HMA Vital Viewpoints on Healthcare

HMA Vital Viewpoints on Healthcare · healthmanagement.com

Join us for concise conversations with HMA experts that identify practical approaches to make healthcare and human services work better. What defines expertise, and how does it benefit those we serve? True expertise is forged through experience, continuous learning, and a relentless curiosity in tackling complex problems. Vital Viewpoints on Healthcare illuminates these challenges, with HMA experts sharing their perspectives and approaches to addressing the industry’s most intricate issues.

29 episodes

25d ago latest

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Episodes 29

Is Your Healthcare Strategy Built for Change?
25d ago · 30:02
https://www.youtube.com/watch?v=9HwxWHF5px0&list=PLKpkKZ4OxkU7kgB8MVqDoo-t_K17673tF In this episode of Vital Viewpoints on Healthcare, HMA Regional Director Cara Henley discusses how healthcare organizations can plan for constant policy change without losing focus on their mission. Drawing on decades of experience in Medicaid policy, ACA implementation, and state healthcare transformation, Cara shares practical strategies for successfully transitioning policy upheaval into operational success. The conversation explores how organizations can prepare for the impacts of One Big Beautiful Bill Act
Can Better Program Integrity Lead to Better Behavioral Health?
2mo ago · 29:23
https://youtu.be/xzbBFO95Zyw?si=1Cx8taXFPtTYaWyN Behavioral health is essential to whole-person care, but obstacles include fragmented systems, rising costs, and paperwork burden. On this episode of HMA Vital Viewpoints on Healthcare, HMA Principal Alyssa Lord, former Secretary of Maryland’s Behavioral Health Administration, discusses how behavioral health integration and program integrity can work hand in hand to improve care. Alyssa shares practical strategies for building more connected, effective, and sustainable behavioral health systems by supporting Medicaid innovation that reduces admi
The Coverage Gap Grows: ACA Changes Reverberate Across Healthcare
3mo ago · 32:31
https://youtu.be/jd7ahzxb3lw?si=qymi-InQgJeYox80 This episode of Vital Viewpoints on Healthcare explores the growing coverage gap across the health insurance landscape and the pressures shaping affordability, enrollment, and access to care. The discussion covers coverage churn between Medicaid and ACA Marketplace plans, the operational and financial realities faced by states, and the warning signs emerging for consumers, providers, and health plans alike. Zach Sherman, managing director at Health Management Associates and former head of state marketplaces in PA and RI, shares his perspective o
Medicare’s “Inpatient Only” Rule Is Going Away. Now What?
4mo ago · 32:17
https://www.youtube.com/watch?v=LaIwujyoGyo This episode of Vital Viewpoints on Healthcare explores how evolving Medicare payment policy is reshaping where and how care is delivered. The discussion covers the phase-out of the inpatient only list and the operational and financial challenges tied to shifting procedures into outpatient settings. Zach Gaumer, regional director at Health Management Associates, shares his perspective on the policy mechanics, provider behavior, and market signals emerging from CMS rulemaking; while Rachel Stewart, senior consulting actuary at Wakely (an HMA Company),
How Do Life Sciences Companies Keep Innovating When the Rules Keep Changing?
5mo ago · 33:15
https://www.youtube.com/watch?v=QUpHAdaPkMY&list=PLKpkKZ4OxkU7kgB8MVqDoo-t_K17673tF&index=1&t=9s This episode of Vital Viewpoints on Healthcare unpacks the rapidly evolving regulatory landscape for pharmaceuticals. The discussion covers the challenges to innovation, such as the growing unpredictability in FDA policy, the challenges with reimbursement, and the increasing role of real-world evidence in bringing therapies to market. Julie Tierney, principal at Leavitt Partners (an HMA Company) shares her expert perspectives on rare disease innovation and upcoming user fee negotiations; while Ben
The Power of Alliances: Finding Consensus In Healthcare Policy
9mo ago · 25:24
Eric Marshall, principal at Leavitt Partners, an HMA company, shares how collaboration, not competition, is the way to move healthcare policy forward in a polarized environment. In this episode of Vital Viewpoints on Healthcare, he discusses how multi-sector alliances are advancing solutions to common pain points that too often impede progress on issues like drug pricing, supply chain security, and rural health access. Drawing on years of experience bringing stakeholders together, Eric explains why consensus-building is essential to creating durable, effective policy solutions and how trust, p
No Wrong Door: Aligning Hospitals and Community Care for Sustainable Health
10mo ago · 34:34
In this episode of Vital Viewpoints on Healthcare, Robert Ross and Warren Brodine from HMA’s Delivery Systems practice explore how hospitals and community health centers can work together to strengthen access, improve health outcomes, and improve financial sustainability across the healthcare system. Drawing from decades of leadership in safety-net hospitals, FQHCs, and integrated care models, they discuss the real-world challenges of fragmented incentives, payer mix, and regulation and share bold ideas for building a truly interdependent and patient-centered delivery system.
Is the ACA Marketplace Built to Survive Another Decade of Change?
11mo ago · 32:27
Michelle Anderson, director and senior consulting actuary at Wakely, an HMA Company, joins Vital Viewpoints on Healthcare to unpack the state of the Affordable Care Act (ACA) marketplace. From the market’s volatile beginnings to today’s uncertainty around subsidies, Michelle shares how insurers, states, and consumers have adapted and what challenges lie ahead. We explore the forces shaping affordability, coverage options, and consumer behavior, as well as the critical policy decisions that could redefine the individual market in 2026 and beyond.
What Should Quality in Healthcare Really Mean Today?
1y ago · 38:16
Quality is a word we all use in healthcare, but what does it truly mean for patients, clinicians, and systems striving to improve care? In this episode of Vital Viewpoints on Healthcare, Sarah Hudson Scholle, Principal at Leavitt Partners, an HMA company, and a nationally recognized expert in healthcare quality unpacks how quality has been defined and measured over the years, why measurement sometimes gets in the way of improvement, and how digital interoperability will more accurately capture true drivers of quality. Sarah also shares why engaging patients in defining their goals and outcomes
Ready or Not: Implementing Strategy Amid Massive Healthcare Disruption
1y ago · 30:31
Rebecca Nielsen and Alex Rich, co-leaders of HMA’s Strategy and Transformation practice, have been supporting healthcare strategies in an ever-changing environment defined by constant healthcare disruption from AI, shifting regulatory policies, and financial strain. With so much change in the air now, many strategic plans are outdated before they ever get implemented. In this episode of Vital Viewpoints on Healthcare, they expose the blind spots that sabotage even the most well-crafted strategies and offer a grounded look at what actually works when change is the only constant. They unpack the
Medicaid At (Another) Crossroads: The Future of Public Healthcare Coverage
1y ago · 37:56
As Medicaid faces another set of policy shifts, this episode provides a look-back on the many twists and turns Medicaid has faced throughout the years. Jay Rosen, president and chairman of HMA, reflects on his work with states and health plans over the past four decades in their efforts to deliver services to vulnerable populations amidst shifting federal and state priorities, innovative delivery and payment models, and increased private sector involvement. With a sharp focus on policy, equity, and system transformation, Jay offers strategic insights for leaders across healthcare, government,
What If Mental Health Checkups Were as Normal as Mammograms?
1y ago · 36:23
Monica Johnson, managing director at Health Management Associates, takes us through her compelling journey from frontline caregiver to national leader in behavioral health policy. In this episode of Vital Viewpoints on Healthcare, Monica reflects on the national rollout of the 988 crisis line as one of the most transformative shifts in creating a stigma-free behavioral health system of care that meets people where they are to support whatever crisis they may face. Monica shares personal stories and strategic insights that illuminate why policymakers must ensure these systems prioritize the loc
Is Medicare Ready for the Next Era of Innovation?
1y ago · 39:48
Amy Bassano is a Managing Director at Health Management Associates and a nationally recognized Medicare policy expert. In this episode of Vital Viewpoints on Healthcare, we unpack the complexities of Medicare innovation and examine where the program is headed next. Drawing on decades of experience—including her leadership at the Center for Medicare and Medicaid Innovation—Amy breaks down what makes value-based care so complex, why scaling successful models is harder than it sounds, and how Medicare Advantage continues to reshape the healthcare landscape. She also discusses how financial incent
What Strategies Help Local Governments Stay Resilient Amid Health Policy Changes?
1y ago · 28:56
John Eller, managing principal at Health Management Associates, joins Vital Viewpoints on Healthcare to discuss the critical role of resilience in local health services. As communities navigate shifting federal policies, economic uncertainty, and natural disasters, John shares insights on how agencies can remain nimble, collaborative, and innovative. Drawing from his extensive experience in Medicaid transformation, behavioral health, and social services leadership, he highlights the power of community trust and cross-sector partnerships in maintaining stability during turbulent times.
Can Stable Housing Unlock Better Health Outcomes?
1y ago · 26:53
Maddy Shea is a public health leader and passionate advocate for housing as a critical component of community health. In this episode of Vital Viewpoints on Healthcare, she shares insights on how housing and healthcare sectors can break down silos to improve outcomes for vulnerable populations. Drawing from her experience at the CMS Office of Minority Health and her work with health plans, affordable housing organizations, and policymakers, Maddy explores the challenges and opportunities in aligning incentives, leveraging policy tools such as Medicaid waivers, and fostering public-private part
Fraud, Waste and Abuse in Healthcare: Changing mindsets or changing reimbursement?
1y ago · 35:35
Jennifer Bridgeforth, associate principal at Health Management Associates, dives into the complexities of fraud, waste, and abuse in healthcare, examining the blurred lines between inefficient processes and intentional misconduct. The conversation explores how value-based care, provider education, and technology could pave the way for more efficient and patient-centered healthcare. Listen to discover insights on navigating these challenges in a shifting healthcare landscape.
How Can Technology Empower Human Connection in Healthcare?
1y ago · 34:15
Tom Cochran, partner at 720 Strategies, is a renowned expert in digital communication and healthcare public relations. Tom reflects on the broader impact of digital tools, acknowledging both their potential to connect us and their unintended consequences, such as cognitive overload and societal fragmentation. The conversation highlights practical strategies for navigating transitions in leadership—whether in politics or healthcare—and emphasizes the importance of understanding, listening, and adapting communication strategies to fit the moment. Tom leaves us with a reminder of the irreplaceabl
Has Medicare’s Drug Policy Struck the Right Balance Between Access and Cost?
1y ago · 40:05
Kevin Kirby, managing director at Health Management Associates, gives a closer look at the evolution of Medicare’s drug coverage and the policies that have transformed patient access and affordability. From Clinton era ideas, to the launch of the Medicare Modernization Act and then the Affordable Care Act, Kevin has advised clients as these significant milestones have shaped and reshaped Medicare’s drug benefits. He discusses the implications of the Inflation Reduction Act, raising important questions about sustainability and cost control. The episode will explore how these pivotal policies wi
Why Are Family Services Critical to Improving Children’s Health?
1y ago · 33:39
Uma Ahluwalia, managing principal at HMA, discusses the importance of keeping families at the center of children’s health and welfare services and highlights how government should provide services in support of the family unit. The conversation emphasizes that addressing family issues like poverty, trauma, and lack of resources is key to improving child welfare. She also explores the need for integrated services—across health, behavioral health, education, and safety—to address the interconnected challenges families face. Uma shares why it’s so important to sustain the commitment to long-term
Is Enhancing Quality of Care the Future of Medicaid Innovation?
1y ago · 38:49
Caprice Knapp, a seasoned health economist with over 20 years of experience in Medicaid and healthcare policy, shares her journey through various roles in government, academia, and private insurance. In this episode, Caprice offers a unique perspective on the challenges of measuring quality in healthcare, the importance of data-driven decision-making, and how global healthcare models can inspire innovation in Medicaid. From pediatric palliative care to cost-effective policy solutions, Caprice sheds light on how improving quality of care can transform healthcare outcomes for vulnerable populati
How Is Harm Reduction Redefining Recovery in Modern Treatment Approaches?
2y ago · 36:14
Erin Russell is a principal at Health Management Associates and joins our podcast to discuss the importance emphasizing harm reduction as a compassionate approach to drug policy. She shares her journey from volunteering at a syringe service program to becoming deeply invested in harm reduction, highlighting how these programs offer critical support and connections to treatment and reduce overdose deaths. Erin also explores the impact of drug policy on drug-related harms, advocating for the need to overcome stigmas that impede treatment. This podcast is being released the same week as Internati
How Can We Better Transition Healthcare Services for People Leaving Incarceration?
2y ago · 34:35
Linda Follenweider, an advanced practice registered nurse and board-certified family nurse practitioner with extensive experience in correctional healthcare, discusses the critical gaps in continuity of care for incarcerated individuals. She emphasizes how many receive necessary medical care while in jail or prison but struggle to maintain this care upon release. Highlighting the significant health risks and economic costs associated with this disconnect, she advocates for integrating correctional healthcare into the broader healthcare continuum. The episode showcases the opportunities present
Let’s Stop Doing Stupid Things: How Can We Scale Digital Healthcare Innovation to Ease the Burden on Patients and Providers?
2y ago · 31:58
Ryan Howells is a leading expert in digital health policy and interoperability from Leavitt Partners, an HMA company. Ryan has been a catalyst for change since the early days of the internet to his current role in advancing consumer-directed health data exchange through application programming interfaces (API). In this episode, he discusses the evolution of digital health, the challenges of data accessibility, and the transformative potential of AI in healthcare. Whether you’re a healthcare professional or simply interested in healthcare innovation, this podcast offers practical solutions and
How Can States Use Opioid Settlement Funds to Truly Transform Substance Use Disorder Treatment?
2y ago · 24:05
Debbi Witham is a principal in the Health Management Associates behavioral health practice group. She shares her in depth understanding of the complexities of substance use disorder (SUD) treatment systems and highlights the critical need for quality measures and sustainable healthcare funding. Debbi emphasizes the importance of not throwing more money into systems that are not producing outcomes, and that states have an opportunity to course correct. The conversation explores topics such as the impact of reimbursement on care delivery, the urgency of addressing addiction within the larger hea
Can data shape the future of Medicare’s value proposition?
2y ago · 31:33
Tim Murray is a principal and senior consulting actuary of Wakely Consulting Group, an HMA Company. With over two decades of experience as a health actuary, Tim illuminates the challenges and opportunities within Medicare, particularly focusing on value assessment and the pivotal role of data collection. Digging into the complexities of Medicare Advantage, he discusses predictive modeling, innovative supplemental benefits, and the need for structured data metrics to drive sustainable healthcare solutions.

Episodes

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HMA Vital Viewpoints on Healthcare

Episodes 29

Is Your Healthcare Strategy Built for Change?

Can Better Program Integrity Lead to Better Behavioral Health?

The Coverage Gap Grows: ACA Changes Reverberate Across Healthcare

Medicare’s “Inpatient Only” Rule Is Going Away. Now What?

How Do Life Sciences Companies Keep Innovating When the Rules Keep Changing?

The Power of Alliances: Finding Consensus In Healthcare Policy

No Wrong Door: Aligning Hospitals and Community Care for Sustainable Health

Is the ACA Marketplace Built to Survive Another Decade of Change?

What Should Quality in Healthcare Really Mean Today?

Ready or Not: Implementing Strategy Amid Massive Healthcare Disruption

Medicaid At (Another) Crossroads: The Future of Public Healthcare Coverage

What If Mental Health Checkups Were as Normal as Mammograms?

Is Medicare Ready for the Next Era of Innovation?

What Strategies Help Local Governments Stay Resilient Amid Health Policy Changes?

Can Stable Housing Unlock Better Health Outcomes?

Fraud, Waste and Abuse in Healthcare: Changing mindsets or changing reimbursement?

How Can Technology Empower Human Connection in Healthcare?

Has Medicare’s Drug Policy Struck the Right Balance Between Access and Cost?

Why Are Family Services Critical to Improving Children’s Health?

Is Enhancing Quality of Care the Future of Medicaid Innovation?

How Is Harm Reduction Redefining Recovery in Modern Treatment Approaches?

How Can We Better Transition Healthcare Services for People Leaving Incarceration?

Let’s Stop Doing Stupid Things: How Can We Scale Digital Healthcare Innovation to Ease the Burden on Patients and Providers?

How Can States Use Opioid Settlement Funds to Truly Transform Substance Use Disorder Treatment?

Can data shape the future of Medicare’s value proposition?

Episodes

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Episodes 29

Is Your Healthcare Strategy Built for Change?

Can Better Program Integrity Lead to Better Behavioral Health?

The Coverage Gap Grows: ACA Changes Reverberate Across Healthcare

Medicare’s “Inpatient Only” Rule Is Going Away. Now What?

How Do Life Sciences Companies Keep Innovating When the Rules Keep Changing?

The Power of Alliances: Finding Consensus In Healthcare Policy

No Wrong Door: Aligning Hospitals and Community Care for Sustainable Health

Is the ACA Marketplace Built to Survive Another Decade of Change?

What Should Quality in Healthcare Really Mean Today?

Ready or Not: Implementing Strategy Amid Massive Healthcare Disruption

Medicaid At (Another) Crossroads: The Future of Public Healthcare Coverage

What If Mental Health Checkups Were as Normal as Mammograms?

Is Medicare Ready for the Next Era of Innovation?

What Strategies Help Local Governments Stay Resilient Amid Health Policy Changes?

Can Stable Housing Unlock Better Health Outcomes?

Fraud, Waste and Abuse in Healthcare: Changing mindsets or changing reimbursement?

How Can Technology Empower Human Connection in Healthcare?

Has Medicare’s Drug Policy Struck the Right Balance Between Access and Cost?

Why Are Family Services Critical to Improving Children’s Health?

Is Enhancing Quality of Care the Future of Medicaid Innovation?

How Is Harm Reduction Redefining Recovery in Modern Treatment Approaches?

How Can We Better Transition Healthcare Services for People Leaving Incarceration?

Let’s Stop Doing Stupid Things: How Can We Scale Digital Healthcare Innovation to Ease the Burden on Patients and Providers?

How Can States Use Opioid Settlement Funds to Truly Transform Substance Use Disorder Treatment?

Can data shape the future of Medicare’s value proposition?

Podcast 森辺一樹のグローバル・マーケティング〜すべてはアジアで売るために〜