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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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1456 Results found.

Webinar

Webinar Replay: Initiating a Successful Medicare Advantage Plan: Strategic, Operational and Planning Considerations

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This webinar was held on July 24, 2019.

If your managed care organization or health system is considering joining the growing market for Medicare Advantage (MA) plans, including Special Needs Plans (SNPs), or expanding your MA service area, now is the time to start planning for a 2021 launch.

During this webinar, HMA Managing Principal and former CMS Deputy Administrator for Medicare Jonathan (Jon) Blum is joined by HMA Managing Principal Mary Hsieh and Principal Julie Faulhaber. Together, they discussed the strategic, operational, and planning considerations every organization must address before initiating a successful Medicare Advantage plan. Our experts discussed regulatory concerns, operational readiness, benefit structure, marketing, risk management, and other key considerations.

Learning Objectives

  1. Find out what your organization needs to make a go/no go decision on the launch of a Medicare Advantage plan, including an assessment of financial feasibility, member opportunity, capital requirements, and operational capabilities.
  2. Understand the federal requirements and timelines and internal preparations involved in filing a successful application to initiate a Medicare Advantage plan.
  3. Learn why Medicare Advantage plans serve as a foundation for further efforts to initiate SNPs.
  4. Understand the key differences between SNPs and Medicare Advantage plans, including special SNP requirements such as the Model of Care.

Speakers

  • Jon Blum, Managing Principal, Washington, DC
  • Julie Faulhaber, Principal, Chicago
  • Mary Hsieh, Managing Principal, Atlanta

Who Should Listen

Executives from managed care organizations, insurers, hospitals, health systems and other entities considering the launch of a Medicare Advantage plan such as a Special Needs Plan or considering a Medicare Advantage Service Area Expansion.

Webinar

Webinar Replay: Unpacking the MassHealth One Care Procurement Databook: Key Considerations for Strengthening the Program, Advancing Health Equity

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This webinar was held on July 16, 2019. 

The Massachusetts One Care program, which went out to bid this year, is an 1115A Duals Demonstration (both a Financial Alignment Demonstration and a state demonstration) for dually eligible Medicare and Medicaid beneficiaries age 21-64 at the time of enrollment and living with disabilities. To assist potential bidders, the state released a Databook containing historical demographic, cost and utilization information for individuals who are eligible for One Care but not currently enrolled.

During this webinar, HMA experts broke down the One Care Databook and provided an eye-opening review of the data that can help regulators, health plans, providers and community-based organizations strengthen the program and advance health equity for the eligible population. Speakers also used sophisticated geo-mapping software to illustrate geographic variation in the cost and utilization of both Medicare and Medicaid services.

Learning Objectives

  • Gain insights into the eligible population and their use of Medicare and Medicaid services.
  • Consider regional variation in the cost and use of Medicare and Medicaid services.
  • Learn more about Medicare Part D service use among the eligible population.
  • Take stock of the opportunities to advance health equity gleaned from the data.

HMA Speakers

Ellen Breslin, Principal, Boston
Eric Hammelman, Principal, Chicago
Anissa Lambertino, Senior Consultant, Chicago

Who Should Listen

Federal and state regulators, Medicaid officials, and officials from the Centers for Medicare & Medicaid Services; executives of health plans, health systems, community-based organizations, and providers of long-term services and supports (LTSS).

Blog

Dual Eligible Financial Alignment Demonstration Enrollment Update

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This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (“Duals Demonstrations”) for beneficiaries dually eligible for Medicare and Medicaid (duals) in nine states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Rhode Island, South Carolina, and Texas. Each of these states has begun either voluntary or passive enrollment of duals into fully integrated plans providing both Medicaid and Medicare benefits (“Medicare-Medicaid Plans,” or “MMPs”) under three-way contracts between the state, the Centers for Medicare & Medicaid Services (CMS), and the MMP. As of May 2019, approximately 372,600 duals were enrolled in an MMP. Enrollment was flat from May of the previous year.

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Blog

Highlights from NASBO Spring 2019 Fiscal Survey of States

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This week, our In Focus section section highlights some of the key findings of the Spring 2019 Fiscal Survey of States, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget officers in all 50 states from March through May 2019. 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.

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Blog

New Opportunities and Requirements for Integrated Managed Care Models for Medicare-Medicaid Dually Eligible Individuals Served by Health Plans

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This week, our In Focus section provides a high-level overview and an analysis for how health plans should consider two related and significant policy statements from the Centers for Medicare & Medicaid Services (CMS) about opportunities to further integrate care for dually eligible individuals.  Specifically, the CMS April 24, 2019, State Medicaid Director letter (SMDL) outlines new opportunities for states, largely working with health plans, to test models of integrated care, including opportunities to continue current financial alignment initiatives (FAIs).[i] CMS also issued final rules related to Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) definitions and requirements for Medicare-Medicaid integration activities and unified grievances and appeals for calendar year 2021.[ii] Together, these guidance documents should present greater opportunities for health plans to partner with CMS and states to integrate care for dual eligible beneficiaries.[iii]

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