This week, our In Focus section reviews the policy changes included in the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Final Rule (CMS-1735-F). This year’s IPPS Final Rule includes several important policy changes that will change hospitals’ administrative procedures and may alter hospitals’ Medicare margins, beginning as soon as October 1, 2020.
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Webinar Replay – Health Performance Accelerator Webinar Series: Maximizing the “Value” of Value-Based Payment Arrangements
This webinar was held on September 15, 2020.
Provider-based organizations – particularly groups of providers such as accountable care organizations (ACOs), independent practice associations (IPAs), and clinically integrated networks – are in a unique position to create value for patients. Moreover, payers are increasingly being called upon to enter into value-based payment arrangements with providers. During this webinar, experts from HMA and HealthEC discussed ways in which providers can maximize the “value” of their value-based payment arrangements through careful contract design, robust performance measurement systems, and an orientation toward population health management.
Learning Objectives:
- Learn about strategies provider-based organizations should employ to design, negotiate and administer value-based payment contracts.
- Learn how HMA can work with provider-based organizations to succeed in a value-based payment environment.
- Find out how IT solutions such as HealthEC’s can dramatically improve processes such as data aggregation, synthesis, transformation, validation and comparative analysis in support of value-based payment contract negotiation, administration and continuous optimization.
Speakers
Greg Vachon, MD, MPH, Principal, HMA
Sanjay Seth, MD, MPH, MS, HealthEC, Executive Vice President
Resources referenced in this webinar can be found here.
Webinar Replay – Health Performance Accelerator Webinar Series: How Health Plans Can Meet Competing Performance Demands of Stakeholders
This webinar was held on September 10, 2020.
Health plans face complex and competing demands from a wide variety of stakeholders for measurable improvements in performance. That’s especially challenging for small and mid-sized health plans that don’t have the resources of larger entities. During this webinar, experts from HMA and HealthEC outlined ways in which health plans can use data and robust analysis to prioritize performance management efforts, improve key business functions, and meet the varied needs of state and federal regulatory agencies, enrollees, providers, advocacy groups, and other constituencies.
Learning Objectives:
- Learn about how health plans should approach improvements in business functions and overall performance to address the needs of various stakeholders.
- Learn how HMA can work with health plans on process and performance improvement initiatives.
- Find out how IT solutions such as HealthEC’s can dramatically improve health plan processes such as data aggregation, synthesis, transformation, validation and comparative analysis in support of process and performance improvement initiatives.
Speakers
Glenda Stepchinski, RN, BSN, Senior Consultant, HMA
Frank Persinger, Vice President, Strategic Development, HealthEC
California Releases Medi-Cal Managed Care RFI
This week, our In Focus section reviews the California request for information (RFI) regarding the Medi-Cal Managed Care Plan (MCP) contract and the upcoming Medi-Cal MCP procurement. The California Department of Health Care Services (DHCS) is seeking information to update boilerplate contracts and develop the request for proposals (RFP) scheduled for release in 2021.
Health Management Associates Acquires Health Policy Consulting Firm Burns & Associates
Today, Jay Rosen, founder and president of Health Management Associates (HMA), announced the firm’s acquisition of Burns & Associates, Inc., an Arizona-based health policy consulting firm that specializes in innovative approaches to the financing and delivery of health care and human services.
Webinar Replay – Health Performance Accelerator Webinar Series: How States Are Rethinking Medicaid Managed Care Performance Management
This webinar was held on September 8, 2020.
State Medicaid agencies (SMAs) are actively exploring improved approaches to managing the performance of Medicaid managed care organizations (MCOs) and accountable care organizations (ACOs), emphasizing tailored quality measures, new incentive models, more effective use of information technology, and revised contract requirements.
During this webinar, experts from HMA and HealthEC outlined potential improvements to MCO/ACO performance management and showcased ways in which information technology can be deployed to enable these improvements.
Learning Objectives:
- Learn about ways in which the number and mix of measures, the design of business processes and use of information systems should change to achieve improvements in MCO/ACO performance management.
- Learn how HMA can work with SMAs on performance management initiatives.
- Find out how IT solutions such as HealthEC’s can dramatically improve SMA processes such as data aggregation, synthesis, transformation, validation, and comparative analysis in support of performance management system improvements.
Speakers
Steve Soto, Principal, HMA
Sita Kapoor, HealthEC, Chief Information Officer
Webinar Replay – Health Performance Accelerator Webinar Series: Optimizing Your Communicable Disease Outbreak Management
This webinar was held on September 3, 2020.
The COVID-19 pandemic has demonstrated the challenges faced by state and local data management and analytics infrastructures in preventing and responding to infectious disease outbreaks. During this webinar, experts from HMA and HealthEC provided a framework for how states and local jurisdictions can leverage data to prevent major disease outbreaks and implement targeted strategies to address outbreaks when they occur.
Learning Objectives:
- Understand how data and analytics infrastructures can be used to help prevent infectious disease outbreaks.
- Learn about surveillance capabilities, including “early warning” capabilities, made possible by more robust contact tracing functionality and Internet-enabled devices, such as thermometers and remote monitoring systems.
- Explore response management capabilities, such as robust real-time adaptive modeling that can drive resource allocation and deployment.
- Understand risk stratification and predictive modeling which supports smart pre-deployment of outreach to vulnerable populations.
Speakers
Liddy Garcia-Bunuel, Principal, HMA
Jennifer Leaf Jaeger, MD, MPH, MS, HealthEC, Senior Medical Director
Webinar Replay – Health Performance Accelerator Webinar Series: Achieving Health Equity for Disadvantaged Populations
This webinar was held on September 1, 2020.
Across the nation, an unprecedented focus is being placed on achieving the goal of health equity. This goal requires acquiring, aggregating, and analyzing data on social determinants of health to help identify and address the root causes of health disparities. During this webinar, experts from HMA and HealthEC provided a roadmap for how states, health plans, and providers can leverage data to support the design, development, and implementation of successful health equity initiatives.
Learning Objectives:
- Understand why achieving health equity is an increasingly important goal for state Medicaid agencies, health plans and providers.
- Learn how racial inequality and social determinants of health contribute to inequities in health care access, outcomes, and status.
- Assess the readiness of states, health plans, and providers to address concerns over the impact of health equity on the morbidity and mortality or disadvantaged populations.
- Understand the role of analytics and population health management in identifying the causes of health disparities and building successful health equity initiatives.
Speakers
Desmond Banks, MPH, PhD, Senior Consultant, HMA, Washington DC
Jennifer Leaf Jaeger, MD, MPH, MS, Health EC, Senior Medical Director
HMA Summary of Democratic Nominee Joe Biden’s Healthcare Plan
This week, our In Focus section reviews Democratic Nominee Joe Biden’s healthcare plan to protect and build on the Affordable Care Act (ACA). On August 18, 2020, Biden was officially nominated as the presidential candidate. Biden vowed at the 2020 Democratic National Convention (DNC) that if elected, he would strengthen the ACA and provide a Medicare-like public option. HMA summarizes Biden’s official plan below.