This week’s review comes to us from HMA Principal Sarah Jagger, of our Indianapolis, Indiana office. Sarah provides an overview of the Healthy Indiana Plan (HIP) and the proposed changes under the HIP 2.0 waiver renewal request, submitted to the Centers for Medicare & Medicaid Services (CMS) for approval on January 31, 2017.
LANSING, MICHIGAN – Health Management Associates (HMA) announced today that Donna Checkett, current Aetna vice president for Medicaid growth, will join the independent national healthcare research and consulting firm as vice president of business development on Feb. 6. Checkett will lead new business strategy for HMA.
This week, Andrew Fairgrieve and Greg Nersessian reviewed Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. In federal fiscal year (FFY) 2016, Medicaid expenditures across all 50 states and 6 territories exceeded $548 billion, with nearly half of all spending now flowing through Medicaid managed care programs.
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The Future of Medicaid is Here: Implications for Payers, Providers and States
Sept. 11-12, 2017
Health Management Associates (HMA) is proud to announce its 2nd conference on Trends in Publicly Sponsored Healthcare, Sept. 11-12, 2017, in Chicago. The theme of this year’s event is The Future of Medicaid is Here: Implications for Payers, Providers and States and features as keynote speakers some of the nation’s most innovative healthcare leaders.
This week, our In Focus article provides an overview of Oregon’s Medicaid waiver program, under which the state implemented integrated managed care entities and committed to a per capita reduction on the rate of Medicaid cost growth. The model, viewed widely as a success, may be of interest to states as discussions at the federal level around restraining spending growth in Medicaid develop under the incoming administration.
This week’s article comes to from HMA Principals Meggan Schilkie, Joshua Rubin, and Heidi Arthur in our New York City office and the HMA national behavioral health team. On December 21, 2016, the U.S. Department of Health and Human Services (HHS) announced the selection of eight states for participation in a two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program “designed to improve behavioral health services in their communities.” The eight states are Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon, and Pennsylvania. The demonstration projects are slated to begin on July 1, 2017. They build on a total of 24 state planning grants issued by HHS in 2015 to support states in designing their certification process. Nineteen of the 24 states submitted applications to participate in the demonstration program, and the eight awardees were selected from this pool of 19 applicants.
This week we reviewed two active Medicaid managed care procurements – in the District of Columbia and Massachusetts – and a Medicaid managed care request for information issued by Texas. On December 22, 2016, the District of Columbia issued a request for proposals (RFP) to rebid Medicaid managed care organization (MCO) contracts for the DC Healthy Families and Alliance programs. One day prior, on December 21, 2016, Massachusetts issued a request for responses (RFR) from MCOs interested in participating in the MassHealth managed care program, with a focus on preparing for Medicaid ACO implementation, as well as the planned carve-in of managed long-term services and supports (MLTSS). Finally, also on December 22, 2016, Texas issued a request for information (RFI) ahead of an upcoming statewide reprocurement of the STAR+PLUS Medicaid managed care program.
For providers, transitioning from volume- to value-based care is no easy task. You are likely facing a growing number of pressures that are becoming increasingly difficult to manage. These could include community/political pressures, primary care shortages, medical staff competition, and incentives to measure and manage care quality and total costs and address non-clinical aspects of health. Additional demands include risk sharing arrangements, audits, and pitches from vendors. Aligning your facilities, programs and services into a fully integrated delivery system can seem like a daunting task. But HMA can help.
This week, we reviewed updated reports issued by the Department of Health & Human Services (HHS) on Medicaid expansion enrollment from the “September 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on December 1, 2016. Additionally, we review 2016 Exchange enrollment data from the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) Issue Brief, “Health Insurance Marketplace 2016 Open Enrollment Period: February 2016 Enrollment Report,” and 2017 enrollment snapshot data through December 19, 2016, from the Centers for Medicare & Medicaid Services (CMS). Combined, these reports present a picture of Medicaid and Exchange enrollment at the end of 2016, with a look at progress towards 2017 Exchange enrollment.