This week, our In Focus section provides a model framework examining an option for care for individuals with behavioral health needs who often find themselves involved with law enforcement or in hospital emergency rooms during times of crisis. The framework – Crisis Diversion Facilities – was released by Health Management Associates, led by HMA Principal Bren Manaugh and supported by Arnold Ventures as part of a larger opioid and mental health response initiative.
An HMA-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.
HMA Conference 2020
What’s Next for Medicaid, Medicare, and Publicly Sponsored Healthcare:
How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty
Pre-Conference Workshop: October 25
Conference: October 26-27
Location: Fairmont Chicago, Millennium Park
This week, our In Focus section reviews recent announcements and actions by Congress and the Centers for Medicare & Medicaid Services (CMS) that have significant financial and operational implications for the hospital industry. This brief begins with the most recent of these actions by providing a summary of the key provisions of the CMS Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (CMS-1735-P), which includes Medicare payment updates and policy changes for the upcoming FY, with a comment deadline of July 10, 2020. Although somewhat limited in scope compared to previous proposals, this year’s proposed rule includes several disruptive proposals that the hospital industry should carefully consider.
Health Management Associates’ (HMA) updated analysis projects the potential impact of the COVID-19 pandemic on health insurance coverage and cost by state through 2022. The analysis provides deeper insights into how health insurance coverage is estimated to take years to more closely resemble pre-COVID-19 coverage levels.
This week, our In Focus section reviews Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to the Centers for Medicare & Medicaid Services (CMS), we have received a draft version of the CMS-64 report that is based on preliminary estimates of Medicaid spending by state for federal fiscal year (FFY) 2019. We expect the final version of the report will be completed by the end of 2020 and posted to the CMS website at that time. Based on the preliminary estimates, Medicaid expenditures on medical services across all 50 states and six territories in FFY 2019 exceeded $594 billion, with over half of all spending now flowing through Medicaid managed care programs. In addition, total Medicaid spending on administrative services was $29.5 billion, bringing total program expenditures to $623.5 billion.
This week, our In Focus section reviews key takeaways from the report, How State Medicaid Programs are Managing Prescription Drug Costs: Results from a State Medicaid Pharmacy Survey for State Fiscal Years 2019 and 2020, prepared by Kaiser Family Foundation (KFF) and Health Management Associates (HMA). The report was written by HMA Managing Principal Anne Winter and Principals Kathleen Gifford and Linda Wiant with Rachel Dolan, Marina Tian, and Rachel Garfield from KFF.
This week, our In Focus section reviews an issue brief written by HMA consultants examining Medicare-Medicaid integration. In 2019, 7.7 million people in the United States were eligible to receive access to full benefits under Medicare and individual state Medicaid programs. This group of people is known as the Full Benefit Dual Eligible (FBDE) population. While FBDE enrollment in integrated programs nearly quadrupled over the past five years, the number of people enrolled in an integrated program never rose above one in 10 FBDE people.
A team of HMA consultants have authored a peer-reviewed journal article drawing on data from the recently completed five-year evaluation of the Strong Start for Mothers and Newborns II Initiative to discuss key considerations for implementing a group prenatal care model, including barriers to implementation and sustainability as well as strategies for overcoming barriers and sustaining the model.
As reported by the New York Times (An Army of Virus Tracers Takes Shape in Massachusetts, April 17), Massachusetts has hired 1,000 public health contact tracers to speed containment of COVID-19 during its surge in infections. Contact tracers are reaching out to those who have tested positive, providing information, and talking them through their recent movements and connections, using cell phones and triangulation data. They then, in turn, reach out to inform and educate those contacts.