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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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Brief & Report

Case study examines Georgia’s experience unbundling LARC payments from Medicaid prospective payment system

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A new case study prepared by colleagues from Health Management Associates (HMA) analyzes the Georgia Medicaid program’s experience with unbundling long-acting, reversible contraception (LARC) devices and services from the Medicaid prospective payment system (PPS) for reimbursement in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).

HMA examined Medicaid claims data from 2012-2019 as well as conducted key interviews to understand whether the unbundling reimbursement policy change could have increased LARC utilization and provided analysis for policymakers and stakeholders in other states pursuing similar strategies and programs.

Additional findings and the full report are available here.

HMA’s research was supported by Medicines360 and Waxman Strategies with support from Arnold Ventures. The HMA team included Rebecca Kellenberg, Diana Rodin, and Jim McEvoy.

Blog

New Jersey Shares its Five-Year Vision for the Latest 1115 Waiver Renewal Draft

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This week, our In Focus reviews the the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) draft proposal for the renewal of its 1115 Comprehensive Demonstration Waiver, released on September 10, 2021. The waiver was initially approved and implemented in October 2012. This demonstration is in its second five-year period and is slated to expire on June 30, 2022.

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Blog

Texas Releases STAR Health Draft RFP; Seeks Public Input on STAR+PLUS, STAR Kids ACO

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This week, our In Focus reviews the Texas Health and Human Services Commission (HHSC) draft request for proposals (RFP) for Texas STAR Health, the state’s Medicaid managed care program for foster care kids. The state is also seeking public input for the STAR+PLUS and STAR Kids Accountable Care Organization (ACO) programs, in anticipation of the reprocurement of these Medicaid managed care programs.

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Blog

HMA Launches Novel Project ECHO for MOUD in County Jails

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Aimed at shifting and improving the delivery of addiction treatment within county jails, Health Management Associates (HMA) will partner with the Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA) and Fairfax County Sheriff’s Office to deliver a novel Project ECHO clinic. Funded by W/B HIDTA to support county jails in their region, the Medication for Opioid Use Disorder (MOUD) in County Jails ECHO Clinic will provide participants with HMA training specifically focused on initiating or expanding the use of MOUD within their facilities. The project will broaden county knowledge and understanding of MOUD and its place in the criminal justice system, increase the use of MOUD with evidence-based and emerging promising practices, and promote a culture that supports MOUD in jails.

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Brief & Report

HMA colleagues conduct environmental scan of NEMT benefit to Medicaid enrollees

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As part of a larger Medicaid and CHIP Payment and Access Commission (MACPAC) study on Medicaid non-emergency medical transportation (NEMT) in response to a request from the Senate Appropriations Committee, a team of HMA colleagues conducted a 50-state environmental scan of NEMT programs and stakeholder interviews to better understand approaches and trends in the provision of the NEMT benefit to Medicaid enrollees across the United States.

The culminating report included NEMT trends, challenges, and innovations drawn from the scan of programs and interviews with stakeholders including federal officials, Medicaid officials from six study states, NEMT brokers and providers, managed care companies, beneficiary advocates, and subject matter experts.

The key findings are outlined in the report and include information about:

  • NEMT populations and utilization
  • Various modes of transportation
  • NEMT delivery system model variations, advantages, and challenges
  • NEMT complaints, performance issues, and innovation
  • Performance improvement, oversight, and program integrity
  • Transportation network challenges and increasing role of transportation network companies
  • Coordination across federally assisted transportation services
  • Stakeholders’ view on the value and role of NEMT

In December 2020, following the completion of the interviews for this study, Congress added a requirement to the federal statute requiring states to provide NEMT to Medicaid beneficiaries who have no other means of transportation to medically necessary healthcare services.

The HMA team included Principals Sharon Silow-Carroll, MSW, MBA and Kathy Gifford, JD, Senior Consultant Carrie Rosenzweig, MPP, Consultants Anh Pham and Julie George, JD as well as retired Managing Principal Kathy Ryland.

The research underlying this report was completed with support from the Medicaid and CHIP Payment and Access Commission (MACPAC). The findings, statements, and views expressed are those of the authors and do not necessarily represent those of MACPAC.

Blog

Arizona Releases Competitive Contract Expansion (CCE) RFP

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This week, our In Focus section reviews the Arizona Health Care Cost Containment System (AHCCCS) Competitive Contract Expansion (CCE) request for proposals (RFP), released on August 4, 2021. The procurement will expand the current AHCCCS Complete Care (ACC) Medicaid contracts to include responsibilities as an ACC Contractor (health plan) with a Regional Behavioral Health Agreement (ACC-RBHA).  At least one incumbent Medicaid ACC Contractor will be selected in each of the state’s three Geographic Service Areas (GSAs).  The responsibilities will include management of:

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