This week our In Focus section reviews the Delaware request for proposals (RFP) for Diamond State Health Plan (DSHP) and Diamond State Health Plan Plus (DSHP Plus), the state’s Medicaid managed care programs. The RFP was released by the Delaware Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) on December 15, 2021.
1804 Results found.
Second behavioral health issue brief focuses on workforce crisis and call for immediate action
The National Council for Mental Wellbeing (National Council) and HMA have released the second in the series of three issue briefs examining the ongoing, and exacerbated, workforce and staffing crisis facing behavioral health services providers and facilities.
The brief, Immediate Policy Actions to Address the National Workforce Shortage and Improve Care, focuses on clinical transformation and provides short-term recommendations to support states in addressing the workforce shortages, provider burn-out, recruitment and retention.
Recommendations include:
- Adopting transformative clinical approaches and team-based care
- Identifying short-term actions and developing long-term strategies for improvement
- Expanding the workforce to build a more robust provider pipeline
- Increase adoption of in-person/telehealth hybrid models
HMA and the National Council colleagues contributed to the briefs and surrounding research.
Webinar Replay: Comparing Medicaid program delivery models on quality outcomes
This webinar was held on February 15, 2022.
In 2020, state and federal government spending on Medicaid was $646 billion, with just over half going to Medicaid managed care programs and the rest to fee-for-service (FFS), primary care case management (PCCM), and other models. Despite the large investments, little evidence exists on differences in quality between the various models. Using the 2019 CMS Adult and Child Core Set Quality Measures, HMA normalized performance data across states to compare outcomes between managed care, FFS and PCCM. During this webinar, HMA consultants discussed the findings, which were published in an HMA white paper in November 2021.
Learning Objectives:
- Understand how the different Medicaid delivery models performed on quality measures from the 2019 Adult and Child Core Set.
- Learn more about the Adult and Child Quality Measure Core Set and why the 2019 dataset provides one of the first opportunities to make valid comparisons between the Medicaid delivery models.
- Find out how this research could be expanded upon in the future to assess the key factors that drive higher quality and better performance in population health for low-income individuals.
- Explore the broader implications of this research for policymakers and state Medicaid officials.
HMA Speakers
Anthony Davis, Managing Director, Quality and Accreditation Services, Portland, OR
David Wedemeyer, Principal, Los Angeles, CA
Joe Moser, Principal, Indianapolis, IN
Beth Kidder, Managing Principal, Tallahassee, FL
Minnesota Releases Medicaid Medical Assistance, MinnesotaCare RFP Covering 80 Counties Outside Twin Cities
This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of the Twin Cities seven-county region. The RFP was released by Minnesota Department of Human Services, Purchasing and Service Delivery Division on January 18, 2022. Contracts will begin January 1, 2023, covering approximately 470,000 members.
CMS Seeks New Direction for Medicare Advantage and Part D Markets on Health Equity, Dual Eligible Integration
This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, and market dynamics for future years. The analysis and insight reflect the combined expertise of HMA and its companies including the Wakely Consulting Group and The Moran Company.
Federal guidance provides clarity on the opportunity to include mobile crisis intervention services
HMA Federal Policy Principal Andrea Maresca, Managing Principal Gina Eckart, Principal John Volpe, and Senior Consultant Suzanne Rabideau weigh in on the recent changes and HMA experience in crisis intervention services.
CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings
This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Authored by Suzanna-Grace Sayre and Dani Cronick and published January 2022, this paper outlines the CMS modifications to the 2022 Star Ratings due to COVID-19, quantifies the estimated impact on 2023 MA spending, and discusses how these changes could influence the MA market in 2023.