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Brief & Report

HMA experts publish 50-state Medicaid pharmacy study with Kaiser Family Foundation

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In conjunction with the Kaiser Family Foundation (KFF), a team of HMA experts have published survey results and analysis examining administration of the Medicaid pharmacy benefit. HMA contributing colleagues were Kathleen Gifford, Anne Winter and Linda Wiant. Rachel Dolan, Marina Tian, and Rachel Garfield  from KFF also contributed.

The report, How State Medicaid Programs are Managing Prescription Drug Costs: Results from a State Medicaid Pharmacy Survey for State Fiscal Years 2019 and 2020, summarized the survey conducted in all 50 states and the District of Columbia.

The survey outlines Medicaid pharmacy policy areas and key issues to watch based on feedback from the states in several categories including pharmacy benefit administration, cost-containment and utilization controls, payment and rebates, 340B management and long-term priorities.

Brief & Report

Medicare-Medicaid integration: integrated model enrollment rates show majority of Medicare-Medicaid dual eligible population not enrolled

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Working in conjunction with Arnold Ventures, a team of HMA consultants has written an issue brief, Medicare-Medicaid Integration: Integrated Model Enrollment Rates Show Majority of Medicare-Medicaid Dual Eligible Population Not Enrolled. This brief presents key findings on their examination of the availability of integrated programs in states, the growth in enrollment rates, and differences in enrollment and programs across the country.

The HMA team cited several reasons why Medicare-Medicaid integrated program options are not equally available nationwide and why enrollment is limited in places where programs exist. The result is that millions of people are not enrolled in whole-person, integrated program options – a reality that is inefficient, and worse yet, inequitable.

The HMA team, led by Managing Principal Jon Blum and Principal Sarah Barth, includes Narda Ipakchi, Ellen Breslin, Mindy Cohen, Sharon Silow-Carroll and other HMA subject matter experts.

Brief & Report

HMA experts author LA city and county studies

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HMA Community Strategies (HMACS) experts have released a pair of evaluation reports commissioned by the City of Los Angeles and the County of Los Angeles.

HMACS worked with the Los Angeles Housing + Community Investment Department (HCIDLA) to facilitate the inaugural, interactive Los Angeles Poverty Prevention Summit and produced a report and policy recommendations.

The report, Breaking the Cycle of Poverty, Defining Innovative and Equitable Strategies, summarized ideas and input from the summit and provides analysis and recommendations to move forward by harnessing existing resources and leveraging them with other efforts to alleviate poverty in the county.

A second report, prepared for the Los Angeles County Chief Executive Office, evaluated strategies to combat homelessness put forth by the Office of Homeless Initiatives (HI). The evaluation of HI’s strategies is summarized in the report, Evaluating the Effectiveness of Los Angeles County’s Strategies to Expand and Enhance Interim Housing and Emergency Shelter Services. The report focuses on analyzing existing strategies and how they are preforming and goes on to identify best practices and areas of needed improvement.

HMACS is involved in continued work to address homelessness, poverty and other social determinants of health in Los Angeles County and beyond with the goal of improving health and wellbeing, particularly for at-risk patients and families.

The HMACS teams, led by Principal Charles Robbins, also included Catherine Guerrero, Nayely Chavez, and Rathi Ramasamy as well as Michael Stiffler and Kara Riehman.

Brief & Report

HMA explores potential issues for individuals with end-stage renal disease enrolling in Medicare Advantage

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Starting in 2021, Medicare beneficiaries with End-Stage Renal Disease (ESRD) will be able to enroll in any Medicare Advantage (MA) plan. The Anthem Public Policy Institute asked HMA to explore some of the potential issues associated with how MA plans are currently paid by the Centers for Medicare & Medicaid Services (CMS) for individuals with ESRD, and identify any possible modifications that CMS or Congress could make to more closely align payment with costs.

This white paper was prepared for Anthem Public Policy Institute by HMA Managing Principal Jon Blum, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi.

Brief & Report

HMA prepares report detailing economic implications of a Medicaid expansion in Missouri

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On January 30, 2020, the Missouri Hospital Association issued a press release outlining a report prepared by Health Management Associates. View the official press release here.

The report, Medicaid Expansion in Missouri – Economic Implications for Missouri and Interviews Reflecting Arkansas, Indiana, and Ohio Experiences, was prepared by HMA MMS Managing Director Matt Powers and Managing Principal Sharon Silow-Carroll, and Jack Meyer. They conducted interviews with leaders directly involved with expansion in Arkansas, Indiana, and Ohio to evaluate the policy and operational adjustments they undertook to design a budget-conscious program while maximizing state value. Those interviews allowed clarification of many of the questions raised about state-level costs and budget savings of a potential Missouri expansion.

The report was commissioned by the Missouri Hospital Association and Missouri Primary Care Association and released in partnership with stakeholders from the healthcare community.

Brief & Report

Report maps out strategies, recommendations for preventing poverty

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In order to stimulate new thinking around addressing the crisis of poverty, Councilmember Mitch O’Farrell and the Los Angeles Housing + Community Investment Department (HCIDLA) convened the inaugural Los Angeles Poverty Prevention Summit. HMA Community Strategies worked with HCIDLA to facilitate the interactive event and produce a policy recommendations report.

“Breaking the cycle: Defining innovative & equitable strategies” is a summary, which synthesizes the ideas generated from the summit into recommendations aimed at reducing poverty in Los Angeles.

HMA Community Strategies colleagues Nayely Chavez, Catherine Guerrero, Rathi Ramasamy, and Charles Robbins conducted research for this report.

Brief & Report

HMA analysis of Medicaid fiscal accountability regulation

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In November 2019, the Centers for Medicare & Medicaid Services (CMS) officially proposed a comprehensive regulation on Medicaid fiscal accountability. To facilitate review of the rule, HMA staff have created an overview of key elements of the proposed regulation and summary. This document is designed to give a framework to analyze the proposal and provides analysis in most sections. The HMA team can provide in-depth policy support unique and local issues may require.

Brief & Report

Final HMA-authored reports on reproductive care access released

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A final report and series of five case studies, Beyond the Numbers: Access to Reproductive Health Care for Low-Income Women in Five Communities, have been released.

Working with the Kaiser Family Foundation (KFF),  a team of HMA colleagues, Managing Principal Sharon Silow-Carroll, Consultant Carrie Rosenzweig, Senior Consultant Diana Rodin, and Principal Rebecca Kellenberg, completed the project.

Through state policy reviews, site visits, interviews with local stakeholders, and focus groups with low income women, the team examined how national, state, and local policies, as well as cultural factors, shape access to contraceptive care, sexually transmitted infection prevention and treatment, obstetrical care, and abortion services.  The study focused on the on-the-ground experiences of women living in these communities and the reproductive health professionals caring for them.

The study identified themes that cut across all five “medically underserved” communities but play out in different ways depending on the local environment. The key factors influencing access include cultural and social determinants of health, healthcare coverage, provider supply and distribution, sex education, and abortion policies and environment.

In addition to an executive summary report, KFF has also published case study briefs that detail the findings in each of the five communities. The complete report is available here.

Brief & Report

Issue brief explores child care needs of families experiencing homelessness

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Recently, the HMA Community Strategies team of Managing Director Marci Eads, Principal Catherine Guerrero, Senior Associate Robyn Odendahl, Research Assistant Rathi Ramasamy and Principal Charles Robbins, contributed to a research project conducted in Los Angeles: Child Care Needs of Families Experiencing Homelessness.

Funded by the Child Care Resource Center, the study’s purpose was to understand the needs of families experiencing homelessness with children ages zero to five living in Los Angeles County Service Planning Areas 1 and 2 (San Fernando and Antelope Valleys). Through multiple sources of data including a literature review, publicly available data on homelessness in Los Angeles County, interviews with national and local experts and focus group with families experiencing homelessness, the research highlighted a need to develop and expand access to child care resources specifically designed for families experiencing homelessness.

 

Brief & Report

Annual 50-state Medicaid director survey released: states report expansion and enhancement

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Results of the 19th annual Medicaid Budget Survey were released Oct. 18, 2019 and examine changes taking place in Medicaid in all 50 states and the District of Columbia. The Kaiser Family Foundation (KFF) and HMA conducted the annual survey in partnership with the National Association of Medicaid Directors.

Key findings of the survey include:

  • Multiple states reported expansions or enhancements to provider rates and benefits.
  • Several states implemented, adopted, or continued to debate the ACA Medicaid expansion.
  • A growing number of states continued to pursue work requirements and other policies promoted by the Trump administration that could restrict eligibility.
  • States are implementing Medicaid initiatives to address social determinants of health, control prescription drug spending, improve birth outcomes and reduce infant mortality, and address the opioid epidemic.

The report was prepared by Kathleen Giff­ord and Aimee Lashbrook, Eileen Ellis and Mike Nardone, and by Elizabeth Hinton, Robin Rudowitz, Maria Diaz, and Marina Tian.