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HMA Insights: Your source for healthcare news, ideas and analysis.

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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1426 Results found.

Webinar

Webinar replay: summary and implications of the 2023 Medicare Advantage advance notice

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This webinar was held on February 22, 2022. 

The Centers for Medicare & Medicaid Services (CMS) recently released the 2023 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C/D Payment Policies, which proposes important changes in plan payments, risk adjustment, Star Ratings, and other key financial and regulatory requirements for 2023.

During this webinar, consultants from Wakely Consulting Group, an HMA Company, provided an overview of the proposed changes, with an emphasis on the likely impact that the new rates and policies will have on Medicare Advantage bids, membership growth, quality, and strategy. Speakers also touched on other recent public statements from federal regulators that could point to additional future changes for Medicare Advantage plans.

Learning Objectives 

  • Understand how the proposals in the Advance Notice will impact Medicare Advantage payment rates in 2023.
  • Learn about updates to payment models and risk-adjustment methodologies, including a new effort to engage Medicare Advantage plans in value-based models that transform care.
  • Find out how new initiatives to account for how well plans address equity and social determinants of health will impact Star Ratings.
  • Understand the growth prospects for Medicare Advantage, including a look at how COVID-19 continues to affect plan membership growth, financial risk, and profitability.

HMA Speakers

Thomas Grivakis, Senior Consulting Actuary, Wakely

Rachel Stewart, Consulting Actuary, Wakely

Blog

CMS payment notice signals shift in COVID-19 policies for Medicare Advantage, Part D

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This week our In Focus section reviews the Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies issued by the Centers for Medicare & Medicaid Services (CMS) on February 1, 2022. The Advance Notice includes proposed updates to MA payment rates and guidance to plan sponsors as they prepare their bids for CY 2023. It also shows CMS’ updates to Part D benefit parameters. Comments are due by 6:00 PM EST on March 4, 2022. The final Rate Announcement will be published by April 4, 2022.

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Blog

Delaware Releases Medicaid Managed Care RFP

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This week our In Focus section reviews the Delaware request for proposals (RFP) for Diamond State Health Plan (DSHP) and Diamond State Health Plan Plus (DSHP Plus), the state’s Medicaid managed care programs. The RFP was released by the Delaware Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) on December 15, 2021.

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Brief & Report

Second behavioral health issue brief focuses on workforce crisis and call for immediate action

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The National Council for Mental Wellbeing (National Council) and HMA have released the second in the series of three issue briefs examining the ongoing, and exacerbated, workforce and staffing crisis facing behavioral health services providers and facilities.

The brief, Immediate Policy Actions to Address the National Workforce Shortage and Improve Care, focuses on clinical transformation and provides short-term recommendations to support states in addressing the workforce shortages, provider burn-out, recruitment and retention.

Recommendations include:

  • Adopting transformative clinical approaches and team-based care
  • Identifying short-term actions and developing long-term strategies for improvement
  • Expanding the workforce to build a more robust provider pipeline
  • Increase adoption of in-person/telehealth hybrid models

HMA and the National Council colleagues contributed to the briefs and surrounding research.

Webinar

Webinar Replay: Comparing Medicaid program delivery models on quality outcomes

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This webinar was held on February 15, 2022.

In 2020, state and federal government spending on Medicaid was $646 billion, with just over half going to Medicaid managed care programs and the rest to fee-for-service (FFS), primary care case management (PCCM), and other models. Despite the large investments, little evidence exists on differences in quality between the various models. Using the 2019 CMS Adult and Child Core Set Quality Measures, HMA normalized performance data across states to compare outcomes between managed care, FFS and PCCM. During this webinar, HMA consultants discussed the findings, which were published in an HMA white paper in November 2021.

Learning Objectives: 

  • Understand how the different Medicaid delivery models performed on quality measures from the 2019 Adult and Child Core Set.
  • Learn more about the Adult and Child Quality Measure Core Set and why the 2019 dataset provides one of the first opportunities to make valid comparisons between the Medicaid delivery models.
  • Find out how this research could be expanded upon in the future to assess the key factors that drive higher quality and better performance in population health for low-income individuals.
  • Explore the broader implications of this research for policymakers and state Medicaid officials.

HMA Speakers

Anthony Davis, Managing Director, Quality and Accreditation Services, Portland, OR

David Wedemeyer, Principal, Los Angeles, CA

Joe Moser, Principal, Indianapolis, IN

Beth Kidder, Managing Principal, Tallahassee, FL

Blog

Minnesota Releases Medicaid Medical Assistance, MinnesotaCare RFP Covering 80 Counties Outside Twin Cities

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This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of the Twin Cities seven-county region. The RFP was released by Minnesota Department of Human Services, Purchasing and Service Delivery Division on January 18, 2022. Contracts will begin January 1, 2023, covering approximately 470,000 members.

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