understand what these changes mean for individuals who receive services and supports.
  • Learn more about how the pandemic may be changing the future of HCBS.

HMA Speakers

Sarah Barth, JD, Principal, New York, NY
Ellen Breslin, MPP, Principal, Boston, MA
Sharon Lewis, Principal, Portland, OR
Susan Tucker, CPA, Tallahassee, FL