This week, our In Focus comes from an HMA cross-cutting subject matter team, who have updated a core set of federal policy slides that analyzes recent federal policy actions following the Presidential and Congressional elections. It includes an analysis of President Biden’s $1.9 trillion COVID-19 relief legislation currently in development and recent CMS regulatory and administrative actions. Specifically, the analysis looks at:
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Medicaid Managed Care Spending in 2020
This week, our In Focus section reviews preliminary 2020 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), HMA 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) 2020. Based on the preliminary estimates, Medicaid expenditures on medical services across all 50 states and six territories in FFY 2020 exceeded $649.4 billion, with over half of the total now flowing through Medicaid managed care programs. In addition, total Medicaid spending on administrative services was $29.7 billion, bringing total program expenditures to $679.1 billion.
HMA enters strategic partnership with The College for Behavioral Health Leadership
HMA recently entered into a strategic partnership with The College for Behavioral Health Leadership (CBHL) for the 2021 calendar year.
Medicaid managed care enrollment update 鈥� Q4 2020
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):
New report supports state Medicaid programs in advancing health justice
Rates of illness and death due to the COVID-19 pandemic have disproportionally impacted Americans who are Black, African American, Latinx, Native American, Asian, and other people of color as well as people with disabilities and those subsisting on poverty-level income. In response to this, , in partnership with the a Massachusetts-based cross-disability advocacy and action research organization, released a new report: Advancing Health Justice Using Medicaid Data: Key Lessons from Minnesota for the Nation. This report provides information on the importance of investing in data analysis to advance health justice in Medicaid populations. It further highlights the importance of partnering with communities most impacted by injustices that cause inequities in health outcomes.
CMS Releases New Tools
Two new tools have been released by the Centers for Medicare & Medicaid Services (CMS) to help states and territories plan to transition back to regular operations after the COVID-19 public health emergency (PHE) ends.
MACPAC report examines Medicaid services for ID/DD populations
In a report to the Medicaid and CHIP Payment and Access Commission (MACPAC), HMA consultants Sarah Barth, Sharon Lewis and former research assistant Taylor Simmons, provided insight and review of Medicaid services for people with intellectual or developmental disabilities (ID/DD).
CMS Innovation Center鈥檚 Geographic Direct Contracting Model opportunity
This week, our In Focus section reviews a new model 鈥� Geographic Direct Contracting 鈥� introduced by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. The model will test whether a geographic-based approach to care delivery and value-based care can improve health and reduce costs for Medicare beneficiaries enrolled in the traditional fee-for-service program across an entire region. This model represents one of the most transformational models released by the Innovation Center. During the 6-year Geographic Direct Contracting model performance period the traditional Medicare program will be replaced by the Direct Contracting program in the 10 selected regions.
Commonwealth Fund blog highlights Medicare changes due to COVID-19
Jennifer Podulka penned a for The Commonwealth Fund in conjunction with The SCAN Foundation, highlighting the legislative and regulatory changes made to Medicare in response to the COVID-19 pandemic. She was part of the HMA team who authored an and policy tracker earlier this year.
The future of quality reporting: understanding digital quality measurement practices
In the wake of the COVID-19 pandemic, the need for greater health information technology interoperability, 鈥渄igital鈥� measures of healthcare quality and performance, and advanced value-based care systems has grown. In January 2021, the National Committee for Quality Assurance (NCQA) publicly released its vision for healthcare quality measurement to the Biden-Harris Department of Health and Human Services (HHS) transition team. The paper, focuses on four core areas, with three of them being specific to the evolution of a digital quality ecosystem:
Drivers and barriers to adopting flexible Medicare Advantage supplemental benefits
This week鈥檚 In Focus highlights a recent HMA publication examining the drivers and barriers to Medicare Advantage plan adoption of newly available supplemental benefits intended to address unmet health and social needs. Unlike Traditional Medicare, Medicare Advantage plans, which provide coverage for 40 percent of all Medicare beneficiaries, may offer enrollees supplemental benefits which are not covered by the Medicare program. Until recently, the Medicare program has required that supplemental benefits be limited to those that are medical in nature. However, in recent years, Congress and CMS 鈥攖hrough four different legislative and regulatory authorities 鈥� granted new flexibilities for Medicare Advantage plans to offer non-medical benefits that address social needs. Medicare Advantage plans may also now tailor supplemental benefits and make them available only to certain subpopulations based on chronic disease or health status.
Exploring Medicare Advantage supplemental benefits: HMA’s assessment of adoption, access, and policy opportunities
The experts at 黑料网 (HMA) have released Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access. The white paper examines the factors contributing to a Medicare Advantage plan鈥檚 decision to offer or not offer newly available supplemental benefits and opportunities and challenges with adoption and implementation. Newly available supplemental benefits are intended to address unmet health and social needs.