Tuesday, March 15, 2016, 1 to 2 p.m. EDT — New proposed federal regulations require health plans to cover all medically necessary care for transgender individuals, including transition-related services. But it’s more than just covering care. It’s also about ensuring access to appropriate services, training staff to understand the needs of transgender populations, and recognizing the social and financial implications of delaying transition-related care.
During this webinar, Marci Eads and John O’Connor of HMA Community Strategies will outline what health plans need to know about the needs of transgender individuals and about how to not only comply with the new guidelines, but also to ensure transgender individuals receive the care they need.
Wednesday, March 9, 2015, 1 to 2 p.m. EST — A growing number of health systems and Managed Care Organizations (MCOs) are moving to become Medicare Advantage plans. The launch of a Medicare Advantage plan can transition a health system to value-based payments and ensure a steady revenue stream. MCOs can serve a broader and complementary base of members with a Medicare Advantage HMO or a Special Needs Plan. However, launching a Medicare Advantage plan is a complex undertaking, requiring clear organizational intent and a well thought-out product and infrastructural strategy to navigate the regulatory environment and manage the population.
During this webinar, HMA expert Mary Hsieh will discuss what is required to launch a successful Medicare Advantage plan, with a special focus on product and pricing strategies as well as key infrastructural and operational considerations.
Thursday, March 3, 2016, 1 to 2 p.m. EST — As the shift from volume-based to value-based payment accelerates, primary care providers, including Federally Qualified Health Centers (FQHCs) and behavioral health providers, must make critical changes to become ready for value-based payments and ensure their financial sustainable. But what changes need to be made? There is now an online self-assessment tool that providers can use to pinpoint specific strengths and gaps in value-based payment readiness and identify core care delivery, operational, and financial capabilities and high-priority elements to implement. The protocol was designed by HMA and CohnReznick in partnership with the DC Primary Care Association. During this webinar, HMA experts Deborah Zahn and Mary Goddeeris, along with CohnReznick expert Peter Epp, will demonstrate how the readiness tool can help practices as they prepare themselves for value-based payments.
Thursday, February 25, 2016, 3 to 4 p.m. EST — A growing number of states are transitioning Long-Term Services and Supports programs to managed care – raising important concerns about provider network adequacy. For health plans, the challenge is how to best meet state mandated access requirements given a fragmented market in which more than half of the care is delivered by home and community-based services providers. During this webinar, HMA experts Sarah Barth and Karen Brodsky will provide an overview of the market for Managed Long-Term Services and Supports (MLTSS), outline the challenges of maintaining an adequate network, and provide a framework that health plans and states can follow to ensure that MLTSS members receive the best possible care.
Thursday, February 25, 2016, 1 to 2 p.m. EST — Let’s face facts. Talking about dying is difficult. To shift from talking about curative care to palliative care can make people so uncomfortable that they avoid the conversation: patients and families are sometimes reluctant to accept diagnoses and prognoses or have fears about what care may not be provided as part of an end-of-life care plan; and providers are reluctant to deliver bad news and may focus on pursuing curative options rather than shifting the discussion to a patient-centered plan for dying. Furthermore, risk-bearing healthcare payers, like managed care entities, are in danger of being accused of a conflict of interest if they appear to be steering patients into palliative-only care.
However, there is growing evidence that end-of-life planning and value-based end-of-life care is a win-win for patients, providers, and payers – resulting in higher quality care that is aligned with patients’ preferences and eliminates relatively high cost futile care.
During this webinar, HMA experts Sukey Barnum, Laurie Lockert, and Suzanne Mitchell, MD, will build the case for value-based end-of-life care and planning, and provide a roadmap for health plans and providers looking to launch end-of-life care policies and educational programs.
Wednesday, February 3, 2016, 3 to 4 p.m. EST — California has received federal approval for a five-year, $6.2 billion 1115 waiver renewal, which can best be described as a mix of old and new. The waiver reauthorizes Medi-Cal managed care and other existing state Medicaid programs – as well as initiating important reforms and innovations. Though scaled down from the state’s original proposal, the new waiver moves California closer to value-based purchasing in Medicaid in several ways. Among the most significant is the successor to the state’s DSRIP program: an initiative called PRIME (Public Hospital Redesign and Incentives in Medi-Cal), which aims to move 60 percent of the Medicaid managed care population of public and district/municipal hospitals into value-based payment arrangements. Other new programs target behavioral integration, promote primary care over emergency care, and seek to shore up access to dental care.
During this webinar, business and policy experts from HMA’s California offices will provide a comprehensive overview of the waiver’s various components, with an emphasis on the type of organizational structures, systems, and performance measurement capabilities providers and health plans will need to successfully compete in the state’s emerging value-based environment.
