Category Archives: HMA Weekly Roundup

NC Releases Foster Care Specialty Plan Program RFP

This week, our In Focus section reviews the statewide North Carolina request for proposals (RFP) for the new Children and Families Specialty Plan (CFSP), which the North Carolina Department of Health and Human Services (DHHS) released on February 7, 2024.

| Comments Off on NC Releases Foster Care Specialty Plan Program RFP

Interoperability and Patient Access Final Rule: The Next Phase in the Data Exchange Journey

This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule, published on January 17, 2024.

| Comments Off on Interoperability and Patient Access Final Rule: The Next Phase in the Data Exchange Journey

CMS Releases Advance Notice of Methodological Changes for MA Capitation Rates and Medicare Part C and Part D Payment Policies

This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage (Part C) and Part D Prescription Drug Programs published on January 31, 2024.

| Comments Off on CMS Releases Advance Notice of Methodological Changes for MA Capitation Rates and Medicare Part C and Part D Payment Policies

New HMA Report Analyzes the Expanded Landscape of Value-Based Entities and Market Growth Opportunities

This week, our In Focus section highlights a new report released on January 25, 2024, Analyzing the Expanded Landscape of Value-Based Entities: Implications and Opportunities of Enablers for the CMS Innovation Center and the Broader Value Movement. The second In Focus section reviews the request for applications (RFA) that the Commonwealth of Pennsylvania Department of Human Services (DHS) released January 30, for the Community HealthChoices (CHC) Program.

| Comments Off on New HMA Report Analyzes the Expanded Landscape of Value-Based Entities and Market Growth Opportunities

CMS Announces Innovation in Behavioral Health Model

This week, our In Focus section highlights the Innovation in Behavioral Health (IBH) model, which the Centers for Medicare & Medicaid Services (CMS) announced January 18, 2023.

| Comments Off on CMS Announces Innovation in Behavioral Health Model

CMS Approves Next Phase of New York’s Medicaid 1115 Waiver Journey

This week, our In Focus section describes New York State’s Medicaid Section 1115 waiver amendment authorizing at least $6.7 billion in funding for new programs and initiatives in the state’s Medicaid program.

| Comments Off on CMS Approves Next Phase of New York’s Medicaid 1115 Waiver Journey

Rhode Island Releases Medicaid Managed Care Program RFP

This week our In Focus section reviews the Rhode Island statewide, capitated risk-bearing Medicaid managed care program request for proposals (RFP), which the Rhode Island Executive Office of Health and Human Services (EOHHS) released December 15, 2023.

| Comments Off on Rhode Island Releases Medicaid Managed Care Program RFP

Discover the Challenges and Opportunities Associated with Implementing Value-Based Care at the HMA Spring 2024 Workshop

Policymakers have been working to move the U.S. healthcare system away from the costly and inefficient framework of fee-for-service to patient-centered structures focused on value and quality.

| Comments Off on Discover the Challenges and Opportunities Associated with Implementing Value-Based Care at the HMA Spring 2024 Workshop

CMS Transforming Maternal Health Model Offers State Medicaid Agencies an Opportunity to Accelerate Improvements in Quality and Outcomes

This week, our In Focus section reviews the new Transforming Maternal Health (TMaH) Model, which the Centers for Medicare & Medicaid Services (CMS) Center for Medicaid and Medicare Innovation (the Innovation Center) announced on December 15, 2023.

| Comments Off on CMS Transforming Maternal Health Model Offers State Medicaid Agencies an Opportunity to Accelerate Improvements in Quality and Outcomes

The Role of Specialized Managed Care in Addressing the Intersection of Child Welfare Reform and Behavioral Health Transformation

This week, our In Focus section highlights the efforts of Health Management Associates (HMA) and partner organizations to better coordinate services for children in foster care and for children with behavioral health needs.

| Comments Off on The Role of Specialized Managed Care in Addressing the Intersection of Child Welfare Reform and Behavioral Health Transformation