Medicaid and Exchange Enrollment Update – May 2017

This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “May 2017 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on July 21, 2017. Additionally, we review 2017 Exchange enrollment data from the “Health Insurance Marketplaces 2017 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on March 15, 2017. Combined, these reports present a picture of Medicaid and Exchange enrollment in the first half of 2017, representing nearly 75 million Medicaid and CHIP enrollees and more than 12 million Exchange enrollees.

Read More

North Carolina Outlines Proposed Design for Medicaid Managed Care

This week, our In Focus section reviews “North Carolina’s Proposed Program Design for Medicaid Managed Care,” a draft proposal published this week for public comment, which provides a detailed overview of the planned statewide Medicaid managed care program to be launched in 2019. By 2023, North Carolina estimates it will have transitioned roughly 1.8 million Medicaid beneficiaries in the state to managed care. North Carolina’s Department of Health and Human Services (DHHS) is encouraging public comment on the program design proposal through September 8, 2017, ahead of a planned request for information (RFI) release later this year.

Read More

Chronicle of a Death Foretold: ACA Repeal and Replace Stalls in Senate

This In Focus article, authored by HMA Managing Principal Greg Nersessian, CFA  and Research Assistant Anh Pham, was originally published in the August 2, 2017 HMA Weekly Roundup.

In deference to Miracle Max, after last week’s failed votes on “Repeal and Replace,” “Straight Repeal,” and “Skinny Repeal,” the GOP’s efforts to undo the Affordable Care Act (ACA) through budget reconciliation appear to be at least “mostly dead.” While it is possible strictly partisan discussions will reaccelerate at some point, it appears that Congress is, for the first time, considering bipartisan proposals for shoring up the underwriting challenges in the individual market. In light of this change in direction, we are using this week’s In Focus section to chronicle the events that transpired over the last five months leading to last week’s historic vote. Our objective here is to create a reference piece for our readers so that the next time Congress revisits major healthcare legislation we can look back on the strategies and approaches that led to last week’s result.  Many times over the last eight months, we have reflected on the key dynamics surrounding the passage of the ACA in 2010 as a guide for what factors to watch in the efforts to repeal the ACA – budget reconciliation issues, Congressional Budget Office (CBO) scoring, key proposals to win over recalcitrant legislators, the President’s role in pushing the agenda – but our memories were not always up to the task. So in the spirit of having a reference document for future reflection, we record below the key events associated with this effort.

Read More

HMA Principal to Speak about Role Public Health Plays in Implementing Retail Marijuana Legalization at National Cannabis Summit

The 2017 National Cannabis Summit will feature the workshop, Implementing Retail Marijuana Legalization: Public Health’s Role in Implementation of Prevention and Education Efforts Following Legalization of Retail Marijuana. During this workshop, HMA Principal Shannon Breitzman will share her unique expertise on how state agencies begin the complex implementation process of regulatory and programmatic needs after retail marijuana is legalized.

Read More

Virginia Releases Medallion 4.0 Medicaid Managed Care RFP

This week, our In Focus section reviews the request for proposals (RFP) issued by the Virginia Department of Medical Assistance Services (DMAS) for the Medallion 4.0 Medicaid managed care program. Medallion 4.0 will serve roughly 740,000 children, including those with special health care needs, families, and individuals in foster care and adoption assistance programs, with annual Medicaid managed care spending of more than $3 billion when fully implemented by the end of 2018. Proposals are due to DMAS on September 8, 2017.

Read More

Quarterly Medicaid Managed Care Enrollment Update – Q2 2017

This In Focus article was originally published in the July 12, 2017 HMA Weekly Roundup.

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 elect to 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 have released monthly Medicaid managed care enrollment data through the second quarter (Q2) of 2017. This report reflects the most recent data posted.

Read More

Highlights from NASBO Spring 2017 Fiscal Survey of States

This In Focus article was originally published in the June 21, 2017 HMA Weekly Roundup.

This week, our In Focus section highlights some of the key findings of the Fiscal Survey of the States Spring 2017, released this month by the National Association of State Budget Officers (NASBO). The association conducted surveys of state budget officers in all 50 states in February through April 2017. The findings in the report focus on the key determinants of state fiscal health, highlighting data and state-by-state budget actions by area of spending. Below we summarize the major takeaway points from the report, as well as highlight key findings on Medicaid-specific and other health care budget items.

Read More

Register Now: 30-plus Speakers Slated for HMA Conference

The Future of Medicaid is Here: Implications for Payers, Providers and States is a two-day event organized by Health Management Associates (HMA). Confirmed speakers include industry executives from Medicaid plans across the nation as well as Medicaid directors from California, Florida, Kansas, Hawaii, Michigan, Tennessee, Texas, and Washington.

Read More

It Takes a Community to Divert Populations with Behavioral Health Needs from Jail

This blog post was authored by HMA Principal Bren Manaugh, LCSW-S, CPHQ and Senior Consultant Laquisha Grant, MPA.

We have all seen the headlines about jails and prisons becoming the largest de facto mental healthcare providers in the country. Nationally, 14 to 17 percent of inmates have a serious mental illness, 53 to 68 percent have a substance use disorder[1], and up to 72 percent of jail inmates have both a mental illness and substance use disorder. The overrepresentation of individuals with mental illness and substance use disorder did not happen overnight — and it is not a result of one system or issue.

Read More