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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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1814 Results found.

Blog

CMS Renews Healthy Indiana Plan Through 2021

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HMA Medicaid Market Solutions helped the State of Indiana secure approval for an extension of its Medicaid Section 1115 Waiver, the Healthy Indiana Plan. Below is a summary of what the renewal entails. 

On February 1, 2018, Indiana received approval from the Centers for Medicare and Medicaid Services (CMS) to continue its long-standing Healthy Indiana Plan (HIP) with a three-year renewal. This CMS approval maintains the core of the HIP program and incorporates additional features, including expansion of the current Gateway to Work initiative to add required community engagement for non-exempt HIP members beginning in 2019. Also new is a substance use disorder component that will be available to all Indiana Medicaid members, including those enrolled in HIP.

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Webinar

Webinar Replay: Innovations in Medicaid Managed Long-Term Services and Supports

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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.

Blog

Texas Receives 1115 Waiver Renewal

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This week, our In Focus section reviews Texas’ 1115 Medicaid waiver renewal. After more than a year of negotiations, on December 21st the Texas Health and Human Services Commission (HHSC) received CMS approval to extend the state’s 1115 waiver.[1] The Texas Healthcare Transformation and Quality Improvement Program waiver was initially approved by CMS as a five-year demonstration waiver that began December 2011 and ended September 2016 and included $29 billion in funding.  The waiver authorized the expansion of Medicaid managed care while preserving federal hospital funding historically received as supplemental payments. The waiver created two new funding pools:  the Uncompensated Care (UC) payment pool and the Delivery System Reform Incentive Payment (DSRIP) pool.

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Webinar

Webinar Replay: New Life for 1332 Waivers: Next Steps in State Health Insurance Exchange Market Innovation

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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.

Blog

Kentucky Becomes First State to Enact Community Engagement & Employment Requirements for Medicaid Members

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This article was written by Senior Consultants Amanda Schipp and Lora Saunders of HMA Medicaid Market Solutions (HMA MMS). HMA MMS helped the Commonwealth of Kentucky secure a groundbreaking Medicaid Section 1115 Waiver. Below is a summary of what the waiver entails.

On January 12, 2018, Kentucky’s section 1115 Medicaid Demonstration Waiver was approved by the Centers for Medicare and Medicaid Services (CMS). The demonstration includes two significant components: an expansion of substance use disorder (SUD) services, including a waiver of the Institution for Mental Disease (IMD) exclusion, and the creation of a new Medicaid program for able-bodied adults, known as Kentucky HEALTH (Helping to Engage and Achieve Long Term Health). The demonstration contains several groundbreaking policies never previously approved by CMS, most notably, a requirement for non-exempt Medicaid enrollees to work or participate in approved work-related activities, such as education, training, or volunteering as a condition of Medicaid eligibility. This approval paves the way for the nine other states that also have pending waivers requesting similar work requirements.[1]

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Blog

CMS approves Kentucky Medicaid Waiver

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The Centers for Medicare & Medicaid Services (CMS) has approved the “Kentucky Helping to Engage and Achieve Long Term Health” 1115 Medicaid Waiver, a five-year waiver that includes a “community engagement” or work requirement as a condition of eligibility for non-disabled adult Medicaid beneficiaries ages 19-64.

The decision from CMS represents the first approval of a Medicaid waiver that includes a work requirement as a condition of eligibility. Kentucky developed the waiver in collaboration with HMA Medicaid Market Solutions (HMA MMS).

Kentucky defines “community engagement activities” as 80 hours per month of employment, education, job skills training, and community service. Exempted groups include pregnant women, the medically frail, and full-time students. The waiver also includes “consumer-driven tools” that provide incentives for healthy behavior.

Come back to the HMA blog Monday to read more about Kentucky HEALTH.

Read the full text of the press release issued by the Kentucky Governor’s Office here.

Read the Kentucky HEALTH Demonstration Approval here.

Blog

Medicaid Managed Care Enrollment Update – Q4 2017

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This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 27 states.[1] Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 27 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2017. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):

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