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HMA Insights: Your source for healthcare news, ideas and analysis.

HMA Insights – including our new podcast – 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 podcast, blogs, webinars, case studies, reports and more.

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Webinar

Webinar Replay: The Growing Role of Business Intelligence and Information Technology in State Medicaid Population Health Management Programs

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This webinar was held on August 5, 2021. 

State Medicaid agencies (SMAs) are increasingly relying on business intelligence platforms and other information technology (IT) solutions to provide the type of robust analytics needed for successful population health management programs. During this webinar, experts from Health Management Associates (HMA) and Cerner discussed the business intelligence and related IT needs of SMAs specific to population health management, based in part on the results of a recent, proprietary survey of SMAs.  Speakers also discussed how modern IT solutions can be leveraged to address these needs, especially in a world in which modularity and interoperability are king.

Learning Objectives

  • Understand the major SMA drivers of IT investments in support of population health management goals and programs, including the need to better manage cost and improve outcomes among high acuity beneficiaries.
  • Identify common gaps in information technology and business intelligence capabilities at SMAs which can impact the success of population health management initiatives.
  • Find out how business intelligence platforms and information technology solutions can promote interstate and intrastate collaboration on population health management programs, including enterprise initiatives across Medicaid agencies and health and human services agencies.
  • Gain insights into the evolution of population health management analytics, business intelligence platforms, and IT solutions that promote modularity and interoperability.

Speakers

Jake Engle, Senior Director, State Government, Cerner
Nathan Gray, Senior Manager, Information System Architecture, Cerner
Juan Montanez, Managing Director, IT Advisory Services, Health Management Associates

Blog

HMA Prepares Issue Briefs Exploring MLTSS Impacts on State Medicaid Programs

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This week, our In Focus section highlights a recent pair of reports prepared for Arizona for Better Medicaid. HMA colleagues examined the impact of managed long-term services and supports (MLTSS) in state Medicaid programs. The first report, Growth in MLTSS and Impacts on Community-Based Care, examines the historical increase in the adoption of LTSS by state Medicaid programs and how that has contributed to a shift in long-term care from institutions to the community. The second report, Managed LTSS Improves Quality of Care, describes the evidence on the impact of managed LTSS in state Medicaid programs on the quality of care.

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Brief & Report

HMA briefs on Medicare-Medicaid integration

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This issue brief from Health Management Associates, Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals is part of a multi-phased research initiative to increase enrollment in integrated care programs (ICPs)[1] that meet full benefit dually eligible individuals’[2] needs and preferences. Dually eligible individuals have a range of chronic conditions and disabilities requiring both Medicare and Medicaid services, which makes integrated programs important to their lives.

For a succinct overview of the essential elements and policy recommendations, please access the brief fact sheet. For a full discussion of the elements and policy recommendations, please access the full brief.

The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Narda Ipakchi.[3]

For further information or questions, contact Sarah Barth at [email protected], Ellen Breslin at [email protected], or Samantha DiPaola at [email protected].

[1] Integrated Care Programs (ICPs): For this research, we defined ICPs as financing and care delivery organizing entities or programs that coordinate and integrate Medicare and Medicaid-covered services and supports for dually eligible individuals.They include the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative (FAI) capitated and fee-for-service models; the Program of All-Inclusive Care for the Elderly (PACE); Medicare Advantage (MA) Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs); Medicaid Managed Long-Term Service and Supports Program (MLTSS) managed care organizations and aligned MA dual eligible special needs plans (D-SNPs); and state-specific programs that may be proposed to CMS.

[2] Dually Eligible Individuals: When using the term dually eligible individuals, we are referencing Medicare-Medicaid full benefit dually eligible individuals (FBDEs), those who qualify for full Medicaid benefits.

[3] Narda Ipakchi was formerly a Senior Consultant with HMA.

Blog

Vermont Proposes Risk-Bearing, State-Run Medicaid Managed Care Entity

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This week our In Focus section reviews Vermont’s Global Commitment to Health Section 1115 waiver renewal application. In the proposed five-year demonstration extension, Vermont seeks to move the Medicaid population to a new a risk-bearing public, state-run managed care organization (MCO). Under the arrangement, the Department of Vermont Health Access (DVHA) would transition into the new entity and accept capitated risk for the state’s Medicaid population, covering physical and mental health, pharmacy services, substance use disorder (SUD) services, and long-term services and supports (LTSS) beginning January 1, 2022.

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Brief & Report

HMA prepared issue briefs explore MLTSS impacts on state Medicaid programs

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In a recent pair of reports prepared for Arizona for Better Medicaid, HMA colleagues examined the impact of managed long-term services and supports (LTSS) in state Medicaid programs. The first report, Growth in MLTSS and Impacts on Community-Based Care, examines the historical increase in the adoption of LTSS by state Medicaid programs and how that has contributed to a shift in long-term care from institutions to the community. The second report, Managed LTSS Improves Quality of Care, describes the evidence on the impact of managed LTSS in state Medicaid programs on the quality of care.

Authors:
Principal Stephen Palmer
Senior Consultant Ashlen Strong
Senior Consultant Aaron Tripp

Webinar

Webinar Replay: Improving Child Welfare Outcomes: Role of Behavioral Health and Child Welfare in Strengthening Families, Building Resilience, and Increasing Protective Factors

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This webinar was held on July 20, 2021, was the eighth webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.

This eighth session featured HMA behavioral health, child welfare and Medicaid experts primed to specifically discuss strategies across child welfare and behavioral health to enhance family engagement and collaboration in increasing protective factors and family resilience.

Learning Objectives

  • Learn options for designing policies and implementing infrastructure that support a multisystem response facilitating family engagement and improving protective factors.
  • Learn about other successful state models for prevention and building family resilience.
  • Learn key benchmarks for successful engagement and empowerment that can be incorporated into QI programs.
  • Introduce and engage in dynamic discussion on the importance of the intersection of race equity, social justice, cultural humility, and responsiveness with family centered/multi-generational practice in addressing inequities.

Speakers

Doris Tolliver, JD, Principal, HMA

Uma Ahluwalia, MSW, MHA, Managing Principal, HMA

Susan Smith, Data Advocates, LLC

Annalisa Baker, MPH, LCSW, Senior Consultant, HMA

Brief & Report

HMA colleagues, report examines cost of stemming gun violence

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In a new report, “Cost Estimate for Federal Funding for Gun Violence Research and Data Infrastructure,” HMA colleagues were engaged by Arnold Ventures and the Joyce Foundation, to examine the cost to fund research and create a data infrastructure aimed at reducing gun violence. Each organization had previously released separate, but complimentary, reports outlining recommendations to stem gun violence in the United States.

This research and final cost estimate found the federal government would need to spend nearly $600 million over the next five years in order to close the gun violence information gap and provide sufficient resources to conduct appropriate research and collect and share comprehensive, transparent data to help policymakers and lawmakers address and solve gun violence.

HMA colleagues Catherine Guerrero, Zach Gaumer, Jay Shannon, Cindy Zeldin, and Yamini Narayan contributed to the research and final report.

During a webinar on Wednesday, July 14, a panel of experts including Dr. Shani Buggs, Zach Gaumer, and Dr. John Roman, shared their perspectives on report and discuss key issues in gun violence prevention research, data infrastructure and federal investment needed to close the current policy research gap.