This week, we reviewed recent Medicaid enrollment trends in capitated, risk-based managed care in 25 states. 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 25 states have released monthly Medicaid managed care enrollment data through the first quarter (Q1) of 2017. This report reflects the most recent data posted.
This week, we reviewed two proposed statewide Medicaid managed long-term services and supports (MLTSS) program designs. Alabama is currently accepting public comments on a plan to implement provider-driven Integrated Care Networks (ICNs) to provide MLTSS statewide to roughly 25,000 beneficiaries who are residing in nursing facilities or receiving home and community based services (HCBS) through three of the state’s Medicaid HCBS waiver programs. Meanwhile, Ohio Governor John Kasich proposed in his upcoming state budget to implement a statewide MLTSS program for more than 100,000 beneficiaries in the state. We review both states’ plans for MLTSS, including market sizes, implementation timing, and existing Medicaid managed care plans in the states.
This blog post was authored by HMA clinicians
Margaret Kirkegaard, MD, MPH, and Jeffrey Ring, PhD.
Patient: I am anxious about my results, Doctor.
Doctor: Let’s take a look … Yes, you do indeed have cancer. I will refer you to the surgeon for an evaluation as fast as possible. You must have questions.
Patient: (Silent, in shock)
Doctor: OK, well hang out here for a few minutes, and our medical assistant will bring you contact information for the surgeon. We are backed up with patients today, so this may take a short while.
This brief exchange illustrates missed opportunities for healthcare clinicians to provide empathic relationship-centered care.
Health Management Associates is pleased to announce that Early Bird Registration is now open for our second conference on Trends in Publicly Sponsored Healthcare, September 11-12, at the Renaissance Chicago Downtown Hotel. The theme of this year’s event is The Future of Medicaid is Here: Implications for Payers, Providers and States.
Featured speakers already include some of the nation’s most innovative healthcare leaders. Visit the conference website to receive the Early Bird rate and stay up to date on the latest conference news: https://2017futureofmedicaid.healthmanagement.com/.
SVC, founded by CMS Administrator Seema Verma, is now part of Health Management Associates (HMA). The acquisition, announced March 13 by HMA founder Jay Rosen, was finalized late Friday, March 31. SVC now becomes HMA Medicaid Market Solutions (HMA MMS), a subsidiary of HMA.
This week, HMA Principal Juan Montanez, of our Washington, D.C. office, provides an update on the fiscal crisis in Puerto Rico, the relationship between the fiscal crisis and Puerto Rico’s Government Health Plan (GHP), as well as what may lie ahead for the GHP. Puerto Rico has been in the news over the last couple of years, primarily because of the central government’s inability to meet its debt obligations. In 2015 the central government’s finances reached a point where it could have literally run out of cash to service its debt and fund regular operations. A significant contributor to this fiscal crisis is the cost of and associated funding for the GHP, known colloquially on the island as Mi Salud (“My Health”). This article provides some history and context on the GHP, in addition to outlining current proposals for addressing the program’s impending funding “cliff.”
March 30th is Doctors’ Day, and for most physicians that means a special lunch in the hospital cafeteria or a carnation on their white coat. But a few years ago, I hung up my white coat and made the transition to healthcare consulting. The questions immediately started. Won’t you miss seeing patients? What exactly will you do? Did you lose your license? That last one is my favorite. So what exactly is a doctor like me doing in a place like this?
This week, we reviewed updated reports issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “December 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on February 28, 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 at the beginning of 2017, representing more than 74 million Medicaid and CHIP enrollees and more than 12 million Exchange enrollees.
This blog post was authored by HMA clinicians Margaret Kirkegaard, MD, MPH, and Jeffrey Ring, PhD
While most people would agree that social relationships improve day-to-day quality of life, do social connections actually provide a health benefit? The answer is a resounding yes!
In 1921, a remarkable study began tracking the lives of 1,500 Americans from childhood to death. It sought to track what factors in life — such as faith, marriage, pets and exercise — increased longevity. The most significant finding was that strong social networks mattered the most. The quality of social connections was more significant than the quantity. In an interview with National Public Radio, lead researcher Howard Friedman notes, “We saw that over and above the number of connections and the frequency of interactions that when those connections involved helping other people, reaching out, being actively engaged to do things for others, that was an added bonus on top of what we already see as quite beneficial from the social contacts themselves.”
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.