NASHP

MAY 10, 2024

This blog post summarizes both the Primary Care AHEAD requirements identified by CMS and additional strategic considerations for states. Primary Care AHEAD Overview and Requirements Primary Care AHEAD is a key component of the AHEAD Model. A core aspect is a focus on alignment between payers.

Primary Care 52

Primary Care Medicaid Medicare Integration 52

Home Health Care

NOVEMBER 7, 2023

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. Medicare Shared Savings Program (MSSP) ACOs are an opportunity for home-based care providers to enter the space. Currently, roughly 13.2

Medicare 89

Medicare Accountable Care Home Care Accountability 89

Home Health Care

FEBRUARY 8, 2024

This article is a part of your HHCN+ Membership Home-based care providers avoiding the shift to value-based care are running out of time and excuses. Home health providers are already under the Home Health Value-Based Purchasing (HHVBP) Model, which is, by definition, a value-based care model.

Medicare 109

Medicare Accountable Care Accountability Primary Care 109

NASHP

DECEMBER 10, 2021

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. RAE Regional Accountable Entity. Acronym Guide. APM Alternative Payment Model. CBO Community Based Organization.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

NASHP

OCTOBER 20, 2022

High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices. Yet, states often face barriers to integrated care including a lack of trust across agencies, privacy regulations that may hinder data sharing, and misaligned eligibility, enrollment, and referral systems.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

NASHP

NOVEMBER 29, 2021

The Department of Health Care Policy and Financing (the Medicaid program administrator) does not specifically require the Regional Accountable Entities (RAEs), care coordinating entities contracted with Colorado’s Medicaid program, or other managed care entities to cover CHW services, nor does the Department pay for CHW services under FFS.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care 60

Primary Care Integration Urgent Care Pharmaceuticals 60