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This week, our In Focus section summarizes the revised California Advancing and Innovating Medi-Cal (CalAIM) proposal, released on February 17, 2021. Medi-Cal, the state’s Medicaid program, covers over 12 million individuals, with over 11 million in managed care. CalAIM seeks to standardize and streamline the Medi-Cal program and address health disparities and social determinants of health for high-risk, high-cost Medi-Cal members through broad-based delivery system, program, and payment reform. CalAIM was originally scheduled to begin its tiered implementation in January 2021, but due to COVID-19 has been delayed until January 2022. The revised proposal incorporates additional stakeholder input, learnings from the workgroup meetings, and ongoing policy development.
This webinar was held on March 31, 2021.
During this Health Performance Accelerator by HMA & HealthEC webinar, our panel of experts summarized the CMS Interoperability and Patient Access Final Rule, walked through what this data will do for your organization, and explored how it could positively impact the economics of healthcare.
This blog was written by Laura Zaremba, Principal, HMA, and Robert Chouinard, VP Public Sector, HealthEC
What are we really talking about?
CMS published the Interoperability and Patient Access Final Rule in the Federal Register on March 4, 2019, the pre-publication text of the final rule was released on March 9, 2020, and the final rule was published in the Federal Register on May 1, 2020. The rules are effective as of January 2021 and will be enforced by July 2021.
This week, our In Focus comes from an HMA cross-cutting subject matter team, who have updated a core set of federal policy slides that analyzes recent federal policy actions following the Presidential and Congressional elections. It includes an analysis of President Biden’s $1.9 trillion COVID-19 relief legislation currently in development and recent CMS regulatory and administrative actions. Specifically, the analysis looks at:
This webinar was held on March 18, 2021.
Efforts by Federally Qualified Health Centers (FQHCs) to reach underserved communities, address health inequity, and re-engage marginalized individuals are greatly enhanced when payment models are maximized to support innovation in the delivery of care. During this webinar, HMA experts addressed how FQHCs can enhance payments and boost opportunities to innovate under both the current Prospective Payment System and under emerging alternative, value-based payment models. Speakers also addressed creative strategies for outreach, engagement, care management, and the implementation of alternate clinical care modalities such as group visits and telehealth.
- Understand the strengths and weaknesses of the Prospective Payment System.
- Learn how to enhance reimbursements for specialized services.
- Identify opportunities and barriers among alternative payment models.
- Find out how to succeed in a value-based care environment.
Art Jones, MD, Principal, Chicago, IL
Diana Rodin, Senior Consultant, New York, NY
This webinar was held on March 16, 2021.
COVID-19 vaccination has lagged among underserved populations and communities of color in part because of a deeply rooted historical skepticism concerning the safety and efficacy of certain medical treatments and procedures. During this webinar, experts from HMA, Tufts Health Plan, and ConsejoSano discussed how healthcare providers and public health officials can engage underserved populations and communities of color, build trust through tailored strategies, and raise the level of comfort and confidence among individuals still reticent to receive the COVID-19 vaccine.
- Understand the drivers of lagging COVID-19 vaccination rates among underserved populations and communities of color.
- Find out how to build confidence in the safety and efficacy of COVID-19 vaccines using strategies tailored to specific populations and specific healthcare settings.
- Understand the special challenges and promising strategies for increasing vaccine confidence among individuals with behavioral health issues.
- Explore a novel high-tech, high-touch multicultural engagement solution for tailoring vaccine confidence strategies to diverse populations.
- Learn how to tackle underlying health equity challenges that might hinder efforts to improve COVID vaccination rates among underserved populations and communities of color.
Margaret Kirkegaard, MD, Principal, HMA
Karen Hill, Senior Consultant, HMA
Deb Peartree, Senior Consultant, HMA
Gary Rosenfield, SVP of Business Development & Strategy, ConsejoSano
Juan Lopera, Corporate Business Diversity Officer, VP of Marketing & RI Medicaid, Tufts Health Plan
This week, our In Focus section reviews preliminary 2020 Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to the Centers for Medicare & Medicaid Services (CMS), HMA received a draft version of the CMS-64 report that is based on preliminary estimates of Medicaid spending by state for federal fiscal year (FFY) 2020. Based on the preliminary estimates, Medicaid expenditures on medical services across all 50 states and six territories in FFY 2020 exceeded $649.4 billion, with over half of the total now flowing through Medicaid managed care programs. In addition, total Medicaid spending on administrative services was $29.7 billion, bringing total program expenditures to $679.1 billion.