Briefs & Reports

HMA’s Breslin Authors Primer on Medicaid Managed Care Capitation Rates

HMA Senior Consultant Ellen Breslin prepared the recently released “Primer on Medicaid Managed Care Capitation Rates: Understanding How MassHealth Pays MCOs” for the Massachusetts Medicaid Policy Institute. It includes: An explanation of how state Medicaid programs generally pay their managed care organizations (MCOs) The overall process for setting Medicaid managed care capitation rates; and The … Read More

A Primer on Medicaid Managed Care Capitation Rates: Understanding How MassHealth Pays MCOs

HMA Senior Consultant Ellen Breslin prepared this recently released primer for the Massachusetts Medicaid Policy Institute. It includes: An explanation of how state Medicaid programs generally pay their managed care organizations (MCOs) The overall process for setting Medicaid managed care capitation rates; and The various tools states use to mitigate the risks that MCOs face … Read More

Medicaid Enrollment & Spending Growth: FY 2015 & 2016

This issue brief was released Oct. 15 by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) in conjunction with its 15th annual budget survey of Medicaid officials, “Medicaid Reforms to Expand Coverage, Control Costs and Improve Care: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2015 and 2016.” HMA … Read More

Michigan Medicaid Managed Care Results Announced

  In previous editions of The Michigan Update (most recently in August) we have reported on the Michigan Department of Health and Human Services’ (MDHHS) release of a Request for Proposals (RFP) to re-procure its Medicaid managed care contracts. The RFP was released in early May with bidder responses due in early August. This procurement … Read More

HMA Principals Designated NCQA PCMH Certified Content Experts

HMA Principals Lori Weiselberg and Lynn Dierker recently achieved the National Committee for Quality Assurance’s (NCQA) Patient-Centered Medical Home Certified Content Expert™ (PCMH CCE™) status. NCQA is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. Its certified content experts are required to complete two NCQA educational seminars, pass a comprehensive exam and … Read More

HMA’s Edwards Co-authors Health Affairs MLTSS Policy Brief

HMA Principal Barbara Edwards is co-author of the Health Affairs health policy brief “Rebalancing Medicaid Long-Term Services and Supports.” The brief examines Medicaid’s support of more flexible community-based long-term services and supports, including what’s at issue, the current debate and what’s next.

Total Cost of Care Regional Initiative Phase 1 Evaluation Complete

With support from the Robert Wood Johnson Foundation (RWJF), Health Management Associates (HMA) recently conducted a qualitative evaluation of Phase 1 of the RWJF Total Cost of Care and Resource Use (TCOC) pilot. The TCOC framework, developed by HealthPartners and endorsed by the National Quality Forum (NQF), is an analytical tool that measures cost and … Read More

HMA, AristaMD Announce Strategic Partnership with Referral Intelligence Platform

Health Management Associates (HMA) and AristaMD have announced they will combine the consulting and content expertise of HMA with a technology solution designed by AristaMD. The partnership will offer healthcare providers a new way to facilitate specialty consults and referrals at significantly decreased costs.