While social determinants of health (SDOH) have been a topic of much discussion and a driver toward understanding and furthering health equity, definitions and approaches vary across the healthcare spectrum.
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Missouri Releases Medicaid Managed Care RFP
This week our In Focus reviews the Missouri MO HealthNet (MHD) Medicaid Managed Care Program request for proposals (RFP), released on November 19, 2021, by the Department of Social Services (DSS). The MHD managed care program serves about 850,000 Medicaid and Children鈥檚 Health Insurance Program (CHIP) members including the state鈥檚 newly implemented Medicaid expansion population, across all regions of Missouri. Missouri鈥檚 General Plan managed care program covers TANF, CHIP, expansion and similar eligibility groups but does not include individuals with disabilities or those over age 65. The RFP also contains a separate section for a single, statewide Specialty Plan for foster children and children receiving adoption subsidy assistance. Managed care organizations must bid on and win a General Plan contract in order to be eligible for the Specialty Plan contract.
HMA report evaluates quality outcomes across various state Medicaid program delivery models
A recently completed analysis of the impact of Medicaid managed care on key quality indicators found managed care organizations (MCO) outperformed fee-for-service (FFS) and primary care case management (PCCM) programs for both Child and Adult Core Set measures, once the data was normalized with respect to beneficiary distribution in each model.
Former CMMI director joins HMA to help lead Medicare team
Amy Bassano, former deputy director for the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services, has joined national healthcare consulting firm 黑料网 (HMA), taking the helm as a managing director of Medicare services.
Rhode Island releases Medicaid managed care RFQ
This week our In Focus reviews the Rhode Island Medicaid managed care request for qualifications (RFQ), released on November 12, 2021, by the Executive Office of Health and Human Services (EOHHS). Contracts are worth approximately $1.4 billion annually and cover over 300,000 individuals.
Former South Dakota Medicaid director joins Leavitt Partners, an HMA company
Bill Snyder, former South Dakota Medicaid director, has joined Leavitt Partners, an HMA Company as a principal with the firm. He is the third former Medicaid Director to join the 黑料网 (HMA) family of companies this year.
Minnesota releases RFPs for Senior Health Options and Special Needs Basic Care
This week our In Focus reviews Minnesota Department of Human Services (DHS) requests for proposals (RFPs) for two of the state鈥檚 Medicaid managed care programs: Minnesota Senior Health Options/Minnesota Senior Care Plus and Special Needs BasicCare/Integrated Special Needs BasicCare. Both RFPs, released on October 25, 2021, cover health care services in all 87 Minnesota counties.
Key takeaways from CMS Innovation Center strategy refresh
This week, our In Focus section shares HMA鈥檚 takeaways from the Centers for Medicare & Medicaid Services (CMS) white paper on the CMS Innovation Center Strategy Refresh: .
Highlights from 21st annual Kaiser/HMA 50-state Medicaid director survey
This week, our In Focus section reviews highlights and shares key takeaways from the 21st annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and 黑料网 (HMA). Survey results were released on October 27, 2021, in two new reports: States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2021 and 2022 and Medicaid Enrollment & Spending Growth: FY 2021 & 2022. The report was prepared by聽Kathleen Giff颅ord,聽Aimee Lashbrook, and Sarah Barth from HMA; Mike Nardone; and by Elizabeth Hinton, Madeline Guth, Lina Stolyar, and Robin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors (NAMD).
New issue brief recommends strategic shifts for CMMI鈥檚 future: insights on Medicare innovation, balancing goals, and enhancing model success
This week, our In Focus highlights a recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, revisits questions raised in a previous HMA report and offers potential answers to guide progress and changes for demonstrations within the Centers for Medicare & Medicaid Services鈥� (CMS) Center for Medicare and Medicaid Innovation (CMMI) or the Innovation Center.
2022 Star Ratings, An Historical Year
This week, our In Focus provides an analysis of 2022 Medicare Advantage (MA) Star Ratings, including a look at how regulatory changes during the COVID-19 pandemic resulted in a record number of Medicare plans receiving historically high scores. HMA Managing Director Anthony Davis and Principal Sarah Owens rely on data from the Centers for Medicare & Medicaid Services (CMS) to take a deep dive into ratings for nearly 500 Medicare plans serving 26.8 million members.
Medicaid managed care enrollment update 鈥� Q2 2021
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 states.[1] Many state Medicaid agencies 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. All 33 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2020. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):