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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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Webinar

Webinar Replay: Telehealth and the COVID-19 Response: Policy Changes and Implementation Strategies

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This webinar was held on March 31, 2020

Telehealth services have become a key strategy for expanding access to care during the COVID-19 pandemic, driven in part by significant changes in laws and regulations to encourage the adoption of technologies that support telehealth. With these rapid changes, providers are struggling to understand how to best serve their patients using telehealth technologies.

During this webinar, HMA experts described the different modalities of telehealth and laid out the policy and reimbursement implications for the Medicare and Medicaid programs. Speakers detailed changes to HIPAA enforcement and policy changes that ensure ongoing support for prescribers and recipients of controlled substances. The webinar also reviewed how recent policy changes impact key provider decisions with regards to selecting, implementing, and building a business case for new telehealth services to support patients during the pandemic.

As mentioned in the webinar, the Telehealth Readiness Questionnaire is also available.

Learning Objectives

  • Understand the different modalities of telehealth services and how to bill for them.
  • Find out about recent changes in Medicare and Medicaid reimbursement policy stemming from the COVID-19 response.
  • Learn the key steps in selecting a telehealth platform, building a business case, adapting workflows, and other implications for physician practices.

HMA Speakers

Jean Glossa, MD, Managing Principal for Clinical Services, Washington, DC

David Bergman, MPA, Principal, New York

Zach Gaumer, Senior Consultant, Washington, DC

Webinar

Webinar Replay: HMA Analysis of Medicare Advantage Advance Notice and Part C/D Proposed Rule

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This webinar was held on February 18, 2020.

On February 6, the Centers for Medicare & Medicaid Services (CMS) issued Part II of the Advance Notice of Methodological Changes for Calendar Year (CY) 2021 which includes proposed updates to Medicare Advantage (MA) payment rates. In a departure from previous years, the agency did not release a separate Call Letter which typically includes Part C and Part D policy guidance and bidding instructions. Instead, the agency released a proposed rule which includes proposed policy and technical changes, most of which are scheduled to go into effect in the 2022 plan year. CMS also issued separate bidding instructions for plans as they prepare their bids for CY2021.

During this webinar, an HMA team of Medicare experts including Jonathan Blum, Eric Hammelman, Julie Faulhaber, and Narda Ipakchi presented an overview of the payment rate updates and proposed policy changes included in the Advance Notice and Proposed Rule. They provided interested stakeholders with an overview and analysis of the proposed changes as well as what these changes mean for Medicare Advantage plans’ existing strategies and opportunities.

Learning Objectives

  • Understand what the expected 2021 rate increase for Medicaid Advantage plans means for continued industry growth and financial performance.
  • Learn about updates to the Medicare Advantage Star Ratings system, including proposals to increase measure weights for patient experience and complaints.
  • Learn about the proposed changes to network adequacy requirements and how the agency is promoting further use of telehealth among plans.
  • Understand CMS’ efforts to implement requirements that expand Medicare Advantage coverage to beneficiaries with ESRD.

HMA Speakers

Jon Blum, Managing Principal, Washington, DC
Eric Hammelman, Principal, Chicago
Narda Ipakchi, Senior Consultant, Washington, DC
Julie Faulhaber, Principal, Chicago

Webinar

Webinar Replay: Lessons from Colorado Community-Based Organizations Engaged in Provider Partnerships that Address Social Determinants of Health

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This webinar was held on January 31, 2020.

HMA’s how-to session last year on development and implementation of social determinants of health (SDOH) partnerships for vulnerable Colorado populations was a tremendous success, offering frameworks and tools for effective SDOH initiatives among community-based organizations (CBOs), health systems, and other providers. As a follow-up to this discussion, HMA hosted a “lessons learned” session, in which two CBOs who have implemented innovative SDOH partnerships outlined the results of their programs and provided insights on how to develop an effective SDOH collaboration.

Learning Objectives

  1. Learn how CBOs and health systems are successfully collaborating on SDOH services, payment models, and payer-provider relationships.
  2. Understand the opportunities and challenges related to contracting between CBOs and healthcare systems, including referrals, coordinated care, and pay-for-performance models.
  3. Find out how to engage and support local communities by activating and financing Community Health Workers (CHWs) for payment by health plans within the Pathways HUB framework.
  4. Learn how to assess potential partnerships and arrangements that address whole person health, including SDOH.

Speakers

  • Grace Damio, Center Director, Hispanic Health Council, Hartford, CT. The Hispanic Health Council has contracted with multiple healthcare provider systems to implement its community CHW-led, home-based diabetes intervention – Diabetes Among Latinos Best Practices Trial (DIALBEST).
  • Giovanna Rogow, Chief Executive, Maternal Infant Services Network (MISN), Newburgh, NY. MISN has contracted individually with healthcare providers and serves as the backbone organization leading a 30-member CBO consortium called Hudson Valley Collective for Community Wellness (HVCCW). This consortium addresses social determinants of health throughout a seven-county region through capacity building and collective action. The HVCCW is presently forming an Independent Practice Association to collectively contract for CHWs to conduct outreach and provide care coordination services on behalf of member organizations via the Pathways HUB model.

Who Should Listen

Representatives of Colorado state and county governments, Colorado Regional Accountable Entities, hospitals, providers, and CBOs working to address SDOH.

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).

Webinar

Webinar Replay: CMS Primary Care Initiative: Key Considerations Concerning New Value-Based Payment Options

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This webinar was held on July 11, 2019. 

The Centers for Medicare & Medicaid Services (CMS) has announced a new Primary Care Initiative, offering primary care providers (PCPs) in 26 regions nationally the opportunity to participate in new Medicare payment models beginning January 2020: Primary Care First (PCF).

During this webinar, experts from HMA described how this initiative builds on prior CMS innovation models in advancing primary care and outlined eligibility, payment models, and key considerations of the program. The PCF program includes an option to care for seriously ill patients who lack a primary care practitioner and opt to participate in this payment model option. It prioritizes the physician-patient relationship, reduces administrative burden, and financially incents improved health outcomes.

Learning Objectives

  1. Understand the eligibility requirements for the PCF programs.
  2. Describe program models including attribution and payment models.
  3. Understand the goals and quality metrics associated with PCF, including incentives aimed at reductions in hospital utilization and total cost of care.
  4. Lean how participation in this primary care initiative can help primary care practices expand their patient base, especially among high needs populations.

Speakers

  • Art Jones, MD, Principal, Chicago
  • Elizabeth Wolff, MD, MPA, Principal, New York

Who Should Listen

Physicians and executives from primacy care practices, IPAs, ACOs, hospitals, health systems, and other provider entities; health plans and other payers. Although eligibility for program participation is limited to the 26 targeted geographic areas, others may be interested in learning how CMS is progressing toward increasing primary care payment through capitation.

Webinar

Webinar Replay: Medication Assisted Treatment: Are You Ready?

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This webinar was held on June 12, 2019 and was the seventh webinar in a series about addressing the opioid crisis in America.

Medication Assisted Treatment (MAT) has been proven to successfully treat opioid use disorder and can be offered in outpatient settings alongside treatment for other chronic medical and behavioral health conditions. However, many providers are unfamiliar with the nuances of providing this treatment in their practices. What’s needed is a systematic understanding of the various operational and regulatory issues that providers will face when providing MAT.

During this webinar, HMA clinicians addressed some of the key considerations for practices looking to offer MAT. They also demonstrated how the use of a readiness assessment tool can help providers identify and work through a variety of potential problem areas, leading to implementation of a successful MAT program.

Learning Objectives

  1. Learn how to institute new workflows and manage the type of change that will come with providing access to MAT.
  2. Understand best practices for integrating MAT into an already busy practice, including the issues of staffing and scheduling.
  3. Find out how to make MAT financially sustainable, including an understanding of billing and coding rules.
  4. Learn how to ensure compliance with Drug Enforcement Administration regulations and requirements.

HMA Speakers

  • Scott Haga PA-C, Senior Consultant, Lansing
  • Jean Glossa, MD, MBA, Managing Principal for Clinical Services Washington, DC

Who Should Listen

Outpatient primary care and behavioral health providers considering adding MAT to their scope of practice, health systems interested in supporting outpatient providers, payers and health plans.

Webinar

Webinar Replay: Creating Effective Health and Law Enforcement Partnerships to Combat the Opioid Epidemic

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This webinar was held on June 5, 2019, and was the sixth webinar in a series about addressing the opioid crisis in America.

Multi-sector collaboration is a key strategy for reversing the upward trend in opioid-related deaths, and there are tremendous opportunities to develop solutions through health and law enforcement partnerships. Historically, these sectors held divergent viewpoints and practices to best address opioid use. But today, successful collaborations involving health and public safety leaders are emerging across the country in response to the opioid crisis.

During this webinar, experts from HMA and the New York City Police Department explored key elements in a multi-sector approach to address opioid use, built on a foundation of shared ownership of policies, system response, and programmatic interventions.

Learning Objectives

  1. Understand the key challenges to partnerships between health systems and law enforcement.
  2. Learn strategies for strengthening partnerships in which law enforcement, health professionals and community members work together to respond to the opioid crisis.
  3. Obtain examples of successful collaboration from around the country.
  4. Uncover current funding opportunities to support your health and law enforcement partnerships.

Speakers

  • Laquisha Grant, Senior Consultant, New York City
  • Ashley Restaino, Managing Director, Staten Island PPS
  • Theresa Tobin, Deputy Chief, New York City Police Department
  • John Volpe, Principal, New York City

Who Should Listen

Officials of state and local government, law enforcement, fire departments, emergency response, crisis hotlines and crisis centers; executives of hospitals, health systems, mobile crisis units, and affiliated community providers and payers of crisis services, including Medicaid payers.

Webinar

Webinar Replay: Advancing and Codifying Health Equity and Wellness for Medicaid Populations

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This webinar was held on June 4, 2019. 

It’s widely recognized that social determinants of health (SDOH) have a significant impact on mortality and morbidity. Community-Based Organizations (CBOs) play a significant role in addressing SDOH factors that drive health disparities and poor health outcomes. CBOs are directly connected to the populations they serve and commonly address an array of overlapping clinical and social service needs. However, CBOs face many challenges creating meaningful partnerships with health care organizations (HCOs) and health plans. Addressing these challenges is important so CBO contributions can be scaled through a more integrative and inclusive approach within the healthcare system.

During this webinar, experts from the Disability Policy Consortium (DPC) and the Arthur Ashe Institute of Urban Health (AAIUH) joined HMA to discuss the recent issue brief, published by Academy Health, which detailed lessons learned from CBOs in New York and Massachusetts.

Learning Objectives

  1. How CBOs can advance health equity and wellness goals for the individuals and communities that are the focus of Medicaid payment and care delivery system reform.
  2. How New York supported CBO engagement in its Delivery System Reform Incentive Payment (DSRIP) plan.
  3. What the challenges CBOs have experienced in healthcare reform.
  4. Why we need a National Blueprint for Advancing Health Equity by leveraging the nation’s CBOs to facilitate greater cross-sector collaboration between CBOs and HCOs.

Speakers

Dennis Heaphy, Health Policy Advocate, Disability Policy Consortium, Boston
Humberto Brown, The Arthur Ashe Institute of Urban Health (AAIUH), NYC
Ellen Breslin, HMA, Principal, Boston
Heidi Arthur, HMA, Principal, NYC

Who Should Listen

Executives of Medicaid and Medicaid-Medicare health plans; community, state and federal policy makers and program administrator; CBO and Accountable Care Organization leaders); advocates; and members of the community working to remove barriers to advance health equity and wellness for Medicaid populations.

Webinar

Webinar Replay: Pathways HUB- A Population Health Model that Activates the Community Response to Social Determinants

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This webinar was held on May 9, 2019.

One of the most successful approaches to addressing social determinants of health involves the coordination of community-based services and civic resources through a community hub funded by performance-based managed care payments.

This webinar will feature the co-developer of The Pathways Community HUB model, an approach designed to help coordinate outreach by specialized community health workers who are incentivized to engage high-need populations.

Speakers will also discuss how community hubs can be adapted to address broader community needs for an array of populations.

Learning Objectives

  1. Learn how to take local healthcare planning to the next level by identifying, activating, and financing community-based organizations through a community hub.
  2. Find out how the Pathways Community HUB can facilitate managed care payments for risk mitigation within attributed populations.
  3. Understand the value of coordinating with grassroots organizations and informal networks, such as faith-based groups, to better address social determinants of health.
  4. Find out how health systems can play a central role as the platform for community hubs, providing infrastructure, information technology, and administrative capabilities.
  5. Learn how to leverage the Pathways HUB toolkit to support the planning, development, and implementation of a community hub.

Speakers

  • Heidi Arthur, Principal, HMA
  • Mark Redding, MD, Co-Developer, Pathways Community HUB

Who Should Attend

Executives of health plans, providers, and community-based organizations; officials of state and local government, civic groups, grassroot organizations, faith-based groups, and community-based collectives.

Webinar

Webinar Replay: Activating Local Communities to Successfully Address Opioid Addiction and Recovery

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This webinar was held on April 17, 2019, and was the fifth webinar in a series about addressing the opioid crisis in America.

Local communities are organizing to battle opioid use disorder, based on the growing understanding that addiction and treatment happen at the community level. Successful efforts include tracking spikes in opioid use, effectively targeting high-burden areas, conducting community-based research on needs and resources, and deploying community-based resources in a meaningful and coordinated fashion.

During this webinar, HMA public health, prevention, and research experts explored how to activate local communities in the battle to prevent the rise of opioid use disorder and how to respond to the needs of community members for wraparound services. Speakers also addressed how the engagement of those most impacted by opioids can improve the availability and effectiveness of recovery and prevention options and solutions.

Learning Objectives

  1. Understand the importance of peers and community health workers and the roles they play in keeping local communities activated.
  2. Find out how to conduct a community gap analysis to identify the type of wraparound supports and services needed to best address opioid use disorder.
  3. Learn how to engage community members in community-based participatory research and program implementation to develop and implement effective services.
  4. Understand how to use surveillance data needed to identify and respond to neighborhoods at growing risk for opioid deaths.
  5. Find out how local communities in Delaware are organizing to prevent overdose deaths in their neighborhoods and ensure those in need have opportunities to engage in treatment.
  6. Learn why targeted Naloxone distribution makes more sense than passive distribution among the “worried well.”

HMA Speakers

  • Liddy Garcia-Bunuel, Principal, HMA Community Strategies
  • Marci Eads, PhD, Managing Director, HMA Community Strategies

Who Should Listen

State and local public health officials; behavioral health practitioners; addiction treatment providers; officials from state healthcare organizations, Medicaid agencies, community-based organizations, federally qualified health centers, and other provider organizations; and community members who have been impacted by addiction.

Webinar

Webinar Replay: Rethinking Behavioral Health Crisis Systems: Saving Lives, Saving Resources

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This webinar was held on April 16, 2019.

Across the country, police and EMS are increasingly called upon to respond to individuals experiencing behavioral health crises, without having received the training, skills and resources to effectively address those scenarios. At the same time, civilian crisis response services (e.g. crisis hotlines, mobile crisis teams) are often siloed from the public safety response, contributing to system fragmentation and inappropriate interventions. Local governments are spending considerable resources without getting the desired outcomes, and individuals frequently receive subpar care, placing them at risk for future crises and cycling in and out of emergency rooms and the criminal justice system.

During this webinar, experts from HMA explored the four key elements of a successful crisis system redesign: crisis prevention, early intervention, appropriate response, and improved post-crisis support. Speakers also addressed why system redesign is the foundational element to a new way of delivering crisis services.

Learning Objectives

  1. Understand the key components of common behavioral health crisis systems.
  2. Identify opportunities for system improvement.
  3. Learn strategies or approaches to achieve a reimagined crisis system where law enforcement, health professionals and community members work together to respond to crises.
  4. Identify funding opportunities to support your crisis system.

HMA Speakers

  • Laquisha Grant, Senior Consultant
  • John Volpe, Principal

Who Should Listen

Officials of state and local government, law enforcement, fire departments, emergency response, crisis hotlines and crisis centers; executives of hospitals, health systems, mobile crisis units, and affiliated community providers and payers of crisis services, including Medicaid payers.