Accountable Care Doctors

MARCH 19, 2021

The Council of Accountable Physician Practices (CAPP), a coalition of visionary medical groups and health systems supporting accountable value-based care, has added Joe Kimura, MD, MPH, to its board of directors. Dr. Kimura is a practicing primary care internist with a specialization in clinical informatics.

Accountability 52

Accountability Accountable Care Primary Care Population Health 52

NASHP

FEBRUARY 27, 2023

During a recent virtual meeting focused on alternative payment approaches, Maine state officials detailed how the state intends to use its Primary Care Plus (PCPlus) program to reimburse for CHW services.­ Including a scan also helps the state assess practices’ needs and take their varying knowledge of CHW roles into account.

Primary Care 52

Primary Care Medicaid Care Transition Medicare 52

Home Health Care

NOVEMBER 1, 2023

Humana’s CenterWell brand includes home health care, primary care and pharmacy services. The integration of CenterWell’s assets continues to be a key focus for Humana in the near-term future. Medicare Advantage Humana continues to show strong growth in its individual Medicare Advantage business as well.

Medicare 108

Medicare Primary Care Accountability Integration 108

Sheppard Health Law

OCTOBER 27, 2021

On October 20, 2021, the Centers for Medicare and Medicaid (“ CMS ”) Innovation Center (“ Innovation Center ”) published a white paper detailing its vision for the next ten years: a health system that achieves equitable outcomes through high quality, affordable, person-centered care. Strategic Objective 1: Drive Accountable Care.

Medicaid 52

Medicaid Medicare Accountable 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

Home Health Care

MAY 19, 2023

Now, Humana is focused on accelerating value-based care and integrating all of its services that fall under the larger CenterWell brand, which includes home-based care, primary care and pharmacy services. We have partnered with organizations like Heal, which provides primary care at home.

Primary Care 80

Primary Care Medicare Integration Urgent Care 80

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

HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. healthcare system has been moving towards value-based care (VBC) which encourages health providers to improve care quality by reimbursing them based on successful outcomes rather than individual medical services.

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Integration Primary Care Telemedicine Patient Experience 98

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

HIT Consultant

MAY 24, 2022

– The funding will fuel growth of the provider/payer platform that integrates with the electronic medical records (EMR) to identify high-value tactical care and coding interventions. KAID Health allows providers to profit from delivering more informed coordinated care. First, how to make clinicians more efficient.

Accountable Care 52

Accountable Care Primary Care Accountability Medicare 52

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

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

Sheppard Health Law

NOVEMBER 2, 2023

2] The increasing demand for these services will also likely proportionally increase health care expenditures of LTSS. trillion spent on personal health care. [3] 3] Notably, the first and second largest payers of LTSS are Medicaid and Medicare, respectively, accounting for 64.1% trillion spent on personal health care. [3]

Medicaid 52

Medicaid Medicare Accountability Nursing 52

HIT Consultant

OCTOBER 31, 2023

on every Medicaid patient visit, according to a new report released by The Michigan Primary Care Association (MPCA). The report suggests that using the Medicare Economic Index (MEI) for annual inflation adjustments may not accurately reflect the cost growth in FQHC services. and indirect costs rising by 26.2%.

Medicaid 52

Medicaid Primary Care Prevention Medicare 52

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

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

HIT Consultant

AUGUST 5, 2022

CMS Proposed Changes to the Physician Fee Schedule 2023 : On July 7, 2022, the CMS announced that it is soliciting public comment on proposed policy changes for Medicare payments under the Physician Fee Schedule (“PFS”) effective on or after January 1, 2023. Behavioural Health and Telemedicine: The Behavioural Health subsector was down 18.4%

Life Sciences 98

Life Sciences Telemedicine Healthcare Biotechnology 98

Health Business Group

NOVEMBER 30, 2021

I’m most bullish on Walgreens with its recent VillageMD and CareCentrix investments , which take the company directly into primary care and care at home. If big primary care providers like Walgreens’ Village MD learn how to manage this opportunity well, Medicare Advantage and commercial risk will follow quickly.

Healthcare 98

Healthcare Primary Care Hospitals Health Data 98

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

OCTOBER 20, 2022

The “National Forum on Advancing High-Quality, Equitable Care Coordination for Children and Youth with Special Health Care Needs” centered on two key topics for improving care coordination systems for CYSHCN: integrated care coordination and the care coordination workforce.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

NASHP

APRIL 24, 2023

Additionally, the alarming rise in mental health challenges among children and youth underscores the need to integrate prevention and early intervention approaches across our child-serving systems. Provide guidance defining integrated care for pediatric populations and data sharing approaches to guide and evaluate integrated care models.

Medicaid 52

Medicaid Integration Prevention Urgent Care 52

HIT Consultant

JANUARY 3, 2023

For sellers, as healthcare reimbursement models become more complex, it’s increasingly appealing to have someone else deal with the business back-end so the selling clinician can focus on providing patient care. This trend is likely to continue for the foreseeable future as Medicare Advantage plans increasingly move to value-based models.

Healthcare 52

Healthcare Primary Care Medicare Integration 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. ii] Rural areas are highly likely to suffer from shortages of primary care and other providers.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

NASHP

MARCH 22, 2024

This includes alignment across the state Medicaid and behavioral health administrations, including shared systems and shared accountability, and a unified contracting approach across all relevant state agencies to create a unified network. Colorado Colorado is engaged in multi-pronged behavioral health reform.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

Health Populi

JULY 29, 2022

Zocdoc launched a data ecosystem enabled through application programming interfaces to streamline care coordination and referrals between primary care providers and specialists, aiming to provide consumers with a better experience and more convenient care access. a Vertically-Integrated retail health provider?)

Telemedicine 87

Telemedicine Doctors Primary Care Healthcare 87

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

Bill Of Health

JULY 26, 2022

Undoubtedly there could be exciting near-term benefits for the 750,000 ONEM members as their Amazon Prime accounts are linked to their ONEM memberships, facilitating targeted Whole Food and Amazon Pharmacy coupons. Amazon now has an important foothold in the Medicare market. Interestingly, Amazon’s market capitalization increased 1.4%

Primary Care 67

Primary Care Population Health Regulations Accountability 67

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

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

Sheppard Health Law

JANUARY 11, 2024

John Kao, CEO of Alignment Healthcare, shared today that only 12% percent of their Medicare Advantage membership accounts for approximately 74% percent of their institutional cost (hospital and facility costs), while conversely their “healthy” membership of 74% accounted for only 5% of their institutional costs.

Healthcare 52

Healthcare Primary Care Accountability Ambulatory Care 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

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

OCTOBER 29, 2021

This provision of the Social Security Act allows states to provide home and community-based services (HCBS) under the Medicaid state plan by obtaining approval from the Centers for Medicare & Medicaid Services (CMS) of a state plan amendment (SPA). The state integrated service authorizations and claims into the state’s MMIS.

Medicaid 97

Medicaid Regulations Primary Care Accountability 97

Healthcare It News

JUNE 30, 2022

For well over a decade, we've seen this challenge progressively worsen partially because we have had a relatively fixed number of graduates from medical programs since 1997, when Medicare started limiting the funding for these programs. In addition to the limited number of professionals, our population is aging and living longer.

Telemedicine 281

Telemedicine Health Data Prevention Integration 281

NASHP

JULY 22, 2022

Strategies include supporting pediatric HCBS providers and caregivers and increasing access to home and community-based behavioral health care. Medicaid Home and Community-Based Services for Children and Youth with Special Health Care Needs. 1] Centers for Medicare and Medicaid Services. Kaiser Family Foundation , June 14, 2019.

Medicaid 105

Medicaid Rehabilitation Nursing Medicare 105

Sheppard Health Law

JANUARY 11, 2022

Morgan Conference – COVID-19, the jittery stock market, the future of Medicare Advantage and recent industry changes. Centene noted that for Centene Medicare members, the inpatient utilization trend was higher than 60%, but lower than 60% for Medicaid and Marketplace members. I really had to look at the shadows and not the backgrounds.

Healthcare 52

Healthcare Medicare Primary Care Nursing 52

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.

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Doctors Nursing Primary Care Healthcare 52