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HMA Insights: Your source for healthcare news, ideas and analysis.

HMA Insights 鈥� including our new podcast 鈥� puts the vast depth of HMA鈥檚 expertise at your fingertips, helping you stay informed about the latest healthcare trends and topics. Below, you can easily search based on your topic of interest to find useful information from our podcast, blogs, webinars, case studies, reports and more.

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Brief & Report

HMA briefs on Medicare-Medicaid integration

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This issue brief听from 黑料网,听Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals听is part of a multi-phased research initiative to increase enrollment in integrated care programs (ICPs)[1]听that meet full benefit dually eligible individuals鈥�[2]听needs and preferences. Dually eligible individuals have a range of chronic conditions and disabilities requiring both Medicare and Medicaid services, which makes integrated programs important to their lives.

For a succinct overview of the essential elements and policy recommendations, please access the听brief fact sheet. For a full discussion of the elements and policy recommendations, please access the听full brief.

The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Narda Ipakchi.[3]

For further information or questions, contact Sarah Barth, Ellen Breslin or Samantha DiPaola.

[1]听Integrated Care Programs (ICPs): For this research, we defined ICPs as financing and care delivery organizing entities or programs that coordinate and integrate Medicare and Medicaid-covered services and supports for dually eligible individuals.They include the Centers for Medicare & Medicaid Services (CMS) Financial Alignment Initiative (FAI) capitated and fee-for-service models; the Program of All-Inclusive Care for the Elderly (PACE); Medicare Advantage (MA) Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs); Medicaid Managed Long-Term Service and Supports Program (MLTSS) managed care organizations and aligned MA dual eligible special needs plans (D-SNPs); and state-specific programs that may be proposed to CMS.

[2]听Dually Eligible Individuals:听When using the term dually eligible individuals, we are referencing Medicare-Medicaid full benefit dually eligible individuals (FBDEs), those who qualify for full Medicaid benefits.

[3]听Narda Ipakchi was formerly a Senior Consultant with HMA.

Brief & Report

HMA prepared issue briefs explore MLTSS impacts on state Medicaid programs

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In a recent pair of reports prepared for , HMA colleagues examined the impact of managed long-term services and supports (LTSS) in state Medicaid programs. The first report, Growth in MLTSS and Impacts on Community-Based Care, examines the historical increase in the adoption of LTSS by state Medicaid programs and how that has contributed to a shift in long-term care from institutions to the community. The second report, Managed LTSS Improves Quality of Care, describes the evidence on the impact of managed LTSS in state Medicaid programs on the quality of care.

Authors:
Principal Stephen Palmer
Senior Consultant Ashlen Strong
Senior Consultant Aaron Tripp

Brief & Report

HMA colleagues, report examines cost of stemming gun violence

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In a new report, 听HMA colleagues were engaged by Arnold Ventures and the , to examine the cost to fund research and create a data infrastructure aimed at reducing gun violence. Each organization had previously released separate, but complimentary, reports outlining recommendations to stem gun violence in the United States.

This research and final cost estimate found the federal government would need to spend nearly $600 million over the next five years in order to close the gun violence information gap and provide sufficient resources to conduct appropriate research and collect and share comprehensive, transparent data to help policymakers and lawmakers address and solve gun violence.

HMA colleagues Catherine Guerrero, Zach Gaumer, Jay Shannon, Cindy Zeldin, and Yamini Narayan contributed to the research and final report.

During a webinar on Wednesday, July 14, a panel of experts including Dr. Shani Buggs, Zach Gaumer, and Dr. John Roman, shared their perspectives on report and discuss key issues in gun violence prevention research, data infrastructure and federal investment needed to close the current policy research gap.

Brief & Report

HMA brief examines state efforts to integrate care across Medicaid FFS LTSS and Medicare Advantage D-SNPs

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Funded by UnitedHealthcare, the issue brief, State Efforts to Integrate Care Across Medicaid Fee-for-Service Long-Term Services and Supports and Medicare Advantage Dual Eligible Special Needs Plans, outlines approaches taken by Medicaid programs seeking to coordinate Medicare and Medicaid services for dually eligible individuals without first implementing standalone Medicaid managed long-term services and supports (MLTSS) programs.

Authors are Sarah Barth, Rachel Deadmon and Julie Faulhaber.

Brief & Report

HMA authors report examining future of COVID-19 Medicare regulation changes

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A new Issue Brief, authored by Jennifer Podulka and Jon Blum, examines the many changes to Medicare regulations put in place during the COVID-19 pandemic. The brief, Which Medicare Changes Should Continue Beyond the COVID-19 Pandemic? Four Questions for Policymakers, tracks and categorizes the regulatory changes, describes the benefits and risks of the changes, and establishes a framework to support policymakers鈥� decisions regarding the future for the changes after the pandemic ends.

Brief & Report

Issue brief explores personal health record for children, youth, and families involved with child welfare in California

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HMA Senior Consultant Suzanne Rabideau, Principals Heidi Arthur and Eileen Moscaritolo and Consultant Anh Pham recently developed the issue brief Exploration of a Personal Health Record for Children, Youth, and Families Involved with Child Welfare in CA for California’s Medicaid CalAIM Foster Care Model of Care Workgroup. The issue brief was developed to assist the workgroup in exploring options for establishing a portable personal health record (PHR) and support the workgroup’s efforts in making long-term recommendations on this topic. The PHR would give children, youth, families, and caregivers access to the child or youth’s health information.

The issue brief also

  • Describes a PHR and it’s uses
  • Identifies ways a PHR could assist in addressing the healthcare challenges often experienced by children, youth, and families involved with child welfare
  • Identifies the federal and California-specific opportunities to facilitate access to a PHR for children and youth in foster care
  • Identifies federal and California-specific challenges to implementing a comprehensive health record for children, youth, and families
  • Shares potential options for the workgroup to consider

Authors

Suzanne Rabideau, MBA, MA, LPC, Senior Consultant
Heidi Arthur, LMSW, Principal
Eileen Moscaritolo, Principal
Anh Pham, Consultant

Brief & Report

HMA publishes white paper “Moving Beyond COVID-19 Public Health Emergency Risk Corridors”

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HMA has published a white paper identifying the appropriate, and inappropriate, uses of risk corridors in the context of Medicaid managed care capitation rate setting. 听The paper is timely due to the widespread use of risk corridors by states during the COVID-19 public health emergency (PHE) and the potential continuation of those risk corridors after the PHE ends.听听

Download the Executive Summary here.

Brief & Report

HMA contributes to NAM perspectives discussion paper 鈥楪uide for Future Directions for Addiction and OUD Treatment Ecosystem鈥�

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HMA Managing Directors R. Corey Waller, MD, MS, and Jean Glossa, MD, MBA, along with members of the Prevention, Treatment, and Recovery Working Group of the Action Collaborative on Countering the U.S. Opioid Epidemic, recently authored a new National Academy of Medicine Perspectives discussion paper calling for a long-term sustainable approach to preventing and managing addiction as a chronic disease.

To adequately respond to America鈥檚 drug overdose and death epidemic, the paper states the ecosystem in which people with addiction receive treatment must be reimagined and made more robust. The National Academy鈥檚 framework best describes the needs of and solutions for the addiction treatment ecosystem using the guidance of 鈥榯he 4 Cs鈥�: capacity, competency, consistency, and compensation.

Authors

R. Corey Waller, MD, MS, Managing Director, HMA Institute on Addiction
Kelly J. Clark, MD, MBA, DFAPA, DFASAM, President, Addiction Crisis Solutions and Immediate Past President, American Society of Addiction Medicine.
Alex Woodruff, MPH, policy analyst, Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System.
Jean Glossa, MD, MBA,听Managing Director, Delivery System, HMA
Andrey Ostrovsky, MD, Managing Partner, Social Innovation Ventures

Brief & Report

Youth needs assessment published

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With a focus on the needs of young people in detention and correctional facilities, a team of 黑料网 (HMA) colleagues completed an in-depth assessment designed to guide future planning and decision making around mental health services for youth.

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Brief & Report

Nursing home report highlights benefits of single resident rooms

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The COVID-19 pandemic highlighted nursing home safety and infection control as critical public health issues. A new report authored by HMA colleagues found compelling evidence that single rooms in nursing homes have numerous benefits for both public health and residents鈥� experience. The authors conclude that transitioning from multi-resident rooms to single rooms should be a component of person-centered nursing home reform. The report calls on stakeholders to come to the table to discuss options and strategies for long-term care redesign and transformation.

The report,听Fundamental Nursing Home Reform: Evidence on Single-Resident Rooms to Improve Personal Experience and Public Health, was developed for a Michigan-based long-term care provider and owner of skilled nursing facilities.

HMA colleagues听Sharon Silow-Carroll, MBA, MSW,听Deborah Peartree, RN, MS,听Susan Tucker, CPA, and听Anh Pham听conducted the research and analysis and prepared this report.听 An appendix prepared by the national accounting firm Plante Moran provides estimates of new costs and other considerations related to transitioning to single-resident rooms, based on data from two Michigan-based multi-facility long-term care organizations.