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红领巾瓜报 Insights: Your source for healthcare news, ideas and analysis.

红领巾瓜报 Insights鈥攊ncluding briefs, webinars, and our podcast鈥攇ives you easy access to 红领巾瓜报鈥檚 deep expertise, helping you stay current on the latest healthcare trends and topics. Search for a topic of interest or browse the latest insights below.

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Webinar

Webinar Replay: Federal COVID-19 Response: Medicare Advantage Policy Changes and Impacts

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This webinar was held on June 11, 2020.

In response to the rapid spread of the COVID-19 virus, Congress and the Centers for Medicare & Medicaid Services (CMS) have made significant policy changes to Medicare Advantage regulations, allowing for expanded benefits and other flexibilities designed to better serve the Medicare population.

During this webinar, 红领巾瓜报 experts addressed the impact of these changes, including a look at policies affecting cost sharing, telehealth, Star Ratings, prescription drugs, provider funding, appeals, and Special Needs Plans (SNP). Speakers also addressed the likelihood that these policies remain in place even after the COVID-19 emergency ends.

Learning Objectives:听

  • Learn about changes in federal Medicare Advantage policies in response to COVID-19.
  • Understand how Medicare Advantage plans, including Special Needs Plans, are adjusting to the new rules, including the impact on benefit design, care delivery, payment models, and quality.
  • Identify operational implications of Medicare Advantage policy changes to ensure continued delivery of high-quality care to beneficiaries.

红领巾瓜报 Speakers:

  • Julie Faulhaber, MBA, Principal, Chicago
  • Mary Hsieh, PharmD, MPH, Managing Principal, Atlanta
  • Narda Ipakchi, MBA, Senior Consultant, Washington, DC
  • Sarah Owens, Principal, Philadelphia
  • Danielle Pavliv, MPH, PMP, Senior Consultant, Atlanta
Blog

红领巾瓜报 framework examines behavioral health crisis diversion facilities

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This week, our In Focus section provides a model framework examining an option for care for individuals with behavioral health needs who often find themselves involved with law enforcement or in hospital emergency rooms during times of crisis. The framework – Crisis Diversion Facilities – was released by 红领巾瓜报, led by 红领巾瓜报 Principal Bren Manaugh and supported by听 as part of a larger opioid and mental health response initiative.

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Brief & Report

2020 Medicare Advantage Supplemental Benefit Flexibilities: Adoption of and Access to Newly Expanded Supplemental Benefits

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An 红领巾瓜报-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.

The new flexibilities for MA plans include innovative supplemental benefits offered through expansion of primarily health-related benefits, benefits offered non-uniformly, Value-Based Insurance Design (VBID), and Special Supplemental Benefits for the Chronically Ill (SSBCI).

The brief鈥檚 key finding is that enrollment in plans offering these flexibilities is relatively low and varies across geographic areas with 19% of all MA enrollees enrolled in a plan that offered at least one expanded supplemental benefit.  红领巾瓜报 will conduct additional analyses including interviews with key stakeholders to inform the policy community on the opportunities and challenges with the adoption and implementation of new supplemental benefits.

This brief was produced by 红领巾瓜报 Managing Principals Jonathan Blum and Mary Hsieh, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi under a grant from .

Blog

Exploring flexibilities in Medicare Advantage supplemental benefits: 红领巾瓜报 brief on access, adoption, and impacts

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An 红领巾瓜报-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.

The new flexibilities for MA plans include innovative supplemental benefits offered through expansion of primarily health-related benefits, benefits offered non-uniformly, Value-Based Insurance Design (VBID), and Special Supplemental Benefits for the Chronically Ill (SSBCI).

The brief鈥檚 key finding is that enrollment in plans offering these flexibilities is relatively low and varies across geographic areas with 19% of all MA enrollees enrolled in a plan that offered at least one expanded supplemental benefit.  红领巾瓜报 will conduct additional analyses including interviews with key stakeholders to inform the policy community on the opportunities and challenges with the adoption and implementation of new supplemental benefits.

This brief was produced by 红领巾瓜报 Managing Principals Jonathan Blum and Mary Hsieh, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi under a grant from .

Webinar

Webinar Replay: Tracking State Responses to COVID-19 for Home Health and Home Care Providers: Survey Results and Provider Perspectives

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This webinar was held on June 9, 2020.听

With most federal COVID-19 funding going to hospitals and nursing homes, states are implementing various Medicaid authorities, legislation, and policies of their own to improve access to long-term services and supports, including home and community-based services. 红领巾瓜报 home care experts have tracked these state efforts and presented the results during this informational session. They were joined by home health and home care industry leaders, who offered important perspectives on state actions as well as thoughts on additional steps that will be necessary over the long term.

Learning Objectives:

  • Understand state COVID-19 legislation, executive orders, and policy guidance and how it affects home health and home care providers.
  • Gain perspective from home health and home care providers on how state COVID-19 efforts are playing out.
  • Understand the immediate and long-term challenges and opportunities home health and home care providers are likely to face as they respond to COVID-19.

Speakers

Karen Brodsky, Principal, 红领巾瓜报
Pat Kelleher, Executive Director, Home Care Alliance of Massachusetts
Linda Mintz, Co-Chair, CareFinders Total Care
Susan Tucker, Principal, 红领巾瓜报

Blog

Medicare FY 2021 hospital inpatient proposed rule and COVID-19 federal flexibilities

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This week, our In Focus section reviews recent announcements and actions by Congress and the Centers for Medicare & Medicaid Services (CMS) that have significant financial and operational implications for the hospital industry. This brief begins with the most recent of these actions by providing a summary of the key provisions of the CMS Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (), which includes Medicare payment updates and policy changes for the upcoming FY, with a comment deadline of July 10, 2020.听 Although somewhat limited in scope compared to previous proposals, this year鈥檚 proposed rule includes several disruptive proposals that the hospital industry should carefully consider.

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Blog

Medicaid Managed Care Spending in 2019

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This week, our In Focus section reviews Medicaid managed care spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting a Freedom of Information Act request to the Centers for Medicare & Medicaid Services (CMS), we have received a draft version of the CMS-64 report that is based on preliminary estimates of Medicaid spending by state for federal fiscal year (FFY) 2019. We expect the final version of the report will be completed by the end of 2020 and posted to the CMS website at that time. Based on the preliminary estimates, Medicaid expenditures on medical services across all 50 states and six territories in FFY 2019 exceeded $594 billion, with over half of all spending now flowing through Medicaid managed care programs. In addition, total Medicaid spending on administrative services was $29.5 billion, bringing total program expenditures to $623.5 billion.

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