Insights

HMA colleagues conduct impact assessments of proposals developed by California future health workforce commission

A team of HMA colleagues, including Carrie Cochran, Helen DuPlessis, Kelly Krinn, Nora Leibowitz and Ryan Mooney, along with Healthforce Center at the University of California, San Francisco conducted impact assessments on recommendations developed by the California Future Health Workforce Commission.

The assessments were provided to the commission and used to help determine which of more than 30 proposals would be part of the commission’s final report. In addition, Nora Leibowitz summarized commissioner dissents with the draft recommendations and organized the outstanding issues for the report.

The final report, which identifies a doctor shortage in California and mechanisms for addressing the problems, included the supporting work by HMA.

Download the impact assessments below.

HMA MACPAC Report Published

A team of HMA colleagues including Sarah Barth, Sharon Silow-Carroll, Esther Reagan, Mary Russell and Taylor Simmons completed a study for the Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission (MACPAC) to examine care coordination requirements for several Medicare-Medicaid integrated care models.

The study’s final report, Care Coordination in Integrated Care Programs Serving Dually Eligible Beneficiaries – Health Plan Standards, Challenges and Evolving Approaches, is posted to the MACPAC website.

The final report details state and federal managed care contract requirements for care coordination, summarizes stakeholders’ perspectives on care coordination based on structured interviews, and highlights promising care coordination practices and challenges for ensuring effective care coordination for dually eligible beneficiaries.

Medicaid Managed Care Spending in 2018

This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to Centers for Medicare & Medicaid Services (CMS), we have 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) 2018. The final version of the report will be completed by the end of 2019 and posted to the CMS website at that time. Based on the preliminary estimates, Medicaid expenditures on medical services across all 50 states and six territories in FFY 2018 exceeded $588 billion, with over half of all spending now flowing through Medicaid managed care programs. In addition, total Medicaid spending on administrative services was $27.8 billion, bringing total program expenditures to $616 billion.

April 17, 2019

Read Roundup

White paper prepared by HMA aligns CenteringPregnancy with value-based payment models

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In, “Aligning Value-Based Payment with the CenteringPregnancy Group Prenatal Care Model: Strategies to Sustain a Successful Model of Prenatal Care,” HMA authors Diana Rodin, MPH, and Margaret Kirkegaard, MD, MPH, review new opportunities to promote improved outcomes and lower costs in maternity care though value-based payment strategies. Prepared for the Centering Healthcare Institute, it demonstrates specifically how CenteringPregnancy can be an effective, financially sustainable model of maternity care, that meets the goals of value-based payment contracts.

The report examines:

Value-based payment in Medicaid maternity care
Alternating payment models in maternity care across states
CenteringPregnancy as a model of prenatal group care – outcomes, evidence, cost and savings
CenteringPregnancy alignment with value-based payment framework

The complete white paper can be downloaded below.

HMA Summary of 2020 Medicare Advantage and Part D Flexibility Final Rule

This week, our In Focus reviews the Calendar Year (CY) 2020 Medicare Advantage (MA) and Part D Flexibility Final Rule (Final Rule) issued by the Centers for Medicare & Medicaid Services (CMS) on April 5, 2019. The Final Rule implemented various provisions contained in the Bipartisan Budget Act of 2018 (BBA), which required the expansion of MA telehealth benefits and established new criteria for Dual Eligible Special Needs Plans (D-SNPs) integration requirements and streamlined Medicare and Medicaid grievance and appeals processes. The Final Rule also established rules to improve MA and Part D program quality and accessibility, clarified program integrity policies, and established new rules for the MA and Part D Quality Rating System.

April 10, 2019

Read Roundup

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

Understand the importance of peers and community health workers and the roles they play in keeping local communities activated.
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.
Learn how to engage community members in community-based participatory research and program implementation to develop and implement effective services.
Understand how to use surveillance data needed to identify and respond to neighborhoods at growing risk for opioid deaths.
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.
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.

HMA Analysis of 2020 Medicare Advantage Rate Notice and Final Call Letter

This week, our In Focus reviews the Announcement of Calendar Year (CY) 2020 Medicare Advantage Capitation Rates and Medicare Advantage (MA) and Part D Payment Policies (Rate Announcement) and Final Call Letter, issued by the Centers for Medicare & Medicaid Services (CMS) on April 1, 2019. The Rate Announcement and Call Letter includes final updates to MA payment rates and guidance to plan sponsors as they prepare their bids for CY 2020. Bids for CY 2020 are due to CMS on or before Monday June 3, 2019. It is important to note that the Announcement and final Call Letter does not take into consideration the Health and Human Services (HHS) Office of Inspector General (OIG) proposed rule which seeks to remove anti-kickback protection for prescription drug rebates, which, if finalized as proposed, could have significant impacts on Part D plans’ bids. While the administration has not provided any guidance on how plans should construct their 2020 bids in response to the rebate changes, HHS could decide to delay the rule’s effective date to 2021 or CMS may allow plans to update their 2020 bids later this year.

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