Sheppard Health Law

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). Notably, within this overall decrease, CMS is also proposing increases for certain forms of direct patient care, including primary care.

Medicare 52

Medicare Accountable Care Primary Care Accountability 52

Home Health Care

APRIL 15, 2024

Last week, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced a new proposed model that will undoubtedly affect home health providers, and also allow them the opportunity to get more involved in value-based care initiatives. TEAM would be yet another model furthering that goal, if enacted.

Accountability 66

Accountability Medicare Home Care Quality of Care 66

HIT Consultant

SEPTEMBER 18, 2023

Michael Pattwell, Principal Business Advisor, Value-Based Care, Edifecs While the need to address social determinants of health (SDOH) is definitely not new, 2023 marks the first year SDOH is codified into national and statewide value-based payment program mandates.

Accountability 114

Accountability Population Health Medicaid Accountable Care 114

NASHP

MAY 10, 2024

Primary Care AHEAD is designed to be tailored to states’ primary care goals within their Medicaid programs, while aligning these goals with Medicare’s primary care strategy that incorporates investments from Medicare. A core aspect is a focus on alignment between payers.

Primary Care 52

Primary Care Medicaid Medicare Integration 52

NCQA

OCTOBER 31, 2023

“ It’s a marathon, not a sprint ,” said Liz Fowler, Director at the Center of Medicare and Medicaid Innovation (CMMI), during a recent Fireside Chat with NCQA Executive Vice President Eric Schneider. NCQA is eager to continue the conversation on multi-payer alignment and tracking state innovations.

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

Home Health Care

MAY 5, 2022

Another major component of the company’s value-based mission was its acquisition of Caravan Health, an accountable care organization (ACO) manager. I’m very pleased with the positive reaction from our clients who are excited about the prospect of Signify Health providing a total cost of care model,” he said.

Accountability 90

Accountability Accountable Care Primary Care Medicare 90

Home Health Care

MARCH 3, 2022

One thing that has remained constant, though, is the organization’s push towards a value-based health care system. For Signify, the recent completion of its Caravan Health acquisition — an accountable care organization (ACO) manager — is a major move toward driving more participation and success in value-based payment arrangements. “We’re

Accountability 81

Accountability Medicare Accountable Care Primary Care 81

NASHP

OCTOBER 20, 2022

This substandard access to quality care can lead to poor health outcomes.[6]. have a special health care need, and an estimated 44 percent of CYSHCN are enrolled in Medicaid.[7] public health, Medicaid, mental health) and other stakeholders (e.g., Nearly 20 percent of children in the U.S.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

HIT Consultant

NOVEMBER 22, 2021

Health Fidelity’s technology uncovers insights that enable better care planning and more complete revenue capture; giving health plans and providers the ability to succeed in risk-sharing arrangements across Medicare Advantage, Affordable Care Act (ACA), Medicaid, and Accountable Care Organization programs.

Accountable Care 52

Accountable Care Medicaid Medicare Accountability 52

HIT Consultant

FEBRUARY 2, 2022

A strong VBC network will often need a sizable technology investment to revise traditionally siloed capabilities, the ability to cater to a spectrum of stakeholders, including accountable care organizations (ACOs), bundled payment programs, full and partial capitation, and the Medicare Shared Savings Program with upside and downside risk.

Accountability 98

Accountability Medicaid Accountable Care Medicare 98

NASHP

DECEMBER 10, 2021

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs integrating?CHWs ACO Accountable Care Organizations. CBCM Community Based Care Management Program. Acronym Guide.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

HIT Consultant

MAY 19, 2023

Together, Rightway and One Medical aim to streamline access to primary care in order to drive down costs and deliver improved outcomes. One Medical will join Rightway’s ecosystem partnership program, RightwayHub, as an Integrated partner to bring easy access to members looking for primary care services.

Primary Care 52

Primary Care Health Science Accountable Care Hospitals 52

NASHP

DECEMBER 15, 2021

NASHP recently updated a 50-state scan that identifies state approaches to supporting the CHW workforce and catalogues CHW Medicaid financing strategies (see text box 1). Evidence indicates that Medicaid spending on CHW services produces both improved health outcomes and a return on investment.

Medicaid 52

Medicaid Accountable Care Accountability Quality Assurance 52

Home Health Care

OCTOBER 11, 2021

We’ve begun to do more work there in terms of not only identifying care and quality gaps, but then subsequently using our services to close them on behalf of the health plan.”. We know that in an episode of care model, about 45% of the readmissions occur after 30 days,” Boumenot said. “We

Accountable Care 52

Accountable Care Medicare Accountability Medicaid 52

NASHP

MAY 26, 2022

By involving the care recipient and family throughout the care process as partners and delivering care in line with an individual’s goals, shared decision-making approaches can reduce delivery of unwanted or unnecessary care and resulting costs.

Patient Experience 52

Patient Experience Medicaid Accountable Care Regulations 52

Home Health Care

FEBRUARY 14, 2022

Smathers will join ATI’s Medicare and Medicaid Integration and long-term services and supports (LTSS) innovation practice. My personal mission is to contribute to innovations in care that are equitable, person-centered, and sustainable,” Smathers said in a press release. The Washington, D.C.-based

Home Care 52

Home Care Life Sciences Accountable Care Accountability 52

NASHP

NOVEMBER 29, 2021

This map highlights state activity to integrate CHWs into evolving health care systems in key areas such as financing, education and training, certification, and state definitions, roles and scope of practice. Medicaid Reimbursement. Medicaid Reimbursement.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

NASHP

AUGUST 31, 2023

State leaders play a critical role in convening key internal and external partners, implementing engagement and input processes that foster shared ownership and accountability toward goals at the state and community levels.

Medicaid 52

Medicaid Accountability Public Health services Population Health 52

NASHP

AUGUST 23, 2021

Primary care case management (PCCM) programs are one of the oldest types of Medicaid managed care, but over time most states have shifted to use managed care organizations (MCOs) to deliver services to Medicaid participants. million Medicaid participants. million Medicaid enrollees.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

Sheppard Health Law

DECEMBER 12, 2022

The Centers for Medicare & Medicaid Services (CMS) Innovation Center continues to move forward with its “strategic refresh” initiative. Through this shift, CMS aims to examine and enhance payments for specialty care provided to Medicare beneficiaries. Value-Based Care and ACOs.

Accountable Care 52

Accountable Care Accountability Primary Care Medicare 52

HIT Consultant

JANUARY 22, 2024

What You Should Know: – The Centers for Medicare & Medicaid Services (CMS) has taken a bold step towards improving care for individuals with both mental health conditions and substance use disorders (SUD), announcing the “ Innovation in Behavioral Health (IBH)” Model.

Medicaid 97

Medicaid Quality of Care Integration Medicare 97

Healthcare It News

JANUARY 4, 2022

Progress toward accountable care is halting. "The adoption of hospital-at-home programs across the country has been rapid, with nearly 200 hospitals participating in the Centers for Medicare and Medicaid Services’ Acute Hospital Care at Home program in only a year since its launch," said Majmudar.

Hospitals 348

Hospitals Nursing Accountable Care Clinical Practice 348

NASHP

OCTOBER 16, 2023

“Palliative care is supported by a robust body of research. For purposes of Medicaid guidance, the state developed a Medi-Cal palliative care policy  with specific definitions of eligible conditions, services, and providers. Not all payers will pay for palliative care services.

Medicaid 52

Medicaid Medicare Regulations Accountable Care 52

Home Health Care

FEBRUARY 1, 2023

After the Centers for Medicare & Medicaid Services (CMS) released a final rule that poses sizable risk to its Medicare Advantage business, Humana Inc. With that said, we are committed to working productively with CMS to ensure the integrity of the program is maintained.” NYSE: HUM) leaders insisted panic was not necessary.

Medicare 84

Medicare Primary Care Medicaid Integration 84

NASHP

AUGUST 24, 2023

There are a number of strategies state health officials can use as they build sustainable access to palliative care services in their Medicaid programs. Target Populations That Could Benefit from Palliative Care Services Use data to identify Medicaid enrollees with serious illness.

Medicaid 52

Medicaid Quality Assurance Quality of Care Hospitals 52

HIT Consultant

MAY 26, 2023

The scheme will enable clinicians at UHCW to collect data – including ECG, activity, weight, height, and symptoms – and monitor them remotely, via Doccla’s technology, integrated with AliveCor’s KardiaMobile device. The monitoring will cover three months pre-operation and six months after the procedure.

Integration 52

Integration Patient Experience Life Sciences Hospitals 52

NASHP

MAY 8, 2023

Transformation at the agency or whole government level can also include establishing organizational policies that address health disparities, systemic and shared accountability, designing culturally appropriate health care, and diversifying decision-makers. Many are changing how government and state partners do business.

Medicaid 52

Medicaid Accountability Integration Accountable Care 52

Home Health Care

AUGUST 25, 2022

The Centers for Medicare and Medicaid Services (CMS) has awarded one of its ACO REACH contracts to Upward Health, a multidisciplinary at-home care provider. ACO REACH is a risk-sharing program between companies and the government, standing for Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health.

Home Care 97

Home Care Medicare Medicaid Accountable Care 97