Insights

HMA Insights: Your source for healthcare news, ideas and analysis.

HMA Insights – including our new podcast – 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 podcast, blogs, webinars, case studies, reports and more.

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Webinar

Webinar Replay: Comparing Medicaid program delivery models on quality outcomes

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This webinar was held on February 15, 2022.

In 2020, state and federal government spending on Medicaid was $646 billion, with just over half going to Medicaid managed care programs and the rest to fee-for-service (FFS), primary care case management (PCCM), and other models. Despite the large investments, little evidence exists on differences in quality between the various models. Using the 2019 CMS Adult and Child Core Set Quality Measures, HMA normalized performance data across states to compare outcomes between managed care, FFS and PCCM. During this webinar, HMA consultants discussed the findings, which were published in an HMA white paper in November 2021.

Learning Objectives: 

  • Understand how the different Medicaid delivery models performed on quality measures from the 2019 Adult and Child Core Set.
  • Learn more about the Adult and Child Quality Measure Core Set and why the 2019 dataset provides one of the first opportunities to make valid comparisons between the Medicaid delivery models.
  • Find out how this research could be expanded upon in the future to assess the key factors that drive higher quality and better performance in population health for low-income individuals.
  • Explore the broader implications of this research for policymakers and state Medicaid officials.

HMA Speakers

Anthony Davis, Managing Director, Quality and Accreditation Services, Portland, OR
David Wedemeyer, Principal, Los Angeles, CA
Joe Moser, Principal, Indianapolis, IN
Beth Kidder, Managing Principal, Tallahassee, FL

Blog

Minnesota releases Medicaid RFP for 80 counties outside Twin Cities

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This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of the Twin Cities seven-county region. The RFP was released by Minnesota Department of Human Services, Purchasing and Service Delivery Division on January 18, 2022. Contracts will begin January 1, 2023, covering approximately 470,000 members.

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Blog

CMS seeks new direction for Medicare Advantage and Part D on health equity and dual eligible integration

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This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, and market dynamics for future years. The analysis and insight reflect the combined expertise of HMA and its companies including the Wakely Consulting Group and The Moran Company.

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Blog

CMS changes boost overall Medicare Advantage star ratings

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This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Authored by Suzanna-Grace Sayre and Dani Cronick and published January 2022, this paper outlines the CMS modifications to the 2022 Star Ratings due to COVID-19, quantifies the estimated impact on 2023 MA spending, and discusses how these changes could influence the MA market in 2023.

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Blog

Medicaid managed care: opportunities to address social determinants of health and equity

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This week, our In Focus highlights a new report prepared by Health Management Associates (HMA) on the potential for Medicaid Managed Care to enable states to address social determinants of health (SDOH) and health equity above and beyond what’s possible with traditional fee-for-service models. The report was released by Together for Better Medicaid, a coalition committed to building a better Medicaid system across the country.

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Blog

MS Releases MississippiCAN, CHIP RFQ

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This week, our In Focus reviews the Mississippi request for qualifications (RFQ) for the state’s traditional Mississippi Coordinated Access Network (MississippiCAN) Medicaid program and the state Children’s Health Insurance Program (CHIP). The RFQ, released by the Mississippi Division of Medicaid on December 10, 2021, seeks two to three health plans to serve roughly 480,000 individuals. This is the first time the state is seeking plans, which it refers to as Coordinated Care Organizations (CCOs), to jointly administer MississippiCAN and CHIP.

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