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.

Show All | Podcast | Blogs | Webinars | Weekly Roundup | Videos | Case Studies | Reports | News | Solutions

Filter by topic:

Receive timely expert insights on topics you care about.

Select Topics

195 Results found.

Webinar

Webinar Replay: Opioid Treatment Eco-Systems: A New Way Forward for Understanding, Addressing the Opioid Crisis

Watch Now

This webinar was held on February 13, 2019 and was the first webinar in a series about addressing the opioid crisis in America.

No one questions the terrible impact opioid abuse has had on America – a grim tally measured in overdoses, dependency, broken families, and soaring health care costs. Less understood is how we got here, and the best way forward. Even as the federal government prepares to invest billions of dollars in battling opioids, important questions remain concerning the most effective way of organizing a complete eco-system of care to tackle this problem.

During this webinar, nationally recognized addiction expert and HMA Principal Corey Waller, MD, discusses how the historical structure of the nation’s approach to addiction treatment hampers progress on opioid addition. Dr. Waller also identifies pathways at the state, provider, and health plan level for fostering an effective opioid treatment eco-system.

Learning Objectives

  1. Learn how the historical decision to treat addiction separately from mainstream medicine has resulted in significant barriers to battling the opioid crisis.
  2. Understand the importance of identifying and adhering to a proven body of evidence-based protocols for overdose and addiction treatment, ensuring that patients receive a consistent and coordinated response from providers, hospitals, emergency rooms, and the criminal justice system.
  3. Quantify the true cost of the opioid crisis, which includes not just the cost of addiction and overdose treatment, but also the added costs associated with HIV, hepatitis C, foster care, criminal justice, and neonatal care.
  4. Get a preview of other opioid treatment-related topics to be covered in this webinar series, including primary, secondary, and tertiary treatment strategies; building treatment access and capacity; and understanding the role of health plans, local community organizations, and correctional health.

HMA Speakers

  • Corey Waller, MD, Principal (Lansing)

Who Should Listen

Executives of Medicaid managed care organizations and behavioral health plans; clinical and administrative leaders of provider organizations, health systems, substance abuse treatment facilities, correctional health facilities, federally qualified health centers, and other provider organizations; state and local public health, Medicaid, and addiction officials and staff.

Webinar

Webinar Replay: Medicare Advantage Advance Notice Overview: Favorable Signs for Managed Care Growth, Performance

Watch Now

This webinar was held on February 11, 2019.

The just-released 2020 Advance Notice Part II represents a net positive for Medicare Advantage plans, including another year of favorable Medicare rates and solid prospects for the growth and performance of the program.

During this webinar, HMA Managing Principal and former CMS Deputy Administrator for Medicare Jonathan (Jon) Blum, joined by HMA Managing Principal Mary Hsieh, provided an overview and analysis of the proposal’s key aspects, including the level of rate increase, growing emphasis on opioids, and efforts to further integrate duals. Speakers also addressed what these changes mean for Medicare Advantage plans’ existing strategies and opportunities.

Learning Objectives

  1. Understand why the expected 2020 rate increase for Medicaid Advantage plans – though smaller than last year – is still favorable enough to ensure continued industry growth and solid financial performance.
  2. Find out how federal regulators continue to push Medicare Advantage plans to play a proactive role in helping to address the opioid crisis.
  3. Learn how CMS will implement new legislative requirements to permit Medicare Advantage plans to offer non-medical benefits and services.
  4. Find out how CMS hopes to further integrate dual eligible members, including tightening its enforcement on Dual Special Needs Plans (D-SNP) that it perceives do not meet D-SNP statutory requirements.
  5. Understand how prescription drug-related proposals in the Advance Notice tie into broader administration efforts to overhaul pharmacy benefit management drug rebate rules.
  6. Learn about updates to the Medicare Star Ratings system.

HMA Speakers

Jonathan Blum, Managing Principal, Washington, DC
Mary Hsieh, Managing Principal, Atlanta, GA

Who Should Listen

Executives of Medicare Advantage plans, Medicare-Medicaid Plans, D-SNPs; providers and executives of provider-led Medicare-Medicaid initiatives; state and federal regulators.

Webinar

Webinar Replay: Evolving Integrated Managed Care Models for Medicare-Medicaid Dual Eligible Beneficiaries: Key Considerations for Health Plans

Watch Now

This webinar was held on January 8, 2019.

Managed care plans face significant strategic and operational questions when it comes to serving individuals enrolled in both Medicare and Medicaid. That’s because existing managed care models and state and federal policies are evolving in ways that will dramatically impact the roles and responsibilities of participating plans. What’s more, no single model has emerged as preeminent – whether it involves variations on the Capitated Financial Alignment Demonstrations (aka dual demonstrations), Dual Eligible Special Needs Plans (D-SNPs), Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs), or even provider-led initiatives.

During this webinar, HMA experts provided an overview of the complex landscape for integrated Medicare-Medicaid managed care and assessed what state and federal changes mean for health plans. Speakers also provided insights into how health plans can best develop the expertise needed to effectively serve this population and successfully compete no matter which models emerge.

Learning Objectives

  • Learn how health plans are tailoring models of care and services within a shifting regulatory framework to successfully serve the diverse needs of dual eligible populations.
  • Understand the implications of new state requirements that Managed Long Terms Services and Supports (MLTSS) plans operate D-SNPs, and that D-SNPs serve and coordinate care for Medicaid members.
  • Understand how rules surrounding default enrollment of dual eligible populations will impact the growth prospects of Medicaid managed care plans and D-SNPs.
  • Find out what to watch for as federal regulators get ready to release new rules encompassing Medicare-Medicaid integration and care coordination.
  • Learn why health plans need to reevaluate internal operations and organizational structures to better focus care coordination efforts for dual eligible members and break down walls between Medicare and Medicaid business lines.

HMA Speakers
Sarah Barth, Principal, New York, NY
Ellen Breslin, Principal, Boston, MA

Who Should Listen
Executives of Medicaid managed care plans, Medicare-Medicaid Plans, D-SNPs, and FIDE-SNPs; providers and executives of provider-led Medicare-Medicaid initiatives; state and federal regulators.

Webinar

Webinar Replay: Medicaid Health Homes

Watch Now

This webinar was held on October 30, 2018.

Health Homes have been implemented in at least 22 states under the federal Medicaid Health Home state plan option, and initial results illustrate the potential for meaningful improvements in the quality and cost of care associated with serving individuals with chronic physical, mental, or behavioral conditions.

During this webinar, HMA experts discuss some of the key lessons learned in these early Health Home initiatives, with a special emphasis on the experience in New York and the District of Columbia.  The webinar also provides practical solutions for the successful development, implementation, and refinement of Health Home care models.

Learning Objectives

  1. Understand the key components of a successful Health Home, including the monitoring of care transitions, early patient engagement, and integration of physical and behavioral health care.
  2. Learn how to work effectively with external stakeholders such as managed care plans, hospitals, community agencies, and other partners.
  3. Find out why the lessons learned from Health Homes programs are germane to any effort to improve the care of high-acuity patients.
  4. Obtain lessons learned from existing Health Home efforts in New York and the District of Columbia, including the potential for improvements in utilization, cost, and quality.
  5. Understand why Health Homes are an effective way to address behavioral health needs, substance abuse disorders, and social determinants of health.

HMA Speakers

  • Jean Glossa, MD, Managing Principal for Clinical Services (Washington, DC)
  • Meggan Schilkie, Principal (New York, NY)
  • Margaret Kirkegaard, MD, Principal (Chicago, IL)

Who Should Listen
Providers caring for high-needs individuals including primary care, behavioral health providers, health systems, and others; providers and payers developing Health Homes and other models of delegated care management and care coordination; state Medicaid officials and staff; consumer advocates and community-based organizations addressing the social determinants of health.

Webinar

Webinar Replay: Electronic Visit Verification for Personal Care Services, Home Health

Watch Now

This webinar was held on May 24, 2018.

The 21st Century Cures Act requires state Medicaid programs to implement electronic visit verification (EVV) for personal care services in 2019 and home health care in 2023. While the aims are noble – reducing fraud and improving quality of care – the practical considerations of understanding and implementing EVV will pose a tremendous challenge for many states.

During this webinar, healthcare experts from HMA and the National Association of States United for Aging and Disabilities (NASUAD) provided a blueprint for effective implementation of EVV requirements as well as a deeper understanding of the implications of the new rules. Speakers provided an update on existing EVV programs at the state level as well as looked at best practices and lessons learned.

Learning Objectives

  1. Understand the specific EVV technology, implementation, and verification requirements of the 21st Century Cures Act.
  2. Identify EVV technologies and design models that best fit the needs of your state.
  3. Find out how EVV not only helps reduce fraud, waste, and abuse in Medicaid programs, but also improves the quality of care for patients needing home health and personal care services.
  4. Learn why more than half of states may not be able to meet the EVV deadlines imposed by the 21st Century Cures Acts.

Speakers

  • Jen Burnett, Principal (Harrisburg, PA)
  • Camille Dobson, Executive Deputy Director, National Association of States United for Aging and Disabilities (NASUAD)

Who Should Listen
Representatives of state Medicaid agencies; Medicaid managed care plans; personal care services, home care, and other providers; EVV vendors; and the federal government.

Click here to view the slides from this webinar: EVV Webinar 05-24-18

Webinar

Webinar Replay: Partnership Opportunities for Payers, Providers and States: Supportive Housing for High Utilizers

Watch Now

This webinar took place on June 7, 2018.

Medicaid managed care plans, health systems, and states are teaming up with community-based organizations and housing authorities to consider a wide variety of supportive housing initiatives. Research indicates that doing so not only improves health outcomes for individuals experiencing homelessness, mental health, and/or substance use disorders, but also reduces utilization of emergency room services, inpatient bed days, and community justice involvement.

During this webinar, leading Medicaid and supportive housing consultants from HMA outlined nationally recognized evidence-based practice supportive housing models used to bend the healthcare cost curve, citing specific programs and outcomes.

Learning Objectives

  1. Learn how supportive housing programs can be used to provide comprehensive, integrated healthcare services for the homeless and high utilizers, improving health outcomes while reducing costs.
  2. Understand the basic components of evidence-based practice supportive housing models that produce improved health outcomes and cost savings.
  3. Find out how to partner with housing authorities and social services organizations to leverage health system funding for supportive housing programs.
  4. Understand the opportunity to use supportive housing targeted to those with substance use disorders and how it can improve treatment completion and long-term recovery outcomes.

Speakers

  • Scott Ackerson, Principal (San Antonio, TX)
  • Carol Clancy, Principal (San Francisco, CA)
  • Rachel Post, Senior Consultant (Portland, OR)
  • Meggan Schilkie, Principal (New York, NY)

Who Should Listen
Representatives of Medicaid managed care plans, hospitals and health systems, community-based organizations, state and federal government.

View the slides from this webinar here: Partnership Opportunities Webinar 6-7-18

Webinar

Webinar Replay: Personal Responsibility & Community Engagement in Medicaid

Watch Now

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

Watch Now

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

Watch Now

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

Watch Now

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

Watch Now

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?

Watch Now

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.