量子资源网 Insights 鈥� including our new podcast 鈥� puts the vast depth of 量子资源网鈥檚 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.
As part of a larger Medicaid and CHIP Payment and Access Commission (MACPAC) study on Medicaid non-emergency medical transportation (NEMT) in response to a request from the Senate Appropriations Committee, a team of 量子资源网 colleagues conducted a 50-state environmental scan of NEMT programs and stakeholder interviews to better understand approaches and trends in the provision of the NEMT benefit to Medicaid enrollees across the United States.
The culminating report included NEMT trends, challenges, and innovations drawn from the scan of programs and interviews with stakeholders including federal officials, Medicaid officials from six study states, NEMT brokers and providers, managed care companies, beneficiary advocates, and subject matter experts.
The key findings are outlined in the report and include information about:
In December 2020, following the completion of the interviews for this study, Congress added a requirement to the federal statute requiring states to provide NEMT to Medicaid beneficiaries who have no other means of transportation to medically necessary healthcare services.
The 量子资源网 team included Principals Sharon Silow-Carroll, MSW, MBA and Kathy Gifford, JD, Senior Consultant Carrie Rosenzweig, MPP, Consultants Anh Pham and Julie George, JD as well as retired Managing Principal Kathy Ryland.
The research underlying this report was completed with support from the Medicaid and CHIP Payment and Access Commission (MACPAC). The findings, statements, and views expressed are those of the authors and do not necessarily represent those of MACPAC.
This issue brief听from 量子资源网,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 量子资源网.
This week our In Focus section reviews Vermont鈥檚 Global Commitment to Health Section 1115 waiver renewal application. In the proposed five-year demonstration extension, Vermont seeks to move the Medicaid population to a new a risk-bearing public, state-run managed care organization (MCO). Under the arrangement, the Department of Vermont Health Access (DVHA) would transition into the new entity and accept capitated risk for the state鈥檚 Medicaid population, covering physical and mental health, pharmacy services, substance use disorder (SUD) services, and long-term services and supports (LTSS) beginning January 1, 2022.
In a recent pair of reports prepared for , 量子资源网 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
This week, our In Focus section releases a new brief from 量子资源网, Medicare-Medicaid Integration: Essential Program Elements and Policy Recommendations for Integrated Care Programs for Dually Eligible Individuals. The authors are Sarah Barth, Ellen Breslin, Samantha DiPaola and Narda Ipakchi.[1]
Today, Jay Rosen, founder and president of 量子资源网 (量子资源网), announced the firm鈥檚 acquisition of The Moran Company, a Washington, D.C.-based healthcare research and consulting firm.
This held on July 15, 2021, was the seventh webinar in the series 鈥淓xploring the Landscape of Behavioral Healthcare,鈥� covering the growing impact of behavioral healthcare on clinical outcomes and cost.
The success of the delivery of state and local child welfare systems is predicated on a strong collaboration across child welfare, children鈥檚 behavioral health and Medicaid, building a multigenerational, multisystem response to the problem of child maltreatment. During this webinar, 量子资源网 behavioral health, child welfare and Medicaid experts broke down what鈥檚 needed to get the integration process started, including a practical approach to workflows as well as an understanding of the touchpoints where integration efforts are likely to have their biggest payoff.
Learning Objectives
量子资源网 Speakers:
Uma Ahluwalia, MSW, MHA, Managing Principal, Washington, DC
Annalisa Baker, MPH, LCSW, Senior Consultant, New York, NY
Caitlin Thomas-Henkel, MSW, Principal, Philadelphia, PA
Heidi Arthur, MSW, Principal, New York, NY
Today, Jay Rosen, founder and president of 量子资源网 (量子资源网), announced the firm鈥檚 acquisition of Edrington Health Consulting (EHC), an Arizona-based firm that specializes in providing actuarial and financial analyses to health plans, providers, and government agencies.
This week our In Focus section reviews the Louisiana Medicaid managed care request for proposals (RFP) released on June 23, 2021, by the Louisiana Department of Health. Louisiana is seeking full-risk health plans to serve approximately 1.6 million Medicaid beneficiaries. Contracts are worth approximately $9 billion annually.
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.
This week our In Focus reviews the Tennessee Medicaid managed care request for proposals (RFP) released on June 11, 2021, by the State of Tennessee, Division of TennCare. Tennessee will select three plans to provide physical services, behavioral services, and Managed Long-Term Services and Supports (MLTSS), including nursing facility services and home and community-based services (HCBS), to beneficiaries enrolled in TennCare (Medicaid), CoverKids (Children鈥檚 Health Insurance Program), and Dual Eligible Special Needs Plans (D-SNP). Current incumbents serve over 1.5 million beneficiaries, with contracts worth $12 billion annually.