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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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Webinar

Webinar Replay: Preparing for the New Medicaid Managed Care Regulations

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On May 17, 2016, HMA Information Services hosted the webinar, “Preparing Your Organization for the New Medicaid Managed Care Regulations.”

After months of comment, discussion, and revision, CMS has released the final version of its new Medicaid managed care regulations, and now it’s up to health plans, states, and providers to comply. What’s required is not just an understanding of what’s in the final rule, but how it impacts your organization – specifically the procedures, processes, staffing, technology, and operational changes required to implement the regulations.

During this webinar, HMA experts provide a framework for assessing the final rule, analyzing your organizational needs, and implementing the operational and functional changes needed.  Hear HMA experts Debby McNamara and Kathleen Nolan provide an overview of the final rule and outline the HMA Impact Analysis and Implementation Tool, a rigorous process for identifying opportunities and challenges the new rules pose to managed care organizations. Listen to the recording and:

  • Understand the impact of the final rule on Medicaid managed care plans, providers who serve vulnerable populations, and state Medicaid programs.
  • Find out how the final rule differs from earlier versions, including information on member plan selection and enrollment, fraud and abuse, and other requirements.
  • Identify operational and process changes needed to implement the new regulations through a rigorous analysis based on HMA’s Impact Analysis and Implementation Tool.

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

Webinar

Webinar Replay: Marrying Strategic, Operational and Information Technology Planning

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On May 17, 2016, HMA Information Services hosted the webinar, “Marrying Strategic, Operational and Information Technology Planning: Two Separate Frameworks in Support of Common Goals for Healthcare Organizational Efficiency and Effectiveness.”

Strategic planning and operations needs assessment go hand-in-hand. That’s especially true for healthcare organizations in an emerging world of risk-sharing, population health management, and integrated care.

During this webinar, HMA and Day Health Strategies outline two complementary frameworks designed to help healthcare organizations achieve higher levels of performance by marrying strategic planning with a clear assessment of the operational and information technology (IT) investments needed to achieve long-term goals. The frameworks include tools that help diagnose critical areas of organizational performance which, if improved, can drive significant efficiency gains across your organization. Listen to the recording and:

  • Understand the value of having strategic planning and operations assessment tools work hand-in-hand to improve your organization’s performance and effectiveness.
  • Identify and address gaps in your organization’s operational and IT capabilities.
  • Develop credible strategic goals, based on a complete understanding of your organizational capability of meeting stated targets.

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

Webinar

Implementing the Final Medicaid Managed Care Rules

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How to Drive Compliance and Delivery System
Performance for States and Health Plans

The hard work of implementing the new Medicaid managed care regulations will fall squarely on the shoulders of states and health plans. For states, the changes come at a time when Medicaid staff are already stretched thin by budgetary constraints and the impact of the continual state and federal regulatory and innovation projects. Now states must drive and oversee new requirements, including a variety of tighter rules around encounter data quality and submission, provider network adequacy, quality rating systems, provider screenings, and program integrity. Medicaid managed care plans, meanwhile, must step up their operational, administrative, and reporting capabilities to accommodate new state oversight requirements across all aspects of the contract performance.

During this webinar, experts from HMA and CNSI will demonstrate the value of using automated dashboard technology and data analytics to establish a single electronic data and reporting portal between states and Medicaid managed care plans for the submission of data and tracking of performance – creating an efficient and centralized compliance audit trail in real time.

Learning Objectives

  • Explore the requirements of the new Medicaid managed care regulations and methods for monitoring for compliance.
  • View compliance solutions like MCTrack, which effectively monitors performance and creates an audit trail to meet expectations of both internal and external stakeholders and auditors.
  • Learn about data analysis and an automated dashboard for tracking key performance criteria, including access to care, quality, enrollment, member and provider satisfaction, accurate encounter data and network adequacy.
  • Find out about dashboards that allow regular monitoring of Medicaid pay for performance requirements, providing health plan with the ability to maximize incentives payments and withholds.
  • Track and drive to completion all Medicaid managed care corrective action and quality improvement plans.
  • Capture health plan readiness metrics during new contract cycles.

Speakers
Heidi Robbins Brown, HMA Principal, Seattle
Diana Criss, HMA Senior Consultant, Lansing, MI
Kathleen Nolan, HMA Managing Principal, Washington, DC
Arvinder Singh, Chief Health Innovation Officer, CNSI

Who Should Attend
Medicaid directors, managed care contract managers, quality oversight directors, program integrity officials and staff; federal and state regulators and auditors; executives of Medicaid managed care plans, including compliance officers.

Webinar

Webinar Replay: Using a Policy Framework to Foster Provider Practice Transformation

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On May 12, 2016, HMA Information Services hosted the webinar, “Using a Policy Framework to Foster Provider Practice Transformation: How the District of Columbia Launched Major Delivery System Change through its Medicaid Health Home Program for Individuals with Serious Mental Illness.”

Many states are looking to health homes to coordinate care and reduce costs for individuals with complex physical and behavioral health needs as well as for individuals with serious and persistent mental health conditions. The District of Columbia is a unique urban environment facing challenges to serve a large Medicaid population with a high prevalence of behavioral health issues. Yet, DC has been a leader in leveraging its health home strategy to drive widespread delivery system transformation – aligning a vision for improved health with policy, payments, and a real-world understanding of the needs and capabilities of providers.

During this webinar, leaders from the DC Departments of Behavioral Health and Health Care Finance describe how they set a course toward integrated care with the structure of the DC health homes, and provide important lessons learned for other states. The webinar also addresses how providers can play an important role during the policy planning process to ensure the effectiveness and feasibility of state initiatives and requirements. Listen to the recording and:

  • Examine a set of important considerations for crafting effective health home policy to drive widespread delivery system transformation.
  • Hear about the process DC used to establish rate structures to ensure provider participation while taking into account variable provider characteristics and the need to ensure improved consumer outcomes.
  • Gain insights into what it takes to attain global buy-in from various constituents and relevant parties, including agencies and behavioral health practices and their executive management teams.
  • Understand the importance of charting a course toward physical and behavioral health integration by aligning with a real-world understanding of provider processes, capabilities and business models at the ground level.

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

Webinar

Webinar Replay: The Impact of the Mental Health Parity and Addiction Equity Act

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On May 11, 2016, HMA Information Services hosted the webinar, “Understanding the Impact of the Mental Health Parity and Addiction Equity Act – Final Regulations.”

The long awaited final regulations for the Mental Health Parity and Addiction Equity Act are out, with important implications for Medicaid managed care plans, behavioral health providers, and other stakeholders serving vulnerable patient populations. The new federal rules have a broad reach, with the intention of improving ease of access to behavioral care, benefit levels, service classifications, coverage decisions, treatment protocols, and billing procedures. The rules also clarify the relationship between payers, providers and federal and state regulators.

During this webinar, HMA experts Barbara Leadholm, Don Novo, and Rich VandenHeuvel summarize key components of the final regulations, with a special focus on opportunities and challenges facing states and Medicaid managed care plans working to comply with the rules and government regulators monitoring their progress. Listen to the recording and:

  • Identify key considerations and actions for behavioral health stakeholders, including managed care plans, state Medicaid regulators, and providers of care for individuals with behavioral health conditions or substance abuse disorders.
  • Learn how the rules impact behavioral health coverage decisions by Medicaid managed care plans, including the criteria for medical necessity determinations.
  • Understand how state and federal regulators will work together to balance their roles in monitoring and assuring compliance and what that means for health plans and providers evaluating the rules’ various provisions.
  • Find out how the rules impact the Medicaid managed care rate setting process, the flexibility afforded states to include the cost of additional services, and the easing of benefit limitations.

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

Webinar

Marrying Strategic, Operational and Information Technology Planning

Watch Now

Strategic planning and operations needs assessment go hand-in-hand. That’s especially true for healthcare organizations in an emerging world of risk-sharing, population health management, and integrated care.

During this webinar, HMA and Day Health Strategies will outline two complementary frameworks designed to help healthcare organizations achieve higher levels of performance by marrying strategic planning with a clear assessment of the operational and information technology (IT) investments needed to achieve long-term goals. The frameworks include tools that help diagnose critical areas of organizational performance which, if improved, can drive significant efficiency gains across your organization.

Speakers

Juan Montanez, Principal, HMA
Rosemarie Day, President, Day Health Strategies
Sarah Matousek, Senior Analyst, Day Health Strategies

Learning Objectives

  • Understand the value of having strategic planning and operations assessment tools work hand-in-hand to improve your organization’s performance and effectiveness.
  • Identify and address gaps in your organization’s operational and IT capabilities.
  • Develop credible strategic goals, based on a complete understanding of your organizational capability of meeting stated targets.

Who Should Attend

Leaders of health systems, integrated delivery systems, accountable care organizations, hospitals, health homes, clinics and public health agencies.

Webinar

Webinar Replay: Are You Ready for Strengthened HIPAA Regulations?

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On April 26 2016, HMA Information Services hosted the webinar, “‘Business Associates’ Redefined: What Healthcare Organizations Need to Know to Comply with Strengthened HIPAA Regulations.”

Attention healthcare providers, managed care plans and other entities that are covered by HIPAA regulations pertaining to patient data. Your relationship with third-party contractors and other outside “business associates” is coming under increased regulatory scrutiny from the federal government. Revised HIPAA rules have created important new responsibilities and instituted new penalties related to “business associates” who handle personal health information or personal health records for covered entities.

During this webinar, HMA experts Heidi Robbins Brown and Margarita Pereyda, MD outline the new regulations, provide a framework for protecting patient data, and present a set of best practices your organization and business associates can use in efforts to ensure HIPAA compliance. Listen to the recording and:

  • Understand the new enforcement tools and penalties established by the strengthened HIPAA regulations and identify your organization’s most likely areas of vulnerability.
  • Obtain best practices for contracting with business associates, monitoring HIPAA compliance and ensuring accountability.
  • Find out how to work collaboratively with business associates, agreeing upon clear expectations and keeping the lines of communication open in the event of a problem.
  • Learn how to identify business associates who aren’t in compliance with federal HIPAA regulations and help establish a plan of remediation.

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

The content of these materials is for general informational purposes and does not constitute a guarantee of compliance or legal advice. Please contact HMA if you would like to learn more about this topic or to schedule a consultation.

Webinar

Webinar Replay: Trauma-Informed Care

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On April 26 2016, HMA Information Services hosted the webinar, “Trauma-Informed Care: Overview and Best Practices in Patient Screening.”

More than three-quarters of Medicaid recipients report experiences of trauma and violence during their childhoods. These experiences may include verbal, physical or sexual abuse; living in poverty or violent surroundings, including war zones; or living with family members who struggle with substance abuse, mental illness or extreme disability. Research demonstrates that there is a direct correlation between traumatic experiences and the 10 most common causes of death in the United States.

The U.S. healthcare system continues to struggle to reach this high-risk population, many whom also have multiple comorbid chronic health conditions. It is imperative that today’s patient-centered and whole-person healthcare teams take a proactive trauma-informed approach to care delivery. Trauma-informed care begins by first understanding the problem and then identifying patients who have endured or witnessed over the course of their lives any number of adverse or traumatic experiences.

During this webinar, HMA experts Karen Hill, PhD, MSN, ANP-C; Laurie Lockert, MS, LPC; and Jeffrey Ring, PhD, provide information about the biopsychosocial impact of adverse and traumatic experiences; identify screening tools; and explore how provider practices can support this at-risk population. Listen to the recording and:

  • Understand adverse/traumatic experiences and trauma-informed care delivery.
  • Examine the correlation between trauma and physical health as well as the importance of integrating treatment through trauma-informed care.
  • Identify who is at risk for adverse or traumatic experiences.
  • Learn how to recognize and mitigate patient behaviors that often are the result of trauma.
  • Discuss screening tools for primary care practices.

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

Webinar

Webinar Replay: Empowered Leadership Can Transform Care for Vulnerable Populations

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On April 19, 2016, HMA Information Services hosted the webinar, “Empowered Leadership Can Transform Care for Vulnerable Populations.”

The emerging transformation of healthcare delivery for safety net populations is forcing clinical and administrative leaders into unfamiliar territory. Successful leadership requires an enhanced set of skills, combining the traditional emphasis on clinical proficiency with the kind of non-traditional leadership qualities necessary to engage teams, impact delivery system transformation, and respond to community, social, and clinical needs.

During this webinar, experts from Rush University Medical Center and Health Management Associates outlined strategies for developing a deep bench of collaborative leaders and empowered providers – the kind necessary to prepare your organization for the challenges of a changing healthcare environment. Listen to the recording and:

  • Understand how the emerging transformation of the healthcare delivery system is driving the demand for leadership and team development skills.
  • Utilize a framework for guiding the assessment of leadership capacity for transforming care across your organization.
  • Identify best practices and skillsets of the most effective leadership teams.
  • Understand the importance of engaged leaders in the transformation process

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

Webinar

‘Business Associates’ Redefined: What You Need to Know to Comply with Strengthened HIPAA Regulations

Watch Now

Attention healthcare providers, managed care plans and other entities that are covered by HIPAA regulations pertaining to patient data. Your relationship with third-party contractors and other outside “business associates” is coming under increased regulatory scrutiny from the federal government. Revised HIPAA rules have created important new responsibilities and instituted new penalties related to “business associates” who handle personal health information or personal health records for covered entities.

During this webinar, HMA experts Heidi Robbins Brown and Margarita Pereyda, MD will outline the new regulations, provide a framework for protecting patient data, and present a set of best practices your organization and business associates can use in efforts to ensure HIPAA compliance.

Learning Objectives

  • Understand the new enforcement tools and penalties established by the strengthened HIPAA regulations and identify your organization’s most likely areas of vulnerability.
  • Obtain best practices for contracting with business associates, monitoring HIPAA compliance and ensuring accountability.
  • Find out how to work collaboratively with business associates, agreeing upon clear expectations and keeping the lines of communication open in the event of a problem.
  • Learn how to identify business associates who aren’t in compliance with federal HIPAA regulations and help establish a plan of remediation.

HMA Speakers
Heidi Robbins Brown, JD, Principal, Seattle
Margarita Pereyda, MD, Principal, Southern California

Who Should Attend
Executives of Medicaid managed care plans, hospitals, health systems, and clinics serving Medicaid populations; state and federal regulators and healthcare policy analysts; Medicaid directors and staff; state and federal officials for public health.

Webinar

Webinar Replay: Targeting Readmissions

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On March 30, 2016, HMA Information Services hosted the webinar, “Targeting Readmissions: A Collaborative Strategy for Hospitals, Health Plans and Local Communities.”

Even as hospitals work to reduce readmissions through internal quality improvement efforts, local healthcare communities must also play an active role in addressing factors outside the hospital’s control. The truth is that a significant percentage of hospital readmissions are associated with community-related factors such as unemployment, poverty, lack of education, and inadequate access to care.

During this webinar, HMA experts outline the rationale for a collaborative approach to reducing readmissions, involving hospitals, health plans, community-based organizations, and other providers who can address cultural and community-related factors that impact healthcare outcomes. Listen to the replay and:

  • Understand the role that community-related and demographic factors play in driving hospital readmissions, including a look at the most recent research.
  • Identify successful partnerships and programs in which collaborative care can reduce hospital readmissions and improve care quality and outcomes.
  • Find out how team communications, early discharge, care management, and follow-up are key components of any readmissions strategy during and after discharge.
  • Understand the economic and business rationale for hospitals to develop strong collaborative efforts to address readmissions.

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

Webinar

Trauma-Informed Care: Overview and Best Practices in Patient Screening

Watch Now

More than three-quarters of Medicaid recipients report experiences of trauma and violence during their childhoods. These experiences may include verbal, physical or sexual abuse; living in poverty or violent surroundings, including war zones; or living with family members who struggle with substance abuse, mental illness or extreme disability. Research demonstrates that there is a direct correlation between traumatic experiences and the 10 most common causes of death in the United States.

The U.S. healthcare system continues to struggle to reach this high-risk population, many whom also have multiple comorbid chronic health conditions. It is imperative that today’s patient-centered and whole-person healthcare teams take a proactive trauma-informed approach to care delivery. Trauma-informed care begins by first understanding the problem and then identifying patients who have endured or witnessed over the course of their lives any number of adverse or traumatic experiences.

Learning Objectives

  • Understand adverse/traumatic experiences and trauma-informed care delivery.
  • Examine the correlation between trauma and physical health as well as the importance of integrating treatment through trauma-informed care.
  • Identify who is at risk for adverse or traumatic experiences.
  • Learn how to recognize and mitigate patient behaviors that often are the result of trauma.
  • Discuss screening tools for primary care practices.

HMA Speakers
Karen Hill, PhD, MSN, ANP-C, Senior Consultant, San Francisco
Laurie Lockert, MS, LPC, Senior Consultant, Portland, OR
Jeffrey Ring, PhD, Principal, Southern California

Who Should Attend
Physicians, physician assistants, nurses, and other healthcare practitioners; executives of health systems, physician practices, FQHCs, and other provider organizations; executives of Medicaid managed care plans; Medicaid directors and staff.