This week, our In Focus section reviews the key provisions of the Centers for Medicare & Medicaid (CMS) Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (CMS-1752-P), which includes Medicare payment updates and policy changes for the upcoming FY, with a comment deadline of June 28, 2021. This year’s proposed rule includes several proposals the hospital industry should carefully consider. In particular, the Biden Administration has proposed to:
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This webinar was held on May 19, 2021.
COVID-19 has exposed deep fissures in our national and local healthcare systems, which comes as no surprise to mental health providers already accustomed to treating behavioral health needs rooted in systemic racial and economic disparities. Addressing these needs requires targeted outreach and robust community engagement efforts aligned with the principles of trauma-informed care. During this webinar, behavioral health experts focused on organizations, networks, partnerships, and protocols that ensure access to supportive, integrated behavioral healthcare for underserved individuals.
- Understand how the COVID-19 pandemic has exacerbated the behavioral health needs of underserved, marginalized, and isolated populations.
- Learn how to activate leaders and organizations to help build trauma-informed communities.
- Find out how engagement with faith and community-based partners can promote trauma-informed care, community healing, recovery, and innovation.
- Understand the intersection of behavioral and public health, including a look at how to maximize community behavioral health resources.
- Learn how accountable care and value-based payment models create opportunities to address trauma and behavioral health disparities.
Heidi Arthur, LMSW, Principal, Health Management Associates, New York
Lawrence Fowler, Deputy Director, Emma L. Bowen Community Services Center
Catherine Guerrero, MPA, Principal, Health Management Associates, Denver
Mark Sasvary, Ph.D., LCSW, Chief Clinical Officer, Coordinated Behavioral Health Services
In the last decade, there has been increasing awareness of the role behavioral health plays in healthcare outcomes and cost of care—especially in the public sector. Starting with Medicaid expansion and the high rates of behavioral health conditions in the expansion population to evidence of the impact of behavioral health on physical chronic disease and medical spending, behavioral health is an area of focus for improving the quality of care and reducing cost.
HMA Senior Consultant Suzanne Rabideau, Principals Heidi Arthur and Eileen Moscaritolo and Consultant Anh Pham recently developed the issue brief Exploration of a Personal Health Record for Children, Youth, and Families Involved with Child Welfare in CA for California’s Medicaid CalAIM Foster Care Model of Care Workgroup. The issue brief was developed to assist the workgroup in exploring options for establishing a portable personal health record (PHR) and support the workgroup’s efforts in making long-term recommendations on this topic. The PHR would give children, youth, families, and caregivers access to the child or youth’s health information.
The issue brief also
- Describes a PHR and it’s uses
- Identifies ways a PHR could assist in addressing the healthcare challenges often experienced by children, youth, and families involved with child welfare
- Identifies the federal and California-specific opportunities to facilitate access to a PHR for children and youth in foster care
- Identifies federal and California-specific challenges to implementing a comprehensive health record for children, youth, and families
- Shares potential options for the workgroup to consider
Suzanne Rabideau, MBA, MA, LPC, Senior Consultant
Heidi Arthur, LMSW, Principal
Eileen Moscaritolo, Principal
Anh Pham, Consultant
HMA has published a white paper identifying the appropriate, and inappropriate, uses of risk corridors in the context of Medicaid managed care capitation rate setting. The paper is timely due to the widespread use of risk corridors by states during the COVID-19 public health emergency (PHE) and the potential continuation of those risk corridors after the PHE ends.
Download the Executive Summary here.
This webinar was held on May 19, 2021.
Member experience measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey play a growing role in the quality rankings of Medicaid and Medicare health plans, with the difference between high and low plan scores often amounting to a few percentage points. During this webinar, HMA quality expert David Wedemeyer delved into how Medicaid and Medicare plans can improve their CAHPS scores and thereby benefit from incentive payments tied to high quality performance.
- Understand the growing role CAHPS measures have in health plan quality rankings and incentive payment models.
- Learn how to develop a comprehensive member experience improvement structure, including a process for identifying and engaging members most likely to be dissatisfied.
- Find out how the use of data analytics can drive a deeper understanding of trends in member experience and help identify real opportunities to improve.
- Discover techniques for obtaining point-of-service feedback that can help address potential member experience issues before they arise
David Wedemeyer, BSN, Principal, Los Angeles, CA
This webinar was held on May 13, 2021.
This was the second webinar in the series “Exploring the Landscape of Behavioral Healthcare,” covering the growing impact of behavioral healthcare on clinical outcomes and cost.
Behavioral health professionals who have cared for their own family members have firsthand knowledge of the effects of depression, schizophrenia, and substance use disorder on individuals and families. While the experience informs their work in many positive ways, it can also make them susceptible to strong emotional reactions that may cloud their judgment. During this webinar, HMA clinical psychologist, consultant, and family caregiving expert Barry Jacobs explored strategies that behavioral health professionals can employ to manage their emotions in professional situations, ensuring the most effective and constructive interactions with family members and treatment teams as well as the best possible outcomes for patients.
- Understand the burgeoning phenomenon of family caregiving in America.
- Find out how behavioral health professionals are impacted by their own personal family caregiving experiences in both positive and potentially negative ways, including a look at the most recent research on the subject.
- Learn three effective strategies behavioral health professionals can employ to manage their own emotional reactions to interactions with clients and staff members.
Barry Jacobs, Psy.D., Principal, Philadelphia
This webinar was held on April 28, 2021.
This is the first webinar in the series “Exploring the Landscape of Behavioral Healthcare,” a series on the growing impact of behavioral healthcare on clinical outcomes and cost.
Behavioral health providers continue to struggle to increase COVID-19 vaccine acceptance among staff and patients, especially in communities of color. During this webinar, HMA behavioral health experts discussed strategies for increasing vaccine acceptance among behavioral health providers and clients. Speakers also addressed how disparities in COVID-19 infection rates impact behavioral healthcare.
Laquisha Grant, MPA, Senior Consultant
Deb Peartree, RN, MS, Senior Consultant
This week, our In Focus section examines differences in Medicare Advantage (MA) churn rates among select provider-sponsored plans (PSPs) and non-PSPs. Enrollee churn rates, or rates at which enrollees switch plans, may be an indicator of enrollee satisfaction. In the years studied, PSP organizations had lower average churn rates compared to non-PSP organizations.