Tuesday, September 15, 2015, 1 to 3 p.m. EDT — There is a growing understanding that the environment in which people live can have a profound effect on their health, wellness and utilization of the healthcare system. The quality and safety of the home environment are part of the social determinants of health. Including home assessments and repairs in a care plan for asthma patients clearly demonstrates the importance of transcending the walls of the traditional health care delivery system to obtain better health outcomes and lower total spending.
Home interventions aimed at eliminating key drivers of asthma attacks like mold, dust, pests and tobacco smoke can improve the lives of those with asthma and dramatically reduce the cost of this chronic disease. Unfortunately, not all asthma-related home interventions are reimbursed by payers, despite the well-documented return on investment.
During this webinar, you’ll learn how to make the business case for asthma-related home interventions and build a sustainable stream of funding for these initiatives.
Wednesday, August 26, 2015, 1 to 2 p.m. EDT — Medicaid managed care plans need to take a proactive approach to meet network adequacy requirements and demonstrate compliance to state regulators. Often that means more than just having the right network in place. It also means being able to identify and address potential problems before they negatively affect member access and trigger regulatory action.
During this webinar, HMA Principal Karen Brodsky (who previously oversaw managed care contracting for the state of New Jersey) discusses the warning signs state regulators look for when assessing the adequacy of a Medicaid managed care plan’s network. Brodsky will also outline some practical ways plans can get out in front of these potential problems – not only demonstrating compliance to regulators but also improving access and satisfaction for members.
Wednesday, July 1, 2015, 1 to 2 p.m. EST — Get ready for a whole new regulatory framework for Managed Long-Term Services and Supports (MLTSS). As part of the newly proposed Medicaid managed care regulations, CMS is seeking to codify the way in which state and federal regulators oversee MLTSS programs. It’s no surprise CMS is taking action, given the dramatic growth of MLTSS. But the proposed rules mean states, health plans, and providers will have to shoulder a wide variety of new compliance requirements in areas such as network adequacy, patient-centered planning, care coordination and quality measurement.
During this webinar, HMA experts will outline the proposed MLTSS rules and discuss the implications for states, health plans, and providers serving the long-term care market.
Speakers:
Lisa Shugarman, Senior Consultant, HMA
Susan Tucker, Managing Principal, HMA
Wednesday, June 17, 2015 1:00 p.m. EST — The proposed Medicaid managed care regulations released last month by CMS include fundamental changes in the way quality and performance is measured among health plans in state-sponsored programs. The rules seek to align quality and performance measures with existing government programs like Medicare Advantage, institute a quality ratings system, support a variety of performance improvement projects, and increase the role of external quality review. During this webinar, HMA experts will outline the proposed quality rules and discuss the implication for states, Medicaid managed care plans and other stakeholders.
Thursday, May 28, 2015 at 3 p.m. EST – The wait is over. CMS has finally released a new set of proposed Medicaid managed care and CHIP regulations – the first major update of federal rules for health plans in state-sponsored programs in more than a decade. The changes seek to align Medicaid managed care regulations with those of other government-sponsored programs, while at the same time fostering innovation, transparency, quality and financial viability. Like all such rules, details matter. And at more than 650 pages, these proposed rules have a lot of details to digest. It will take weeks – if not months – to fully understand the ins and outs of the new regulations. However, an initial read reveals several important themes likely to dramatically impact Medicaid managed care going forward.
During this webinar, HMA experts will provide a “first take,” with initial thoughts and reactions to key components of the new regulations. This will be the first in a series of webinars that will fully explore the implications of the new rules in the weeks and months ahead.
Tuesday, June 16, 2015 at 3 p.m. EST — Among the most important changes in the proposed federal Medicaid managed care regulations released last month are those involving medical loss ratios and rate setting requirements for health plans in state-sponsored programs. The rules dramatically expand federal oversight of the entire rate setting process – including a shift to actuarial certification of specific rate cells and the establishment of an 85% MLR threshold. During this webinar, HMA experts will discuss the proposed changes to the rate setting process and the implications for states, Medicaid managed care plans, and other stakeholders.
Speakers:
Eileen Ellis, Managing Principal, HMA
Steve Schramm, Managing Director, Optumas
