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. And then we’re also developing an approach for certification based on quality improvement and patient experience.”

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

NASHP

MARCH 22, 2024

State Medicaid programs, behavioral health authorities, public health, departments of insurance, human and social service agencies, departments of education, departments of corrections, housing, and employment can collaborate to align overlapping efforts, align policies, and braid funding and accountability mechanisms.

Accountability 52

Accountability Medicaid Primary Care Quality Improvement 52

HIT Consultant

APRIL 20, 2022

Hospitals report the data to the Centers for Medicare & Medicaid Services (CMS), which uses that data to create the Overall Hospital Quality Star rating for each hospital. Rating is based on five areas: mortality, safety of care, readmission, patient experience, and timely/effective care.

Integration 98

Integration Primary Care Telemedicine Patient Experience 98

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 5, 2022

When Walgreens Boots Alliance (Nasdaq: WBA) invested $1 billion into VillageMD , it was largely viewed as a way for Walgreens to enhance its primary care approach, especially in underserved communities. And then we also made an investment in CareCentrix that really focuses the post-acute care episode of a patient’s journey.”.

Primary Care 109

Primary Care Doctors Home Care Nursing 109

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

OCTOBER 31, 2023

What You Shoud Know: – Medicaid prospective payment rate for Michigan’s federally qualified health centers (FQHCs) has not kept pace with the actual costs incurred to provide healthcare, resulting in a substantial reimbursement gap of $97.95 and indirect costs rising by 26.2%.

Medicaid 52

Medicaid Primary Care Prevention Medicare 52

Sheppard Health Law

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 trillion spent on personal health care. [3] This represents 13.2%

Medicaid 52

Medicaid Medicare Accountability Nursing 52

HIT Consultant

MAY 19, 2023

Tampa General Hospital Teams Up with Navina Tampa General Hospital (TGH) partners with AI-powered platform Navina to bring its transformative AI the health system’s primary care clinicians. Clinicians using Navina’s platform can quickly assess diagnoses and opportunities to improve care and compliance with quality measures.

Primary Care 52

Primary Care Health Science Accountable Care Hospitals 52

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

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

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

AUGUST 5, 2022

Policymakers are recognizing the need for payers to increase coverage and reimbursement for integrated behavioral health services, which entails primary care and behavioral health collaboration, to achieve better clinical and cost outcomes along with a healthier workforce.

Life Sciences 98

Life Sciences Telemedicine Healthcare Biotechnology 98

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

MARCH 22, 2024

In addition to expanding Medicaid, North Carolina’s FY2024 budget allocates over $835 million for mental health and substance abuse investments under Medicaid. They focus on crucial areas such as managed care contracting, achieving coverage parity, and enhancing workforce capacity to improve both quality and access to care.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

NASHP

APRIL 24, 2023

States play an essential role in providing and overseeing behavioral health care, and many states have longstanding strategies to increase access to high quality, behavioral health interventions. But the system remains fragmented and strained under the twin crises of mental illness and escalating overdose deaths.

Medicaid 52

Medicaid Integration Prevention Urgent Care 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

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. Executive Summary.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

Health Populi

JULY 13, 2020

health care financing regime of volume-based payment didn’t fare well as millions of patients postponed or cancelled procedures and visits for fear of contracting the virus in the halls, offices and clinics of hospitals and doctor’s offices. Informing integrated communication, decisions, and processes. In other words, the U.S.

Primary Care 110

Primary Care Medicare Accountability Hospitals 110

Home Health Care

AUGUST 29, 2023

Since the start of his career as a primary care, internal medicine physician, Dr. Richard Feifer has sat at the intersection of geriatrics, population health and value-based payment models. The Program of All-Inclusive Care for the Elderly (PACE) model has long been a passion of his.

Nursing 85

Nursing Integration Primary Care Home Care 85

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

JULY 22, 2022

1] Under the American Rescue Plan Act, the federal government expanded funding to states’ Medicaid HCBS programs, including a one-year, 10-percentage-point increase in federal Medicaid matching funds for HCBS. Medicaid Home and Community-Based Services for Children and Youth with Special Health Care Needs.

Medicaid 105

Medicaid Rehabilitation Nursing Medicare 105

NASHP

OCTOBER 29, 2021

State Medicaid agencies recognize that meeting beneficiaries’ social needs (e.g., The 1915(i) option was created by the Deficit Reduction Act of 2005 (DRA) and modified by the Affordable Care Act (ACA) in 2010. Under a 1915(i) SPA, states must allow all Medicaid beneficiaries who qualify for the services to access the services.

Medicaid 97

Medicaid Regulations Primary Care Accountability 97

Health Populi

JUNE 20, 2024

Furthermore, nearly 3 in 5 consumers with less than $35,000/yr believe digital health tools can help with diet and activity, an opportunity to engage people say on Medicaid to adopt digital therapeutics and wearable tech for mindful management of activity and medication adherence, as examples. Research from the USDA (the U.S.

Accountability 71

Accountability Doctors Medicaid Nursing 71

NASHP

MAY 17, 2022

How State Medicaid Programs Serve Children and Youth in Foster Care May 17, 2022 / Veronnica Thompson. Children and youth in foster care (CYFC) often benefit from targeted services and supports. Yet, many receive fragmented or limited access to care, contributing to higher rates of unmet health needs. [1]

Medicaid 64

Medicaid Integration Medicare Primary Care 64

NASHP

MARCH 22, 2024

It includes examples from various states organized by the framework buckets: integrated primary and behavioral health care, crisis continuum of care, in-home and in-community based, and out-of-home and community.

Medicaid 52

Medicaid Integration Primary Care Nursing 52

NASHP

MAY 10, 2023

by expanding the maternal health workforce through Medicaid payment initiatives and other policies to increase access to certified nurse-midwives (CNMs) and midwives. States have varying approaches across their Medicaid service delivery systems for how they finance and operationalize these services.

Medicaid 131

Medicaid Nursing Hospitals Integration 131

HIT Consultant

OCTOBER 14, 2021

We’re looking forward to hearing about the acceleration of technology-driven performance and accountability in healthcare. This could include continuous glucose monitoring devices that are integrated with mobile apps and better pulse oximetry and cardiac rhythm detection built into wearables.

Urgent Care 98

Urgent Care Healthcare Medicare Integration 98

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

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

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

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

Etactics

AUGUST 19, 2021

Over 50% of doctors work 50-80 hours per week (Pacific Companies) Most physicians work 51-60 hours per week, but this only accounts for 26% of physicians. More than half experience dissatisfaction with work-life integration (Mayo Clinic) In 2017, only 42.7% Another quarter work 60-80 hours, so a majority work between 50-80 hours.

Doctors 52

Doctors Nursing Primary Care Healthcare 52

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

NASHP

DECEMBER 16, 2022

Recent increases in federal funding for opioid and SUD-related activities, along with existing grants, Medicaid payments, and legal settlements, are augmenting state SUD budgets. State Medicaid programs cover SUD treatment and supportive services for Medicaid beneficiaries using multiple Medicaid authorities.

Medicaid 52

Medicaid Prevention Pharmaceuticals Primary Care 52

Home Health Care

AUGUST 15, 2021

Centers for Medicare & Medicaid Services (CMS) are again touting the Home Health Value-Based Purchasing (HHVBP) Model as one of the agency’s most successful programs ever. CMMI was created through the Affordable Care Act in 2010. Officials from the U.S. Doing so would allow patients to utilize appropriate home-based services.

Medicare 84

Medicare Medicaid Quality of Care Primary Care 84

NASHP

DECEMBER 20, 2022

This approach requires significant coordination among policymakers from across state systems – behavioral health, Medicaid, courts, and corrections – to share resources, align policies, and develop clear protocols for programming. Integrate peers into crisis response teams. Community Services and Prevention (Intercept 0).

Medicaid 52

Medicaid Prevention Integration Hospitals 52