On January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) issued Part II of the Advance Notice of Methodological Changes for Calendar Year (CY) 2020 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2020 Draft Call Letter. The Advance Notice and Call Letter includes proposed updates to MA payment rates and guidance to plan sponsors as they prepare their bids for CY 2020. Comments are due by 6:00 PM EST on Friday, March 1, 2019. The final Announcement and Call Letter will be published on April 1, 2019.
Health Management Associates (HMA), a leading independent national healthcare consulting firm, is expanding its Medicare services and expert team of consultants.
Specializing in publicly funded healthcare, HMA has long been recognized as a leader in Medicaid consulting services. As Medicare continues to evolve and serve as a catalyst for payment and delivery system innovations, HMA is significantly expanding the depth and breadth of the firm’s expertise of the nation’s single largest health program.
HMA New York colleagues Heidi Arthur and Annalisa Baker played a pivotal role in launching a forum for the Brooklyn Perinatal Network on Jan. 11.
The forum, entitled, “A Community Response to Addressing Maternal Morbidity and Mortality,” was a collaboration between a network of community-based organizations (CBOs) making up the Brooklyn Coalition for the Health Equity for Women and Families Coalition Leadership Team.
This week, our In Focus reviews the Oregon Health Plan’s Coordinated Care Organizations (CCO) 2.0 request for applications (RFA), released by the Oregon Health Authority (OHA) on January 25, 2019. Under CCO 2.0, the CCOs will provide full-risk coordinated care for approximately 840,000 Medicaid members.
This week, our In Focus section reviews Arkansas’ Provider-led Arkansas Shared Savings Entity (PASSE) model, scheduled to transition to full risk capitation in March 2019. The PASSE program provides care coordination to improve the health of Medicaid members with behavioral health needs or developmental/intellectual disabilities.
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 29 states. 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. All 29 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2018. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):
On January 3, 2019, Colorado Attorney General Cynthia H. Coffman released the study, Community Conversations to Inform Youth Suicide Prevention. The multi-layered study, conducted by HMA, analyzes and characterizes the trends and patterns in the fatal and non-fatal suicidal behaviors among young people in the four Colorado counties with the highest rates of youth suicide: El Paso, La Plata, Mesa, and Pueblo. The purpose of the study was to determine the best strategies for addressing and preventing youth suicide in Colorado and to see where the state’s efforts and dollars can be used most effectively.
Editors Note: This post was authored by HMA Principal Ellen Breslin, MPP.
The Minnesota Department of Human Services (DHS) recently submitted a report to the Minnesota Legislature, called Accounting for Social Risk Factors in Minnesota Health Care Program Payments. This report represents a multi-year effort on the part of DHS, and a real step forward in moving from social risk as a concept to a quantifiable methodology to explain its impact on health. The report delivers DHS recommendations to reduce health disparities among Medicaid and other DHS program participants.
Editor’s Note: This post was authored by Managing Principal Roxane Townsend, MD, and Senior Consultant Jeannine Hinton, LCSW, MHA.
HMA recently completed efforts to help the State of Louisiana and Louisiana State University (LSU) enter into a cooperative endeavor agreement with Ochsner LSU Health System of North Louisiana, a private nonprofit corporation.
Editor’s Note: HMA Principals Karen Batia, David Bergman, Meggan Schilkie and Senior Consultants Meghan Manilla and Nicola Pinson contributed to this post.
Across the country, behavioral healthcare is stretched thin and access to specialty care is a challenge. As value-based payment makes its way to the forefront, more than ever government entities, providers, payers and community-based organizations are exploring new avenues to meet shifting priorities and the requirements that accompany them.