In a听new report听released by the Better Medicare Alliance听(BMA),听HMA colleagues Zach Gaumer and Elaine Henry听concluded that the greater flexibility of the Medicare Advantage plan model enabled plans to offer providers additional support during 2020听that听were not found within the听Fee-For-Service (FFS)听Medicare听program. The report鈥檚 findings were previewed in a recent panel discussion during the听BMA鈥檚听.听
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National Council for Mental Wellbeing and HMA have partnered to create a three-part series that examines behavioral health workforce crisis
As demand for behavioral health services continues to grow, accelerated by the COVID-19 pandemic, staffing and workforce capacity to deliver services has not kept up with demand. In a three-part series of issue briefs, colleagues from 量子资源 (HMA) and the (the National Council) offer immediate steps states can take to increase capacity and build a more stable workforce.
The first brief in the series focuses on Policy, Financial Strategies and Regulatory Waivers, and outlines solutions that can be implemented quickly to reduce administrative burden and maximize existing provider resources.
Several HMA and the National Council colleagues, contributed to the briefs and surrounding research.
Study examines Austin LGBTQIA+ community, quality of life
A new report summarizing the ShoutOut Austin Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA+) Quality of Life Study, has been released. The report summarizes research conducted by HMA Community Strategies (HMACS) which included town hall meetings, surveys, stakeholder interviews, and focus group responses from a diverse group of community members.
Center for Medicare and Medicaid Innovation: Recommendations for Future Direction
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.
The brief examines options for how CMMI could refine their approach to testing ideas for improving the Medicare program. HMA colleagues Jennifer Podulka, Yamini Narayan, and Lynea Holmes wrote the brief which was supported by Arnold Ventures.
贬惭础鈥檚 earlier brief examined the progress the Innovation Center has made in learning from Medicare-focused models during its first decade and raised questions to guide policymakers as they plan for the next phase of the Innovation Center鈥檚 work. In the new report, the team returns to those questions and offers potential answers.
The brief outlines seven pairs of competing goals and offers four recommendations that may, in part, help to balance these competing goals, as they are designed to increase the transparency of Innovation Center efforts and improve the likelihood that more models succeed in decreasing spending or improving quality. The recommendations include:
- The Department of Health and Human Services (HHS) should establish a National Healthcare Transformation Strategy
- CMMI should articulate a vision for how different models work together
- CMMI should tailor models to test ideas that address the largest areas of spending growth and key areas of quality concerns, including
- Include Part D in models
- Include Part C in models
- Promote primary care as a counterbalance to excessive low-value care
- Address social determinants of health and other drivers of quality and access disparities
- Congress and HHS should revisit the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
Strategic approaches to utilize ARPA funds to support older adults issue brief authored by HMA
A new issue brief, authored by Madeline Shea and Aaron Tripp, provides an overview of key provisions of the American Rescue Plan Act (ARPA) of 2021 which offer the potential to make communities better places to grow older. ARPA provides an opportunity for states to build sustainable, person-centered systems and infrastructure for older Americans. These provisions aim to allow older Americans to age in their home and communities.
The provisions examined in the issue brief include addressing both long-standing and emerging needs of older adults for state government officials, including staff of Medicaid, aging, and housing and community development agencies; state legislators and their staff; and advisors to governors.
The ARPA funds are now available to states and local governments and will allow the development of better systems for older Americans. Key areas of opportunity outlined in the brief include
- Building integrated data systems
- Expanding affordable housing with services
- Enhancing quality measurement and value-based purchasing models
- Developing workforce recruitment and retention strategies
- Ensuring access to internet services and assistive technology
- Aligning Medicaid and Medicare services and payments
- Creating ongoing structures to engage stakeholders in designing innovative and integrative approaches to meet community needs and monitoring their effectiveness over time
Case study examines Georgia鈥檚 experience unbundling LARC payments from Medicaid prospective payment system
A new case study prepared by colleagues from 量子资源 (HMA) analyzes the Georgia Medicaid program鈥檚 experience with unbundling long-acting, reversible contraception (LARC) devices and services from the Medicaid prospective payment system (PPS) for reimbursement in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
HMA examined Medicaid claims data from 2012-2019 as well as conducted key interviews to understand whether the unbundling reimbursement policy change could have increased LARC utilization and provided analysis for policymakers and stakeholders in other states pursuing similar strategies and programs.
Additional findings and the full report are available here.
贬惭础鈥檚 research was supported by and with support from . The HMA team included Rebecca Kellenberg, Diana Rodin, and Jim McEvoy.
HMA colleagues conduct environmental scan of NEMT benefit to Medicaid enrollees
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 HMA 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 量子资源s.
The key findings are outlined in the report and include information about:
- NEMT populations and utilization
- Various modes of transportation
- NEMT delivery system model variations, advantages, and challenges
- NEMT complaints, performance issues, and innovation
- Performance improvement, oversight, and program integrity
- Transportation network challenges and increasing role of transportation network companies
- Coordination across federally assisted transportation services
- Stakeholders鈥� view on the value and role of NEMT
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 HMA 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.
HMA briefs on Medicare-Medicaid integration
This issue brief听from 量子资源,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.
HMA prepared issue briefs explore MLTSS impacts on state Medicaid programs
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
HMA colleagues, report examines cost of stemming gun violence
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 量子资源s 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.
HMA brief examines state efforts to integrate care across Medicaid FFS LTSS and Medicare Advantage D-SNPs
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.
HMA report examines COVID-19 policy flexibility for children, youth with special needs
A new report by HMA colleagues looks at policies, including new emergency regulations and temporary flexibilities, put in place during the COVID-19 pandemic.