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HMA Insights 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 blogs, webinars, case studies, reports and more.

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Webinar

Webinar Replay: Personal Responsibility & Community Engagement in Medicaid

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This webinar was held on May 17, 2018.

A growing number of state Medicaid agencies are developing initiatives aimed at achieving broader social goals not previously emphasized in Medicaid, including most notably the introduction of community engagement requirements. Personal responsibility initiatives in Medicaid are not new, but today there is intense state and national focus on leveraging these initiatives as a component of coverage for the non-disabled adult Medicaid expansion population.

During this webinar, state policy experts from HMA Medicaid Market Solutions provided an overview of existing Medicaid personal responsibility initiatives and discussed what tools state and industry leaders need to navigate implementation and operation of these unique programs.

Learning Objectives

  1. Learn why states are stressing personal responsibility as a key social determinant of health, including a look at the policy decision-making process states go through when considering community engagement and other personal responsibility initiatives.
  2. Discover the key components in the design of a personal responsibility 1115 waiver program, including the complexities of translating policy into actual practice.
  3. Understand administrative hurdles and information technology challenges that can occur when implementing community engagement strategies.
  4. Gain key insights into how to integrate personal responsibility policies into existing Medicaid operations, including examples of how other states accomplished this.

HMA Medicaid Market Solutions Speakers

  • Kaitlyn Feiock, Senior Consultant (Indianapolis)
  • Amanda Schipp, Senior Consultant (Indianapolis)

Who Should Listen
This webinar was designed for state officials and staff; executives of Medicaid managed care plans; Medicaid systems and operational vendors and stakeholders; clinical and administrative leadership of health systems; behavioral health providers; federally qualified health centers; and other provider organizations trying to understand the emerging trend toward personal responsibility waivers in Medicaid.

View the webinar slides here: HMA Webinar 5-17-2018

Webinar

Webinar Replay: The State of the States: Key Data on State Medicaid Long-Term Services and Supports Programs

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This webinar was held on March 22, 2018.

As the primary payer for long-term services and supports (LTSS) in the U.S., Medicaid accounts for more than 50 percent of all public and private spending on LTSS. For states, paying for LTSS represents a steep financial commitment. Medicaid-funded LTSS accounts for more than 30 percent of state Medicaid program spending, which pays for more than 5 million people who receive home and community-based and institutional services. Adults and seniors represent about 85 percent of Medicaid-funded LTSS beneficiaries. Most are also covered under the Medicare program for their non-LTSS needs. It’s no wonder state Medicaid programs see LTSS as one of their greatest challenges, especially given rising demand for LTSS from the “age wave” and advances that help people with disabilities to live longer.

During this webinar, HMA experts covered an important set of data points to help participants assess the current and future state of the states concerning their LTSS trends and needs. Key data points about states included demographic shifts, social determinants of health, LTSS spending, state economic environment, relationships with Medicare, and system readiness.

Learning Objectives

  1. Enhance your understanding of LTSS challenges facing states given an aging population and continued increases in life expectancy for individuals with disabilities.
  2. Understand how LTSS challenges and opportunities vary by state and how these differences will impact state planning, readiness, and budgetary constraints.
  3. Find out how states are responding to emerging LTSS trends and challenges, including case studies of forward-looking state initiatives concerning LTSS planning and implementation.

Speakers

Sarah Barth, Principal, HMA (New York, NY)
Ellen Breslin, Principal, HMA (Boston, MA)
Barbara Edwards, Principal, HMA (Columbus, OH)
Dennis Heaphy, Healthcare Advocate, Disability Policy Consortium
Anissa Lambertino, Senior Consultant, HMA (Chicago, IL)

Webinar

Webinar Replay: Innovations in Medicaid Managed Long-Term Services and Supports

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This webinar was held on February 28, 2018.

Health Management Associates and the AARP Public Policy Institute discuss the findings of the new report on Emerging Innovations in Managed Long-Term Services and Supports (LTSS) for Family Caregivers. The report shows that health plans are increasingly recognizing and supporting family caregivers for individuals with LTSS needs. The webinar also featured the real-world experiences of Anthem Inc., a health plan that is helping family caregivers in LTSS settings. The emerging innovations report is part of the joint Long-Term Services and Supports State Scorecard series and supported by The Commonwealth Fund, The SCAN Foundation, and the AARP Foundation.

Learning Objectives

  1. Learn about emerging innovations for supporting family caregivers, taken from in-depth interviews with more than 40 LTSS leaders at 15 of the nation’s Medicaid managed care plans.
  2. Understand why state policy, managed care contract language, and advocacy are major drivers for family caregiver supports in managed LTSS.
  3. Learn how health plans, community-based organizations, and regulators can work together to help family caregivers overcome significant barriers, including the need for access to home care workers, instruction, counseling, and respite care.
  4. Find out how health plans can help family caregivers find balance in their caregiver roles, avoiding burnout and compromises to their own health and economic security.

Speakers:

Susan Reinhard, SVP, Director, AARP Public Policy Institute
Barbara Edwards, Principal, Health Management Associates
Merrill Friedman, Senior Director, Disability Policy Engagement, Anthem, Inc.

Who Should Listen
Medicaid directors and officials of state Medicaid programs; Medicaid health plans; accountable care organizations and other provider-led Medicaid managed care entities; safety net providers, including community-based organizations and delivery systems; state aging and disability administrators; LTSS researchers; and advocates.

Webinar

Webinar Replay: New Life for 1332 Waivers: Next Steps in State Health Insurance Exchange Market Innovation

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This webinar was held on February 7, 2018.

With the current administration aiming to provide increased state flexibility in the use of federal healthcare funds, ACA Section 1332 State Innovation Waivers may attract renewed interest. Section 1332 waivers allow states to modify certain aspects of their health insurance Exchange markets and operating rules, for example, easing regulations on benefit levels, allowing flexibility in how subsidies are spent, and developing reinsurance programs to promote the stability of individual markets. While only a handful of states have applied to date, Section 1332 waivers remain an important policy lever to watch.

During this webinar, HMA experts will provide an update on the status of Section 1332 waivers, address the types of modifications states are applying for, and assess the potential impact on health plans, providers, regulators, and consumers.

Learning Objectives

  1. Obtain an update on the status of Section 1332 waivers, including a close look at which states have submitted waiver applications and the innovations proposed.
  2. Understand the operational realities of developing, applying for, and implementing a Section 1332 waiver.
  3. Find out how Congress is trying to change Section 1332 waiver requirements in hopes of increasing state flexibility in relation to ACA requirements.

HMA Speakers

Donna Laverdiere, Principal (San Francisco, CA)
Nora Leibowitz, Principal (Portland, OR)

Who Should Attend

State officials and staff; executives of Medicaid managed care plans; clinical and administrative leadership of health systems, behavioral health providers, FQHCs, and other provider organizations.

Webinar

Webinar Replay: Behavioral Health Mergers: A Step-by-Step Guide to Evaluating, Structuring, and Implementing a Merger

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This webinar was held on December 6, 2017.

A growing number of behavioral health providers have made the decision to merge with one another, or with other health care entities, to achieve the scale, scope and sophistication necessary to thrive in an increasingly complex healthcare system.

During this webinar, behavioral health and legal experts from HMA and Proskauer Rose will walk through how to successfully evaluate, plan, and implement such a merger. This includes not only the decision to merge, choice of partner, structural alternatives, and key deal terms, but also the pre- and post-merger work required to ensure a smooth and successful transition, identify and achieve stated goals, and address strategic, operational and legal concerns.

Learning Objectives

  1. Find out how to establish clear pre- and post-merger goals and metrics.
  2. Understand the role of the “merger committee” in deciding on the type of merger, future corporate structure, composition of board, organizational chart, decision-making processes and timelines.
  3. Learn about alternative and corporate deal structures, and the most important deal terms.
  4. Find out how to develop an internal and external communications strategy to help inform key constituents, including staff, partners, and donors.
  5. Understand the key legal and fiscal analyses and due diligence necessary to inform a meaningful merger process.
  6. Learn how to develop a contingency strategy to identify and address potential risks and pitfalls in the merger implementation.

Speakers
Meggan Schilkie, Principal, HMA
Richard Zall, Partner, Proskauer Rose LLP

Who Should Listen

Executives among behavioral health providers, community-based organizations, health systems, and not-for-profit healthcare organizations.

Webinar

Webinar Replay: What’s Next for CMS Innovation Center?

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This webinar was held on November 30, 2017.

CMS Administrator Seema Verma announced in September that the Center for Medicare & Medicaid Innovation (CMMI) would shift its focus from promoting mandatory, large-scale value-based payment initiatives to an approach that stresses voluntary, home-grown efforts. The upshot: expanded waiver flexibility that will allow providers freedom to develop and test a wide variety of value-based solutions.

During this webinar, experts from HMA and Leavitt Partners discussed why CMMI adopted this new approach and what it means for providers. The webinar also explores CMMI’s underlying desire to foster healthcare competition by promoting value-based payment models without creating market leverage.

Learning Objectives

  1. Understand the practical implications of CMMI shifting away from testing large-scale, standardized value-based models to focus more on voluntary, provider-led, home-grown models and what this approach may mean for the future of innovation.
  2. Obtain a roadmap to building, testing, and assessing the efficacy of potential value-based payment models at the local level.
  3. Understand what makes for a successful model test, including the process for testing a value-based payment model, applying for a waiver, development of a data infrastructure, obtaining provider cooperation, and ensuring an adequate mix of members.

Speakers

Tony Rodgers, Principal, HMA
David Muhlestein, Chief Research Officer, Leavitt Partners

Who Should Listen

Executives of hospitals, health systems, physician practices, clinics, behavioral health providers, and other provider organizations; Medicaid managed care plan executives; and Medicaid directors and staff.

Webinar

Webinar Replay: Managing Social Determinants of Health: A Framework for Identifying, Addressing Disparities in Medicaid Populations

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On September 7, 2017, HMA hosted the webinar, “Managing Social Determinants of Health: A Framework for Identifying, Addressing Disparities in Medicaid Populations,” in partnership with the Disability Policy Consortium.

Social determinants of health are increasingly recognized by Medicaid programs as important drivers of poor health outcomes and disparities that lead to higher costs. In response, Medicaid programs are beginning to analyze social determinants of health as potential causes of health disparities.

During this webinar, Ellen Breslin and Anissa Lambertino of HMA, Dennis Heaphy of the Disability Policy Consortium, and independent consultant Tony Dreyfus presented an analytical framework for understanding the impact social determinants of health have on Medicaid populations. Leveraging work done by the Institute of Medicine, the framework includes measures and statistical methods that Medicaid programs, health plans, and accountable care organizations can use to generate the type of information needed to develop interventions that improve health outcomes. Listen to the recording and:

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Webinar

Webinar Replay: Merger Readiness – What Behavioral Health Providers and CBOs Need to Know Before Considering a Healthcare Merger

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On May 10, 2017, HMA Information Services hosted the webinar, “Merger Readiness: What Behavioral Health Providers and CBOs Need to Know Before Considering a Healthcare Merger.”

Behavioral health providers and community-based organizations increasingly face an important decision.  Can they continue to go it alone? Or is it time to consider merging with another entity to achieve the scale, scope and sophistication necessary to thrive in a healthcare system that continues to grow only more complex? The answer involves not only an honest assessment of your existing goals, values, market prospects, and potential partners, but a clear understanding of what’s required from a strategic and operational standpoint to make your organization “merger ready.”

During this webinar, HMA Principals Josh Rubin and Meggan Schilkie will outline what behavioral providers and community-based organizations (CBOs) need to know when considering and ultimately pursuing a potential health care merger and the steps to take during each merger phase (Pre-Merger, Merger Execution, and Post-Merger). Listen to the recording and:

  • Understand the pros and cons of merging with a large health system vs. teaming up with another behavioral health provider, Federally Qualified Health Center or CBO.
  • Identify the types of data, quality measures, reporting mechanisms, and organizational structure necessary to position your organization as “merger ready” to potential partners.
  • Learn how to identify potential merger partners that align with your organization’s culture, values, and mission.
  • Develop effective messaging and communications strategies, allowing you to properly educate staff, board members, regulators, and other constituents about the pros and cons of a prospective merger.
Webinar

Webinar Replay: Building a Community Collaborative

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On April 12, 2017, HMA Information Services hosted the webinar, “Building a Community Collaborative: Evidence-Based Interventions that Bring Together Healthcare Providers, Community-Based Organizations, and the Criminal Justice System.”

Individuals with complex challenges arising from chronic health conditions, mental health and/or substance-abuse disorders, or involvement in the criminal justice system are among the highest-cost utilizers of the healthcare system. A multi-pronged Community Collaborative can ensure evidence-based interventions that identify and effectively treat high utilizers – helping to keep them out of the emergency room and out of jail.

During this webinar, HMA Principal Bren Manaugh and Senior Consultant Amanda Ternan provide a case study of a successful Community Collaborative in Bexar County, Texas. HMA Senior Consultant Laquisha Grant discusses similar initiatives in New York. The webinar offers practical considerations for building and operating a Community Collaborative, ensuring best practices, and creating a shared recognition of the need for trust and coordination among healthcare providers, community-based organizations (CBOs), and the criminal justice system. Listen to the recording and:

  • Understand the two primary focal points of a Community Collaborative: Interventions that help keep high-cost utilizers of healthcare out of the emergency room; and diversions that help keep people out of jail.
  • Define the roles of the key constituents in a Community Collaborative, including healthcare providers, hospitals, EMS, CBOs, police, judges, and local government health officials.
  • Develop a community impact framework to gather and disseminate the type of data needed to drive effective interventions.
  • Understand the clinical components of the Community Collaborative model, including multi-disciplinary treatment teams; targeted, evidence-based interventions; and person-centered, integrated care that addresses medical, behavioral, and psychosocial needs.
Webinar

Webinar Replay: How CBOs Contract, Receive Reimbursement for HCBS in Medicaid Arrangements – A Blueprint for Success

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On March 1, 2017, HMA Information Services hosted the webinar, “How Community-Based Organizations Contract and Receive Reimbursement for Home and Community-Based Services in Medicaid Arrangements – A Blueprint for Success.”

Community-based organizations (CBOs) have a long history of supporting people with disabilities and older adults to live and thrive in the community, through a variety of funding structures. States are increasingly realizing the value of these organizations as providers and partners in their Medicaid-funded programs. At the same time, many states are partnering with Medicaid managed care organizations to provide long-term services and supports (MLTSS) and considering value-based payment structures for LTSS. This creates both opportunities and challenges for CBOs who have had experience serving individuals who need assistance to be able to live independently in their own homes.

During this webinar, a panel of experts provide real-world strategies that CBOs can use to effectively expand access to their services, work with state Medicaid programs, contract with managed care, and ensure sufficient reimbursements. Listen to the recording and:

  • Learn where CBOs fit within Medicaid-funded long-term services and supports, in an increasingly value-based and integrated healthcare landscape.
  • Understand the challenges in moving from grant-based funding to payment structures based on the development of networks, utilization management, and quality.
  • Identify various contracting strategies available to CBOs in dealing with Medicaid managed care health plans.
  • Obtain case studies of successful CBOs approaches to contracting and reimbursement, including tips on how to form networks of community-based providers.
  • Learn how to address back-office functions, reporting requirements, and IT challenges that come with managed care contracting arrangements or participation in a CBO network

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Webinar

Webinar Replay: Relationship-Centered Care

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On February 16, 2017, HMA Information Services hosted the webinar, “Relationship-Centered Care: A Healthcare Provider’s Guide to Patient Engagement, Shared Decision Making, and Improved Outcomes.”

Relationship-centered care is more than just a good bedside manner. It’s an entire primary and behavioral care construct designed to foster patient engagement, shared decision making, and a deep collaborative approach between healthcare providers and patients.

During this webinar, HMA experts Margaret Kirkegaard, MD, family physician, and Jeffrey Ring, PhD, health psychologist, provide a deep appreciation of the value of relationships in the provision of medical care, including data that illustrates the efficacy of the relationship-centered approach. The webinar also provides a roadmap for provider organizations striving to enhance relationship-centered care initiatives that involve providers, patients, and the entire medical and administrative staff. Listen to the recording and:

  • Understand the psychology behind relationship-centered care and how it drives collaboration, shared decision making, and a team-based approach – in which the patient is part of the team.
  • Discover how relationship-centered care improves outcomes, reduces costs, and enhances patient and practitioner satisfaction.
  • Learn how relationship-centered care can ensure continuity for patients across the healthcare continuum and foster a more team-based approach among providers.
  • Assess the tools and techniques required to implement and monitor relationship-centered care initiatives among providers, office staff, and care teams.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.

Webinar

Webinar Replay: Outlook for Medicare

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On February 15, 2017, HMA Information Services hosted the webinar, “An Assessment of Potential Healthcare Policy Changes that Could Impact Original Medicare and Medicare Advantage.”

Throughout his campaign, President Trump indicated he would not make cuts to the Medicare program. But the reality is that the repeal of the Affordable Care Act could have a significant impact on several important Medicare benefits. Furthermore, many Republican legislators are considering a number of reforms that could drastically change the Medicare program, including the potential transition of Medicare to a premium support program.

During this webinar, HMA Principal Mary Hsieh and Senior Consultants Aimee Lashbrook and Jason Silva outline some of the key Medicare reforms being considered, which – if any – are likely to make it to the President’s desk, and how healthcare organizations can best navigate the evolving Medicare business and regulatory environment. Listen to the recording and:

  • Understand the ACA’s Medicare-related provisions and what might be included in a partial repeal.
  • Identify priorities of the new administration as it relates to Medicare.
  • Find out what premium support could mean to the Medicare program, and identify what factors will impact the likelihood that Congress will take the controversial step of attempting to transition Medicare to a defined contribution model.
  • Understand the potential opportunities and threats for insurance-based programs like Medicare Advantage and Medigap.
  • Assess the likely future of key Medicare programs such as Medicare Advantage, the Center for Medicare & Medicaid Innovation (CMMI), the Independent Payment Advisory Board (IPAB), and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
  • Identify major policy windows and how they could affect timing of any Medicare-related changes.

The slide deck for this webinar can be retrieved by clicking the “DOWNLOAD” button below.