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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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195 Results found.

Webinar

Webinar Replay: Federal COVID-19 Response: Medicare Advantage Policy Changes and Impacts

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This webinar was held on June 11, 2020.

In response to the rapid spread of the COVID-19 virus, Congress and the Centers for Medicare & Medicaid Services (CMS) have made significant policy changes to Medicare Advantage regulations, allowing for expanded benefits and other flexibilities designed to better serve the Medicare population.

During this webinar, HMA experts addressed the impact of these changes, including a look at policies affecting cost sharing, telehealth, Star Ratings, prescription drugs, provider funding, appeals, and Special Needs Plans (SNP). Speakers also addressed the likelihood that these policies remain in place even after the COVID-19 emergency ends.

Learning Objectives: 

  • Learn about changes in federal Medicare Advantage policies in response to COVID-19.
  • Understand how Medicare Advantage plans, including Special Needs Plans, are adjusting to the new rules, including the impact on benefit design, care delivery, payment models, and quality.
  • Identify operational implications of Medicare Advantage policy changes to ensure continued delivery of high-quality care to beneficiaries.

HMA Speakers:

  • Julie Faulhaber, MBA, Principal, Chicago
  • Mary Hsieh, PharmD, MPH, Managing Principal, Atlanta
  • Narda Ipakchi, MBA, Senior Consultant, Washington, DC
  • Sarah Owens, Principal, Philadelphia
  • Danielle Pavliv, MPH, PMP, Senior Consultant, Atlanta
Webinar

Webinar Replay: Tracking State Responses to COVID-19 for Home Health and Home Care Providers: Survey Results and Provider Perspectives

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This webinar was held on June 9, 2020. 

With most federal COVID-19 funding going to hospitals and nursing homes, states are implementing various Medicaid authorities, legislation, and policies of their own to improve access to long-term services and supports, including home and community-based services. HMA home care experts have tracked these state efforts and presented the results during this informational session. They were joined by home health and home care industry leaders, who offered important perspectives on state actions as well as thoughts on additional steps that will be necessary over the long term.

Learning Objectives:

  • Understand state COVID-19 legislation, executive orders, and policy guidance and how it affects home health and home care providers.
  • Gain perspective from home health and home care providers on how state COVID-19 efforts are playing out.
  • Understand the immediate and long-term challenges and opportunities home health and home care providers are likely to face as they respond to COVID-19.

Speakers

Karen Brodsky, Principal, HMA
Pat Kelleher, Executive Director, Home Care Alliance of Massachusetts
Linda Mintz, Co-Chair, CareFinders Total Care
Susan Tucker, Principal, HMA

Webinar

Webinar Replay: Supporting the Behavioral Health Workforce During the COVID-19 Response: Strategies for Providers to Sustain and Strengthen the Behavioral Health System

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This webinar was held on May 18, 2020.

Even as behavioral health providers work tirelessly to respond to COVID-19, the most forward-looking organizations also recognize that the pandemic has laid bare the need to develop a wide variety of short- and long-term solutions to ongoing and emergent needs. The most pressing of these needs concern strategies to support and strengthen the behavioral health system workforce.

During this webinar, HMA experts showed how leading behavioral health providers are using new regulatory flexibilities, emerging staffing models, and new delivery formats to develop and implement organizational changes and innovations that sustain workforce excellence.

Learning Objectives:

  • Hear how behavioral health providers around the country are supporting their workforce and continuing to meet ongoing and emergent behavioral health needs.
  • Learn how collaborative efforts among states and providers can lead to meaningful changes in rules, roles, tools, and approaches to delivering behavioral healthcare.
  • Obtain cross-cutting strategies for management and leadership during a crisis.
  • Find out how to ensure organizational structures are in place to help staff adjust to change, foster resilience, and provide bereavement support when appropriate.
  • Understand the available resources and emerging practices for workforce support, including training, technology, and strategies for enhancing the ability of the behavioral health workforce to meet the needs of special populations.

HMA Speakers

Barry Jacobs, PsyD, Principal, Philadelphia, Pennsylvania
Gina Lasky, PsyD, Principal, Denver, Colorado
Shannon Mong, PsyD, Principal, San Francisco, California
Lori Raney, MD, Principal, Denver, Colorado
Meggan Schilkie, MBA, Managing Principal, New York
Tim Sheehan, MSW, Principal, Chicago, Illinois

Webinar

Webinar Replay: Health Equity and Enlightened Leadership in the Shadows of COVID-19: A Conversation with Jay Bhatt, D.O.

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This webinar was held on April 30, 2020.

True health system innovation and transformation requires the type of enlightened leadership that understands the nature and role of health equity and social justice. That’s especially true in the shadows of COVID-19, when disparities are heightened, and a strong vision is needed to progress toward the elimination of health inequities.

During this webinar, Jay Bhatt, D.O., a practicing internist and past chief medical officer of the American Hospital Association, engaged in a spirited conversation with HMA health system transformation and leadership expert Jeffrey Ring about the role of strong leadership in health system transformation and healthcare justice.

 Learning Objectives

  • Explore the concept of health equity, including a look at how inequities are heightened in the era of COVID-19.
  • Understand the concept of enlightened leadership and its role in achieving optimal healthcare delivery.
  • Gain insight into how the fallout from COVID-19 will impact our understanding of healthcare justice.

Speakers

Jay Bhatt, D.O., practicing internist; Past SVP, and Chief Medical Officer, American Hospital Association; Past President, Health Research and Educational Trust
Jeffrey Ring, PhD, Principal and Health Psychologist, Health Management Associates

Webinar

Webinar Replay: Reflecting on HCBS Policies and Practices in Response to COVID-19

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This webinar was held on April 17, 2020.

Medicaid-covered home and community-based services (HCBS) are critical to the health and well-being of millions of individuals with intellectual or developmental disabilities, physical disabilities, and/or behavioral health conditions.

In response to COVID-19, the Centers for Medicare and Medicaid Services (CMS) has provided state Medicaid programs with increased flexibility to modify HCBS programs to continue to provide timely high-quality care. State Medicaid programs have secured approval for new initiatives through a combination of Section 1135 Waivers, 1115 Emergency Amendments, Emergency State Plan Amendments, and Appendix K amendments to HCBS 1915(c) waivers.

During this webinar, our HMA experts outlined what these changes mean for states, providers, and individuals who rely on HCBS. Speakers provided an overview of key flexibilities, offered examples of promising practices, and shared insights about the present and the future of HCBS as reshaped by COVID-19.

Learning Objectives 

  • Learn how state Medicaid programs have used CMS-approved waivers and amendments to temporarily modify HCBS policies and practices to protect people during the COVID-19 pandemic.
  • Understand how new HCBS flexibilities impact HCBS providers on-the-ground.
  • Understand what these changes mean for individuals who receive services and supports.
  • Learn more about how the pandemic may be changing the future of HCBS.

HMA Speakers

Sarah Barth, JD, Principal, New York, NY
Ellen Breslin, MPP, Principal, Boston, MA
Sharon Lewis, Principal, Portland, OR
Susan Tucker, CPA, Tallahassee, FL

 

Webinar

Webinar Replay: Treatment of Substance Use Disorders During the COVID-19 Pandemic

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This webinar was held on April 2, 2020.

The COVID-19 pandemic has significantly impacted the treatment of individuals with substance use disorder (SUD), including changes in the administration of Medications for Addiction Treatment (MAT), new telehealth rules and billing procedures, and other emerging protocols and regulations designed to ensure individuals with SUD continue to receive the best care possible.

During this webinar, HMA addiction experts Scott Haga and Shannon Robinson outlined how providers and patients can best navigate this changing landscape, with a special emphasis on the opportunities and risks associated with treating SUD during the pandemic.

Learning Objectives

  • Find out how the COVID-19 pandemic significantly increases the risk of SUD relapse and overdose-related fatalities. 
  • Understand federal regulatory changes to the practice of prescribing MAT for opioid use disorder, including changes from DEA, SAMHSA, Office of Civil Rights and more.
  • Obtain best practices and billing guidelines for the use of telehealth to treat individuals with SUD remotely.

HMA Speakers

Scott Haga, MPAS PA-C, Senior Consultant, Lansing, MI
Shannon Robinson, MD, FASAM, Principal, Costa Mesa, CA

As mentioned in the webinar, the Telehealth Readiness Questionnaire is also available.

Webinar

Webinar Replay: Telehealth and the COVID-19 Response: Policy Changes and Implementation Strategies

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This webinar was held on March 31, 2020

Telehealth services have become a key strategy for expanding access to care during the COVID-19 pandemic, driven in part by significant changes in laws and regulations to encourage the adoption of technologies that support telehealth. With these rapid changes, providers are struggling to understand how to best serve their patients using telehealth technologies.

During this webinar, HMA experts described the different modalities of telehealth and laid out the policy and reimbursement implications for the Medicare and Medicaid programs. Speakers detailed changes to HIPAA enforcement and policy changes that ensure ongoing support for prescribers and recipients of controlled substances. The webinar also reviewed how recent policy changes impact key provider decisions with regards to selecting, implementing, and building a business case for new telehealth services to support patients during the pandemic.

As mentioned in the webinar, the Telehealth Readiness Questionnaire is also available.

Learning Objectives

  • Understand the different modalities of telehealth services and how to bill for them.
  • Find out about recent changes in Medicare and Medicaid reimbursement policy stemming from the COVID-19 response.
  • Learn the key steps in selecting a telehealth platform, building a business case, adapting workflows, and other implications for physician practices.

HMA Speakers

Jean Glossa, MD, Managing Principal for Clinical Services, Washington, DC

David Bergman, MPA, Principal, New York

Zach Gaumer, Senior Consultant, Washington, DC

Webinar

Webinar Replay: HMA Analysis of Medicare Advantage Advance Notice and Part C/D Proposed Rule

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This webinar was held on February 18, 2020.

On February 6, the Centers for Medicare & Medicaid Services (CMS) issued Part II of the Advance Notice of Methodological Changes for Calendar Year (CY) 2021 which includes proposed updates to Medicare Advantage (MA) payment rates. In a departure from previous years, the agency did not release a separate Call Letter which typically includes Part C and Part D policy guidance and bidding instructions. Instead, the agency released a proposed rule which includes proposed policy and technical changes, most of which are scheduled to go into effect in the 2022 plan year. CMS also issued separate bidding instructions for plans as they prepare their bids for CY2021.

During this webinar, an HMA team of Medicare experts including Jonathan Blum, Eric Hammelman, Julie Faulhaber, and Narda Ipakchi presented an overview of the payment rate updates and proposed policy changes included in the Advance Notice and Proposed Rule. They provided interested stakeholders with an overview and analysis of the proposed changes as well as what these changes mean for Medicare Advantage plans’ existing strategies and opportunities.

Learning Objectives

  • Understand what the expected 2021 rate increase for Medicaid Advantage plans means for continued industry growth and financial performance.
  • Learn about updates to the Medicare Advantage Star Ratings system, including proposals to increase measure weights for patient experience and complaints.
  • Learn about the proposed changes to network adequacy requirements and how the agency is promoting further use of telehealth among plans.
  • Understand CMS’ efforts to implement requirements that expand Medicare Advantage coverage to beneficiaries with ESRD.

HMA Speakers

Jon Blum, Managing Principal, Washington, DC
Eric Hammelman, Principal, Chicago
Narda Ipakchi, Senior Consultant, Washington, DC
Julie Faulhaber, Principal, Chicago

Webinar

Webinar Replay: Lessons from Colorado Community-Based Organizations Engaged in Provider Partnerships that Address Social Determinants of Health

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This webinar was held on January 31, 2020.

HMA’s how-to session last year on development and implementation of social determinants of health (SDOH) partnerships for vulnerable Colorado populations was a tremendous success, offering frameworks and tools for effective SDOH initiatives among community-based organizations (CBOs), health systems, and other providers. As a follow-up to this discussion, HMA hosted a “lessons learned” session, in which two CBOs who have implemented innovative SDOH partnerships outlined the results of their programs and provided insights on how to develop an effective SDOH collaboration.

Learning Objectives

  1. Learn how CBOs and health systems are successfully collaborating on SDOH services, payment models, and payer-provider relationships.
  2. Understand the opportunities and challenges related to contracting between CBOs and healthcare systems, including referrals, coordinated care, and pay-for-performance models.
  3. Find out how to engage and support local communities by activating and financing Community Health Workers (CHWs) for payment by health plans within the Pathways HUB framework.
  4. Learn how to assess potential partnerships and arrangements that address whole person health, including SDOH.

Speakers

  • Grace Damio, Center Director, Hispanic Health Council, Hartford, CT. The Hispanic Health Council has contracted with multiple healthcare provider systems to implement its community CHW-led, home-based diabetes intervention – Diabetes Among Latinos Best Practices Trial (DIALBEST).
  • Giovanna Rogow, Chief Executive, Maternal Infant Services Network (MISN), Newburgh, NY. MISN has contracted individually with healthcare providers and serves as the backbone organization leading a 30-member CBO consortium called Hudson Valley Collective for Community Wellness (HVCCW). This consortium addresses social determinants of health throughout a seven-county region through capacity building and collective action. The HVCCW is presently forming an Independent Practice Association to collectively contract for CHWs to conduct outreach and provide care coordination services on behalf of member organizations via the Pathways HUB model.

Who Should Listen

Representatives of Colorado state and county governments, Colorado Regional Accountable Entities, hospitals, providers, and CBOs working to address SDOH.

Webinar

Webinar Replay: Initiating a Successful Medicare Advantage Plan: Strategic, Operational and Planning Considerations

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This webinar was held on July 24, 2019.

If your managed care organization or health system is considering joining the growing market for Medicare Advantage (MA) plans, including Special Needs Plans (SNPs), or expanding your MA service area, now is the time to start planning for a 2021 launch.

During this webinar, HMA Managing Principal and former CMS Deputy Administrator for Medicare Jonathan (Jon) Blum is joined by HMA Managing Principal Mary Hsieh and Principal Julie Faulhaber. Together, they discussed the strategic, operational, and planning considerations every organization must address before initiating a successful Medicare Advantage plan. Our experts discussed regulatory concerns, operational readiness, benefit structure, marketing, risk management, and other key considerations.

Learning Objectives

  1. Find out what your organization needs to make a go/no go decision on the launch of a Medicare Advantage plan, including an assessment of financial feasibility, member opportunity, capital requirements, and operational capabilities.
  2. Understand the federal requirements and timelines and internal preparations involved in filing a successful application to initiate a Medicare Advantage plan.
  3. Learn why Medicare Advantage plans serve as a foundation for further efforts to initiate SNPs.
  4. Understand the key differences between SNPs and Medicare Advantage plans, including special SNP requirements such as the Model of Care.

Speakers

  • Jon Blum, Managing Principal, Washington, DC
  • Julie Faulhaber, Principal, Chicago
  • Mary Hsieh, Managing Principal, Atlanta

Who Should Listen

Executives from managed care organizations, insurers, hospitals, health systems and other entities considering the launch of a Medicare Advantage plan such as a Special Needs Plan or considering a Medicare Advantage Service Area Expansion.

Webinar

Webinar Replay: Unpacking the MassHealth One Care Procurement Databook: Key Considerations for Strengthening the Program, Advancing Health Equity

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This webinar was held on July 16, 2019. 

The Massachusetts One Care program, which went out to bid this year, is an 1115A Duals Demonstration (both a Financial Alignment Demonstration and a state demonstration) for dually eligible Medicare and Medicaid beneficiaries age 21-64 at the time of enrollment and living with disabilities. To assist potential bidders, the state released a Databook containing historical demographic, cost and utilization information for individuals who are eligible for One Care but not currently enrolled.

During this webinar, HMA experts broke down the One Care Databook and provided an eye-opening review of the data that can help regulators, health plans, providers and community-based organizations strengthen the program and advance health equity for the eligible population. Speakers also used sophisticated geo-mapping software to illustrate geographic variation in the cost and utilization of both Medicare and Medicaid services.

Learning Objectives

  • Gain insights into the eligible population and their use of Medicare and Medicaid services.
  • Consider regional variation in the cost and use of Medicare and Medicaid services.
  • Learn more about Medicare Part D service use among the eligible population.
  • Take stock of the opportunities to advance health equity gleaned from the data.

HMA Speakers

Ellen Breslin, Principal, Boston
Eric Hammelman, Principal, Chicago
Anissa Lambertino, Senior Consultant, Chicago

Who Should Listen

Federal and state regulators, Medicaid officials, and officials from the Centers for Medicare & Medicaid Services; executives of health plans, health systems, community-based organizations, and providers of long-term services and supports (LTSS).

Webinar

Webinar Replay: CMS Primary Care Initiative: Key Considerations Concerning New Value-Based Payment Options

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This webinar was held on July 11, 2019. 

The Centers for Medicare & Medicaid Services (CMS) has announced a new Primary Care Initiative, offering primary care providers (PCPs) in 26 regions nationally the opportunity to participate in new Medicare payment models beginning January 2020: Primary Care First (PCF).

During this webinar, experts from HMA described how this initiative builds on prior CMS innovation models in advancing primary care and outlined eligibility, payment models, and key considerations of the program. The PCF program includes an option to care for seriously ill patients who lack a primary care practitioner and opt to participate in this payment model option. It prioritizes the physician-patient relationship, reduces administrative burden, and financially incents improved health outcomes.

Learning Objectives

  1. Understand the eligibility requirements for the PCF programs.
  2. Describe program models including attribution and payment models.
  3. Understand the goals and quality metrics associated with PCF, including incentives aimed at reductions in hospital utilization and total cost of care.
  4. Lean how participation in this primary care initiative can help primary care practices expand their patient base, especially among high needs populations.

Speakers

  • Art Jones, MD, Principal, Chicago
  • Elizabeth Wolff, MD, MPA, Principal, New York

Who Should Listen

Physicians and executives from primacy care practices, IPAs, ACOs, hospitals, health systems, and other provider entities; health plans and other payers. Although eligibility for program participation is limited to the 26 targeted geographic areas, others may be interested in learning how CMS is progressing toward increasing primary care payment through capitation.