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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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1825 Results found.

Brief & Report

Report examines Medicaid program features, challenges, and changes in the territories

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Medicaid was designed to serve low-income and vulnerable individuals, but it operates differently in the U.S. territories than it does in the states. While the federal share varies based on per capita income for each state, federal funding for Medicaid in the territories is subject to a statutory cap and a fixed federal matching rate. Following recent hurricanes, typhoons and the North Korean missile crisis, which have damaged infrastructure and limited tourism, the fiscal issues for territories have been exacerbated. This is in addition to the larger share of people living in poverty that are in fair or poor health in the territories.

In a recently published issue brief, Kaiser Family Foundation’s Program on Medicaid and the Uninsured Policy Analyst Cornelia Hall and Associate Director Robin Rudowitz, along with HMA Principal Kathy Gifford, surveyed and interviewed territory Medicaid officials to identify the key issues and trends in the programs for the territories.

Key findings include:

  • The reliance on Affordable Care Act funds for Medicaid programs, which are set to expire in September.
  • Enrollment increases due to recent hurricanes.
  • Benefits and delivery systems differ in the territories.
  • Provider shortages.

View below for the full issue brief.

Webinar

Webinar Replay: Successful Prevention Strategies to Address the Opioid Crisis

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This webinar was held on March 1, 2019, and was the second webinar in a series about addressing the opioid crisis in America, 

State and local governments – backed by an infusion of federal dollars – are beginning to develop and implement a wide variety of prevention strategies to address the opioid epidemic. And several states are already showing positive initial results. Among the early lessons is that success depends on a coordinated approach to prevention; partnerships among government agencies, law enforcement, and providers are critical; and opportunities to positively impact results exist at every level of the prevention spectrum.

During this webinar, HMA public health and prevention experts provided case studies of innovative and effective opioid misuse and overdose prevention initiatives. Speakers also outlined the key components of an effective opioid prevention strategy, including an understanding of the key drivers of success.

Learning Objectives

  1. Understand how to best leverage federal funds earmarked for opioid prevention and treatment.
  2. Learn how to develop coordinated prevention efforts that involve behavioral health and opioid use disorder treatment providers, law enforcement, corrections, Medicaid programs, and public health agencies at the state and local level.
  3. Gain insights about emerging state and local opioid misuse and overdose prevention initiatives and trends, including supervised injection facilities, fentanyl testing strips and medical marijuana for pain management.
  4. Find out how to effectively impact various levels of prevention, including tertiary (e.g., overdose prevention), secondary (e.g., medication-assisted treatment), and primary (e.g., prescribing practices).

HMA Speakers

  • Shannon Breitzman, Principal, Denver
  • Lindsey Kato, Consultant, Denver

Who Should Listen
State and local public health and Medicaid departments; addiction treatment providers, behavioral health providers, and leaders of health systems, correctional health facilities, Federally Qualified Health Centers, and other provider organizations; executives of Medicaid managed care organizations and behavioral health plans.

Webinar

Webinar Replay: Military Competency Among Health Care Providers: Best Practices for Screening, Treating and Coordinating Care of Veterans

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This webinar was held on February 28, 2019.

The unique health care needs of veterans pose significant challenges for providers. What’s required can best be called “military competency,” which is a set of tools and strategies aimed at successfully identifying, screening, and treating veterans. Military competency also means the ability to coordinate care across provider groups and health care facilities for specific medical conditions most prevalent in the veteran community.

During this webinar, HMA Principal Uche Uchendu, M.D., who also served as chief officer for health equity at the U.S. Department of Veterans Affairs, outlined best practices for providers hoping to achieve military cultural health competency. She also offered a variety of hands-on strategies for immediately improving care to patients who are veterans.

Learning Objectives

  1. Understand the importance of identifying patients who have a military history, opening the door for appropriate screening, diagnosis and treatment of conditions prevalent among veterans.
  2. Find out about tools providers can utilize to screen veterans based on military service exposures, combat or non-combat experiences, and conditions such as post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).
  3. Learn how providers can adjust their practices to ensure that veterans receive the proper care, including an understanding of the many services available for support, recommendation and referral.

HMA Speakers

Uche Uchendu, MD, Principal (Washington, DC)

Who Should Listen
Executives and clinicians involved in primary care and behavioral health practices, hospitals, long term care facilities, health systems, community-based organizations, and caregivers interested in providing services for military service veterans and their families.

Blog

Medicaid Plan PMPM Rates Rise 0.3 Percent in 2018 for TANF/CHIP In 19 States, 4 Percent for Expansion, HMAIS Analysis Shows

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This week, our In Focus summarizes the findings of an HMA Information Services (HMAIS) analysis of Medicaid managed care rates in 2018 versus 2017. The analysis represents HMAIS’ first attempt at what will be an annual tracking of Medicaid managed care rate increases, which we will expand upon and refine over time with input from our readers and the Medicaid community. Complete results, including spreadsheets showing underlying analysis, will be made available to HMAIS subscribers. For information on how to subscribe, contact Carl Mercurio.

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Brief & Report

Average Sales Price Reimbursement: Significant Savings from Prior Benchmark

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Prior to the enactment of the Medicare Prescription Drug and Modernization Act of 2003 (MMA), the Balanced Budget Act of 1997 had set reimbursement for drugs and biologics provided incident to physician services under Part B of the Medicare Program at 95% of Average Wholesale Price (AWP). AWP as a benchmark was subject to a variety of criticisms and reports indicating that in most cases it significantly exceeded providers’ costs. As a result, the Congress created Average Sales Price (ASP) as a benchmark intended to more accurately reflect the cost to physicians and hospitals of furnishing Part B drugs. The shift from AWP based reimbursement to ASP reimbursement created significant savings for Medicare and its beneficiaries beginning January 1, 2005 and continuing under current law. The Moran Company was asked by PhRMA to analyze the impact the switch to the ASP system had on Part B medicine spending relative to the prior AWP reimbursement methodology.

Blog

MA Releases One Care Dual Demonstration 2.0 Request for Responses

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This week, our In Focus reviews the Massachusetts One Care Dual Demonstration 2.0 request for responses (RFR), released by the Massachusetts Executive Office of Health and Human Services (EOHHS). One Care will cover Medicare and Medicaid dual eligible adults with disabilities ages 21 through 64 and includes medical, behavioral, Long-term Services and Supports (LTSS), community supports, and care management services statewide.

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Webinar

Webinar Replay: The Future of Medicaid Expansion: States to Watch for Potential Ballot Initiatives, Other Expansion Efforts

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This webinar was held on February 20, 2019.

Who would have guessed that there would be an increase in the number of Medicaid expansion states during the Trump administration? In fact, five states have agreed to expand Medicaid since 2016, bringing to 37 the total number of states expanding under the Affordable Care Act. Several of the remaining holdouts are considering expansion as well. The continued interest has been driven by several factors, and the remaining states are rethinking expansion because the Trump administration has afforded leeway to shape expansion programs through work requirements and other variations and innovations.

During this webinar, HMA experts provided an overview of the Medicaid expansion market and looked at which of the remaining states are most likely to pursue expansion and why. Presenters also addressed some of the important program variations states are most likely to consider when shaping expansion benefits.

Learning Objectives

  1. Find out which remaining states are most likely to expand Medicaid and which ones are most likely to hold the line and remain non-expansion.
  2. Get an overview of Medicaid expansion innovations, including an understanding of how each variation potentially impacts enrollment and costs.
  3. Understand the economics of expansion, including a look at the budget implications of expanding Medicaid and remaining non-expansion.
  4. Understand the operational implications and considerations for states and health plans implementing alternative expansion models.
  5. Learn what the remaining opportunity is for Medicaid managed care plans in states that still haven’t expanded Medicaid.

HMA Speakers

  • Matt Powers, Principal, HMA (Chicago)
  • Jason Silva, Senior Consultant (Sacramento)
  • Lora Saunders, Senior Consultant (Tallahassee)

Who Should Listen

State Medicaid officials and staff; executives of Medicaid managed care plans; and providers, including clinical and administrative leadership of health systems.