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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1809 Results found.

Brief & Report

HMA releases COVID-19 Medicare regulation tracking tool

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The Medicare program has rapidly transformed how it pays for healthcare providers in response to the COVID-19 pandemic. In an effort to capture these changes, HMA, commissioned by The Commonwealth Fund and The SCAN Foundation, tracked, categorized, and analyzed the 212 Medicare policy modifications made in response to the public health emergency.

HMA Senior Consultant Jennifer Podulka and Managing Principal Jon Blum led efforts to analyze and synthesize COVID-19-related legislative, regulatory, and subregulatory changes to existing Medicare regulations issued beginning January 1, 2020. The resulting issue brief Regulatory Changes to Medicare in Response to COVID-19 and companion Policy Tracker use nine categories to organize the data and will be periodically updated to include new information.

The issue brief outlines key COVID-19-related changes including providing telehealth reimbursement for more types of services and providers, and waived conditions of Medicare participation permitting patients to be treated in alternative care settings including community facilities, temporary facilities, homes and in some cases, out of state services on a temporary basis.

Congress and the Trump administration waived or changed regulations to allow flexibility to help healthcare providers, Medicare Advantage plans and Part D plans. The policy tracker catalogs and categorizes these regulatory changes based on characteristics, including types of providers and plans affected, effective date, and expected duration.

These changes have affected virtually all healthcare providers and health plans that participate in the Medicare program, and the issue brief examines several questions surrounding the changes moving forward including risk to beneficiary protections and Medicare spending controls established in the original legislation and rules.

Blog

Hawaii Releases Quest Integration Reprocurement RFI

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This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state’s QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360,000 individuals, including pregnant women, children, parents/caretakers, adults, and individuals who are aged, blind, or disabled (ABD). The state had awarded contracts earlier this year, however, the contracts were rescinded as the state focused on their response to COVID-19.

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Webinar

Webinar Replay: Exploring Medicare Advantage Plans as a New Business Strategy

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This webinar was held on August 6, 2020.

The COVID-19 pandemic shined a spotlight on funding pressures on providers and systems that rely largely on fee-for-service payment. This, along with additional stressors brought on by the pandemic, has led many health systems and providers to consider revenue diversification and service expansion strategies. During this webinar, HMA Medicare Advantage experts addressed the option of using Medicare Advantage as a strategy to better manage care of patients and provide a steady stream of predictable revenues.

Learning Objectives:

  • Evaluate the benefits and risks of exploring a Medicare Advantage business strategy.
  • Understand the evolving national Medicare Advantage policy landscapes and competitive marketplace.
  • Assess various Medicaid Advantage plan options and strategic business considerations.
  • Find out about the unique market opportunities of Medicare Advantage Special Needs Plans.
  • Learn what needs to be done for a successful Medicare Advantage launch or expansion in 2022.

HMA Speakers

Jon Blum, Managing Principal, Washington, DC
Mary Hsieh, Managing Principal, Atlanta, GA

Webinar

Webinar Replay: Leveraging the Primary Care Team’s Strengths During Reopening: Part 3 – Payment and Documentation

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This webinar was held on July 29, 2020.

In this webinar, HMA primary care experts discussed current payment flexibilities that allow physician practices to maintain revenues while operating in a virtual environment. Given the likelihood that many patients will continue to receive care virtually even after the pandemic, HMA experts explored mechanisms for alternative payment models that support virtual care and allow for efficient use of the care team. Speakers also shared necessary considerations for documentation to assure data capture and appropriate billing.

Learning Objectives

  1. Discuss current relaxation of regulations related to the National Emergency Declaration and CMS flexibility.
  2. Understand the use of alternative payment models to enhance revenue opportunities for practices providing virtual care.
  3. Understand the need for new templates and order sets to support virtual care.
  4. Discuss EHR optimization to improve care processes and capture data.

Speakers

Helen Duplessis, MD, Principal, Los Angeles, CA
Lisa Harrison, MS, MHS, PA-C, Senior Consultant, Denver, CO
Roxane Townsend, MD, Managing Principal, Raleigh, NC

Blog

Oklahoma Releases Medicaid Managed Care Request for Public Feedback

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This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state’s Medicaid managed care program design before finalizing a request for proposals (RFP). The RFP, which is currently in development, is scheduled to drop in the fall and has an implementation date of October 2021. Individuals, program participants, providers, trade associations, companies, and other organizations are encouraged to submit responses by August 17, 2020.

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Blog

HMA Announces Cancellation of 2020 Annual Conference

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Health Management Associates has made the decision to cancel its October 2020 conference on Trends in Publicly Sponsored Healthcare, given continuing developments concerning COVID-19 and out of an abundance of caution for the safety of attendees, speakers, and staff. Full refunds will be made to registered attendees and sponsors.

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Webinar

Webinar Replay: Nursing Home Revenue Diversification and Care Options Series: Understanding the Impact of Nursing Home Compare Five-Star Quality Ratings

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This webinar was held on July 24, 2020. 

Even before COVID-19, nursing homes struggled with staffing shortages, inadequate reimbursement rates, and declining occupancy rates. The pandemic has amplified these challenges, forcing nursing homes to consider options for diversifying revenues and broadening services for both residents and individuals who qualify for institutional status but reside in the community. During this webinar (the second in a series), HMA quality experts will provide an overview of the Nursing Home Compare Five-Star Quality Rating System and its impact on nursing homes.

Learning Objectives

  • Understand the components of the Nursing Home Compare Five-Star Quality Rating System.
  • Find out how Nursing Home Compare ratings impact a nursing home’s business.
  • Learn the strengths and limitations of Nursing Home Compare as a true measure of nursing home quality.

HMA Speakers
Doug Elwell, COO, Chicago, IL
Susan Tucker, Principal, Tallahassee, FL