This week, our In Focus section reviews the policy changes included in the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Final Rule (). This year鈥檚 IPPS Final Rule includes several important policy changes that will change hospitals鈥� administrative procedures and may alter hospitals鈥� Medicare margins, beginning as soon as October 1, 2020.
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California releases Medi-Cal managed care RFI
This week, our In Focus section reviews the California request for information (RFI) regarding the Medi-Cal Managed Care Plan (MCP) contract and the upcoming Medi-Cal MCP procurement. The California Department of Health Care Services (DHCS) is seeking information to update boilerplate contracts and develop the request for proposals (RFP) scheduled for release in 2021.
Webinar Replay – Health Performance Accelerator Webinar Series: How States Are Rethinking Medicaid Managed Care Performance Management
This webinar was held on September 8, 2020.
State Medicaid agencies (SMAs) are actively exploring improved approaches to managing the performance of Medicaid managed care organizations (MCOs) and accountable care organizations (ACOs), emphasizing tailored quality measures, new incentive models, more effective use of information technology, and revised contract requirements.
During this webinar, experts from HMA and HealthEC outlined potential improvements to MCO/ACO performance management and showcased ways in which information technology can be deployed to enable these improvements.
Learning Objectives:听听听听
- Learn about ways in which the number and mix of measures, the design of business processes and use of information systems should change to achieve improvements in MCO/ACO performance management.
- Learn how HMA can work with SMAs on performance management initiatives.
- Find out how IT solutions such as HealthEC鈥檚 can dramatically improve SMA processes such as data aggregation, synthesis, transformation, validation, and comparative analysis in support of performance management system improvements.
Speakers
Steve Soto, Principal, HMA
Sita Kapoor, HealthEC, Chief Information Officer
HMA examines current state of Medicare-Medicaid integration programs
The experts at 黑料网 (HMA) have released the Medicare-Medicaid Integration: Reflecting on Progress to Date and Charting the Path to Making Integrated Programs Available to all Dually Eligible Individuals issue brief and companion bibliography appendix, the second in a series of issue briefs examining Medicare-Medicaid integrated programs.
Based on HMA’s review of the literature and available public information, this brief summarizes the elements for success and barriers encountered by integrated programs. It concludes with essential questions and next steps to move forward with federal and state public policies and care delivery options centered around, informed by, and available to, more dually eligible individuals.
HMA colleagues Sarah Barth, Jon Blum, Elaine Henry, Narda Ipakchi and Sharon Silow-Carroll contributed to the research and final brief.
For the next phase of research, HMA will convene and interview individuals, their families and other caregivers, providers, payers, community-based organizations, state government, and other stakeholders in select regions across the country.
The project was funded by a grant from , a philanthropy dedicated to tackling some of the most pressing problems in the United States.听听
Hawaii Releases Quest Integration Reprocurement RFI
This week, our In Focus section reviews the Hawaii request for information (RFI) regarding reprocurement of the state鈥檚 QUEST Integration (QI) Medicaid managed care program, released on July 21, 2020. QI covers approximately 360,000 individuals, including pregnant women, children, parents/caretakers, adults, and individuals who are aged, blind, or disabled (ABD). The state had awarded contracts earlier this year, however, the contracts were rescinded as the state focused on their response to COVID-19.
Oklahoma releases Medicaid managed care request for public feedback
This week, our In Focus section reviews the Oklahoma request for public feedback in the SoonerCare program design, released on June 18, 2020. The Oklahoma Health Care Authority (OHCA) and Governor Kevin Stitt are seeking stakeholder input for the state鈥檚 Medicaid managed care program design before finalizing a request for proposals (RFP). The RFP, which is currently in development, is scheduled to drop in the fall and has an implementation date of October 2021. Individuals, program participants, providers, trade associations, companies, and other organizations are encouraged to submit responses by August 17, 2020.
HMA announces cancellation of 2020 annual conference
黑料网 has made the decision to cancel its October 2020 conference on Trends in Publicly Sponsored Healthcare, given continuing developments concerning COVID-19 and out of an abundance of caution for the safety of attendees, speakers, and staff. Full refunds will be made to registered attendees and sponsors.
Early Bird Registration Expires July 29 for HMA Conference, October 26-27 in Chicago
Be sure to register soon for HMA鈥檚 conference on What鈥檚 Next for Medicaid, Medicare, and Publicly Sponsored Healthcare: How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty, October 26-27, at the Fairmont Chicago, Millennium Park. The Early Bird registration rate of $1595 per person expires on July 29.听 After that, the rate is $1795.
Medicaid and exchange enrollment update 鈥� March 2020
This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the 鈥淢arch 2020 Medicaid and CHIP Applications, Eligibility Determination, and Enrollment Report,鈥� published on June 22, 2020. Additionally, we review 2020 Exchange enrollment data from the 鈥淗ealth Insurance Exchanges 2020 Open Enrollment Period: Final State-Level Public Use File,鈥� published by CMS on April 2, 2020. Combined, these reports present a picture of Medicaid and Exchange enrollment in early 2020, leading up to the COVID-19 pandemic and representing 70.9 million Medicaid and CHIP enrollees and 11.4 million Exchange enrollees. Medicaid/CHIP and Exchange enrollment is expected to rise in 2020 according to a team of HMA Medicaid experts, health economists, and data analysts. Read the previous In Focus on HMA鈥檚 forecast model.
GAO 50-state Medicaid survey on federal policy challenges
This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia to identify challenges related to federal Medicaid policies. 听
HMA conference on trends in publicly sponsored healthcare
HMA Conference 2020
What鈥檚 Next for Medicaid, Medicare, and Publicly Sponsored Healthcare:
How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty
Pre-Conference Workshop: October 25
Conference: October 26-27
Location: Fairmont Chicago, Millennium Park
HMA updates forecast of COVID-19 impact on Medicaid, marketplace, and the uninsured
黑料网鈥� (HMA) updated analysis projects the potential impact of the COVID-19 pandemic on health insurance coverage and cost by state through 2022. The analysis provides deeper insights into how health insurance coverage is estimated to take years to more closely resemble pre-COVID-19 coverage levels.