Nebraska Releases LTSS Redesign Draft

This week, we reviewed the Medicaid long-term services and supports (LTSS) redesign draft paper published on March 7, 2017, by the Nebraska Department of Health and Human Services (DHHS). The paper is the follow-up to a January 2016 DHHS concept paper, which identified increasing pressure on the state’s Medicaid LTSS system. The LTSS redesign paper addresses identified high-priority systemic issues in the current LTSS system, recommends longer-term system changes, and outlines a transition to managed LTSS (MLTSS). Nebraska has long been in discussion around a transition to MLTSS, and this draft redesign paper potentially puts the state on a timeline to begin providing mandatory MLTSS statewide to older adults and individuals with disabilities (Phase 1) as of January 1, 2019, with MLTSS to follow for individuals with intellectual or developmental disabilities (Phase 2) on July 1, 2019. We estimate the potential MLTSS population at more than 50,000 beneficiaries with annual LTSS spending between $800 million and $850 million.

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Health Management Associates to Acquire Firm Founded by Seema Verma

Below is the news release HMA issued March 13th.

WASHINGTON, D.C. – Today, Jay Rosen, founder and president of Health Management Associates (HMA), announced the signing of an agreement by which HMA will acquire SVC, a consulting firm which is owned by Seema Verma, founder and president, and recently confirmed Administrator of the Centers for Medicare & Medicaid Services (CMS).

SVC will become HMA Medicaid Market Solutions, a new subsidiary of HMA.

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New Jersey Health Care Quality Institute Issues “Medicaid 2.0 Blueprint for the Future”

This week’s review comes to us from HMA Principal Karen Brodsky and Research Assistant Anh Pham, both of our New York City office. Anh and Karen provide a review of the “Medicaid 2.0 Blueprint for the Future” issued by the New Jersey Health Care Quality Institute (Quality Institute). Funded by The Nicholson Foundation, the Quality Institute embarked on a year-long project convening a wide variety of stakeholders in New Jersey with the goal of redesigning and modernizing the State’s Medicaid program. The report is a culmination of 24 recommendations to promote the efficient delivery of quality healthcare services to New Jersey’s most vulnerable populations.

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Illinois Issues RFP to Rebid Medicaid Managed Care Programs, Expand Statewide

This week, we reviewed the request for proposals (RFP) issued on February 27, 2017, by the Illinois Department of Healthcare and Family Services (HFS) to rebid the majority of the state’s existing Medicaid managed care program contracts, consolidate multiple programs into a single streamlined program, and expand managed care statewide. The RFP will consolidate the current Family Health Plans/ACA Adults (FHP/ACA) program, the Integrated Care Program (ICP), and the Managed Long Term Services and Supports (MLTSS) program into a single contracting approach, while reducing the number of contracted managed care organizations (MCOs) from 11 to between four and seven. The RFP does not impact the Medicare-Medicaid Alignment Initiative (MMAI) duals demonstration at this time. When fully implemented by the end of 2018, the new managed care program will cover roughly 2.7 million Medicaid beneficiaries in all 102 counties in Illinois.

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Washington Releases Apple Health Fully Integrated Managed Care RFP for North Central RSA

This week, we reviewed the Washington Health Care Authority’s (HCA’s) request for proposals (RFP) for the North Central Regional Service Area (RSA) transition to Fully Integrated Managed Care (FIMC) under the Apple Health Medicaid program. Under the RFP, HCA will contract with fully integrated Medicaid managed care organizations (MCOs) – integrating physical and behavioral health – for the North Central RSA, which consists of Chelan, Douglas, and Grant counties. HCA previously issued a FIMC RFP for Clark and Skamania counties in the second half of 2015. The state eventually intends to transition all counties to the Apple Health FIMC model. Awarded MCOs will begin serving the North Central RSA on January 1, 2018. There are more than 66,200 Apple Health members in the North Central RSA as of February 2017.

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Mississippi Division of Medicaid Issues RFP to Rebid MississippiCAN Program

This week, we reviewed the request for proposals (RFP) issued by the Mississippi Division of Medicaid (DOM) for the reprocurement of Mississippi Coordinated Access Network (MississippiCAN) Medicaid managed care plans. Under the RFP, the DOM is adding 1915(i) Intellectual/Developmental Disabilities Community Support Program (IDD CSP) and Mississippi Youth Programs Around the Clock (MYPAC) services to the MississippiCAN benefit package. As of February 2017, MississippiCAN enrolls roughly 490,000 Medicaid members across all 82 counties in the state, with annual spending of more than $2.7 billion.

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HIP 2.0 Waiver Renewal Summary

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.

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Medicaid Managed Care Spending in 2016

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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HMAIS Launches Business Partner Showcase

Deliver Your Message to Thousands of Medicaid Managed Care Executives
And Gain Access to the Nation’s Leading Database of Medicaid Market Data

There are two things you need to successfully sell products and services to Medicaid managed care organizations.  1. Strategic intelligence on the Medicaid market.  2. Access to decision makers at top Medicaid managed care plans.  HMA Information Services now offers both.

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