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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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

Blog

D-SNP 2021 hospital and SNF admission data sharing: opportunity for states and health plans to support care transitions

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This week, our In Focus section provides an overview of new requirements and opportunities for states and Medicare Advantage (MA) Dual Eligible Special Needs Plans (D-SNPs) to increase Medicare and Medicaid  coordination in plan year 2021. Specifically, states and health plans will need to partner for compliance with calendar year (CY) 2021 Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) data sharing requirements for D-SNPs that are not designated as a fully integrated D-SNP (FIDE SNP) or a highly integrated D-SNP (HIDE SNP)[1]. CY 2021 State Medicaid Agency Contracts (SMACs) with these D-SNPs must document the notification process for sharing hospital and skilled nursing facility (SNF) admissions for at least one group of high-risk enrollees.[2]

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Blog

HMA article highlights value-based payment models

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With a focus on value-based payment (VBP) models and helping primary care practices prepare for a value-driven future, HMA experts Suzanne Daub, Caroline Rosenzweig and Meggan Christmas Schilkie will publish their article in the American Psychological Association journal Families, Systems & Health.

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Blog

Medicare and Medicaid flexibilities during public health emergencies

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This week, our In Focus comes from HMA Vice President Kathleen Nolan and Managing Principal Jon Blum. On March 13, 2020, President Trump declared a national emergency due to the rapid spread of COVID-19 virus. This declaration provides Health and Human Services (HHS) and the Centers of Medicare and Medicaid Services (CMS) new abilities to waive Medicare and Medicaid regulatory requirements to help health care providers, health plans and other stakeholders respond to immediate needs of their patients and communities.   In the past, HHS and CMS have solicited requests for relief needs from states, local providers and trade associations, among other stakeholders.  Health care providers, health plans and others should continue to monitor policy announcements from HHS and CMS and work with their states and trade associations to identify potential areas of need for requested regulatory relief.

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Blog

HMA analysis of the 2020 Medicare Advantage annual election period

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This week, our In Focus section examines Medicare Advantage (MA) enrollment changes resulting from the 2020 Annual Election Period (AEP). The AEP takes runs from October 15 to December 7 each year, and provides an opportunity for Medicare beneficiaries to sign up for, change, or disenroll from an MA plan for the upcoming year. The majority of enrollment changes occur during this period, but depending on beneficiary circumstances, additional opportunities may exist throughout the year to change coverage. Initial findings from the enrollment data suggest:

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Brief & Report

HMA experts author LA city and county studies

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HMA Community Strategies (HMACS) experts have released a pair of evaluation reports commissioned by the City of Los Angeles and the County of Los Angeles.

HMACS worked with the Los Angeles Housing + Community Investment Department (HCIDLA) to facilitate the inaugural, interactive Los Angeles Poverty Prevention Summit and produced a report and policy recommendations.

The report, Breaking the Cycle of Poverty, Defining Innovative and Equitable Strategies, summarized ideas and input from the summit and provides analysis and recommendations to move forward by harnessing existing resources and leveraging them with other efforts to alleviate poverty in the county.

A second report, prepared for the Los Angeles County Chief Executive Office, evaluated strategies to combat homelessness put forth by the Office of Homeless Initiatives (HI). The evaluation of HI’s strategies is summarized in the report, Evaluating the Effectiveness of Los Angeles County’s Strategies to Expand and Enhance Interim Housing and Emergency Shelter Services. The report focuses on analyzing existing strategies and how they are preforming and goes on to identify best practices and areas of needed improvement.

HMACS is involved in continued work to address homelessness, poverty and other social determinants of health in Los Angeles County and beyond with the goal of improving health and wellbeing, particularly for at-risk patients and families.

The HMACS teams, led by Principal Charles Robbins, also included Catherine Guerrero, Nayely Chavez, and Rathi Ramasamy as well as Michael Stiffler and Kara Riehman.

Blog

HMA analysis of new requirements expanding Medicare Advantage eligibility to individuals with end-stage renal disease

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This week, our In Focus section comes from HMA Principal Eric Hammelman and Senior Consultant Narda Ipakchi. Today, Medicare beneficiaries with End-Stage Renal Disease (ESRD) are only eligible to enroll in Medicare Advantage (MA) plans if they select a MA Special Needs Plan (SNP) that specifically serves individuals with ESRD or develop ESRD while already enrolled in a MA plan. In 2018, approximately 121,000 MA enrollees (0.6 percent of the MA population) had diagnoses of ESRD, accounting for approximately 20 percent of the total Medicare ESRD population.[1] The 21st Century Cures Act, which was passed in 2016, included a provision that alters the eligibility and enrollment options for Medicare beneficiaries with ESRD. Starting in 2021, Medicare beneficiaries with ESRD will be able to enroll in any MA plan in their area. The Centers for Medicare & Medicaid Services (CMS) estimates MA enrollment of individuals with ESRD will nearly double to 242,000 in 2024, or approximately 41 percent of the total Medicare ESRD population.[2]

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