HIT Consultant

APRIL 3, 2023

These risk-based care models are designed to encourage proactive care, better population health and reduced spending across the healthcare spectrum. To meet that deadline, provider organizations will need technology tools for administering relationships within a value-based network.

Accountable Care 98

Accountable Care Accountability Integration Private Practices 98

Sheppard Health Law

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. ECM will be accounted for in MCP capitation rates, meaning that once the program is fully implemented, MCPs must provide the benefit to Members if they request it.

Medicaid 59

Medicaid Accountability Nursing Population Health 59

Accountable Care Doctors

MARCH 19, 2021

Coalition of Leading Medical Groups and Health Systems Confirms Board Appointments for 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.

Accountability 52

Accountability Accountable Care Primary Care Population Health 52

NASHP

APRIL 29, 2024

The model also requires Medicaid to establish a hospital global budget for participating hospitals for the first performance year of the model. This means there will be three hospital global budgets: Medicare, Medicaid, and commercial. A state’s lead agency must recruit commercial payers and hospitals to participate.

Hospitals 78

Hospitals Medicaid Medicare Primary Care 78

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations. Health Care Law and Consulting. Your comments are welcome here. David Harlow.

Healthcare 113

Healthcare Population Health Healthcare Innovation Accountability 113

HIT Consultant

SEPTEMBER 14, 2023

By one estimate, healthcare improvements accounted for one-third of the economic growth of developed nations over the last century. Achieving health equity presents an urgent challenge that demands attention from all stakeholders. However, actual medical care accounts for 20% or less of what affects population health.

Health Data 115

Health Data Telemedicine Accountability Doctors 115

Sheppard Health Law

JANUARY 20, 2023

Research has indicated that healthcare systems that connect patients to basic resources have observed improvements in population health metrics, fostered trust with their patient base, and experienced reduced hospitalization costs. Please refer to our prior blog for more information on CalAIM.

Medicaid 52

Medicaid Regulations Federal Healthcare Hospitals 52

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 ACO Accountable Care Organizations. MHP Medicaid Health Plans. NIH National Institutes of Health. integrating?CHWs

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

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

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

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 88

Accountability Population Health Medicaid Accountable Care 88

GoMoHealth

OCTOBER 20, 2022

This led me to GoMo Health, where we create, activate and scale these improvements daily. While most managed care organizations go to great lengths to comply with Medicaid and Medicare mandates, many are still struggling to meet their goals. Measurable ROI and Improved Outcomes from a Postnatal Medicaid Digital Therapeutic Program.

Quality Improvement 87

Quality Improvement Medicaid Population Health Medicare 87

HIT Consultant

MAY 2, 2023

For decades, the industry lacked a patient-centric approach focused on efficiency, reliability, and accessibility for all populations, especially those enrolled in Medicare Advantage and Medicaid plans. In a recent study , 21% of U.S. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Regulations Medicare Integration 96

HIT Consultant

NOVEMBER 2, 2023

Collaboration aims to drive coordinated care and improve quality while reducing costs NS-EEH will strengthen its clinically integrated network (CIN) by incorporating Lumeris’ population health data platform into its value-based care strategy.

Accountable Care 52

Accountable Care Population Health Accountability Medicaid 52

HIT Consultant

MARCH 28, 2023

The High Cost of Poor Behavioral Healthcare A recent study indicates 10% of patients account for 70% of the nation’s costs and that more than half of these patients have a diagnosed mental health disorder. It’s a question that has significant implications for quality of care as well as cost.

Quality of Care 98

Quality of Care Population Health Hospitals Medicaid 98

HIT Consultant

JULY 13, 2022

Initially, Innovaccer will address three distinct use cases in the public sector: – Population Health: Health agencies are launching innovative programs using SDoH to better address the needs of underserved populations and move toward a whole-person care approach. Public Sector Offering Address 3 Use Cases.

Population Health 52

Population Health Medicaid Private Healthcare Quality of Care 52

NASHP

JANUARY 19, 2024

Applicant states must identify a lead agency, which may be the Medicaid, public health, state insurance, or other agency with rate setting or budget authority. States may submit a joint application, but a lead agency must be identified that is ultimately accountable for the model.

Primary Care 59

Primary Care Medicaid Population Health Hospitals 59

HIT Consultant

APRIL 20, 2022

The overarching goal of VBC is to improve the patient experience, improve population health, and reduce per capita health costs. As part of this VBC mode l, hospitals and health systems must store, track, and analyze a large amount of quality-related data for compliance and reimbursement purposes.

Integration 98

Integration Primary Care Telemedicine Patient Experience 98

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] In June 2022, NASHP convened a national forum with state health officials (e.g., Nearly 20 percent of children in the U.S.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

Health Populi

MARCH 1, 2018

The Sage team explains that, by layering knowledge about peoples’ behaviors, beliefs, and attitudes on top of the traditional SDOH factors, health care providers can mash-up SBDoH – “socio-behavioral determinants of health” — your new acronym to add to your growing list of healthcare ABCs.

Population Health 82

Population Health Prevention Accountability Doctors 82

NASHP

AUGUST 31, 2023

Figure 1 displays a consolidated overview of the “Framework for Public Health-Health Care System Collaboration.” 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

Home Health Care

FEBRUARY 10, 2022

Signify Health Inc. The company signed an agreement to acquire Caravan Health, an accountable care organization (ACO) manager, for the price tag of $250 million. “It The company partners with both health plans and health systems to deliver various types of care to patients in their homes.

Accountable Care 57

Accountable Care Medicare Accountability Medicaid 57

NASHP

JUNE 22, 2023

Medicaid covers more than 40 percent of births nationally. Given the critical role that Medicaid plays in maternal health, there is a longstanding interest in the role of Medicaid service delivery systems to improve perinatal health outcomes. All Medicaid beneficiaries served by the practice are included.

Medicaid 59

Medicaid Prevention Accountability Medicare 59

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations. Health Care Law and Consulting. Your comments are welcome here. David Harlow.

Healthcare 60

Healthcare Population Health Healthcare Innovation Accountability 60

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations. Health Care Law and Consulting. Your comments are welcome here. David Harlow.

Healthcare 60

Healthcare Population Health Healthcare Innovation Accountability 60

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations. Health Care Law and Consulting. Your comments are welcome here. David Harlow.

Healthcare 60

Healthcare Population Health Healthcare Innovation Accountability 60

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations. Health Care Law and Consulting. Your comments are welcome here. David Harlow.

Healthcare 60

Healthcare Population Health Healthcare Innovation Accountability 60

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations. Health Care Law and Consulting. Join the conversation on Twitter at #HarlowOnHC.

Healthcare 60

Healthcare Population Health Healthcare Innovation Accountability 60

NASHP

JULY 11, 2022

Although efforts to modernize and strengthen public health systems pre-date COVID-19, the pandemic revealed new urgency and opportunities for states to invest in public health infrastructure and craft new approaches advancing population health goals.

Medicaid 52

Medicaid Population Health Prevention Accountability 52

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations.

Healthcare 60

Healthcare Healthcare Innovation Population Health Accountability 60

Health Blawg

FEBRUARY 19, 2018

As Scott noted in our recent conversation, accountability and risk are being pushed down to the provider level today; payors are creating incentives that allow providers to assume risk, better manage patients, better manage populations.

Healthcare 60

Healthcare Healthcare Innovation Population Health Accountability 60

NASHP

OCTOBER 21, 2024

As states work to advance health equity, concurrent challenges such as workforce shortages , health care deserts , and disruptions in access to care and Medicaid coverage have hindered efforts to reduce health disparities. For example, the Minnesota Department of Human Services (DHS) worked with the state’s U.S.-born

Medicaid 52

Medicaid Population Health Integration Health Data 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.

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

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 Hospitals 52

HIT Consultant

MAY 3, 2022

Social drivers of health, which impact a disproportionate number of non-white Americans who live below the poverty line, account for as much as 90% of individuals’ health outcomes. One recent study of Arizona Medicaid plan members with severe mental illness, compounded by other co-occurring conditions, illustrates this.

Healthcare 52

Healthcare Medicaid Population Health Medicare 52

Home Health Care

AUGUST 8, 2022

It announced in July that it would be leaving the Centers for Medicare & Medicaid Services’ (CMS) Bundled Payments for Care Improvement-Advanced (BPCI-A) program due to adjustments from CMS on trend calculations. It conducted 624,000 of those in the second quarter alone. As of recently, Signify’s business has materially changed.

Primary Care 82

Primary Care Medicare Accountable Care Population Health 82

HIT Consultant

FEBRUARY 10, 2022

What You Should Know: – Today, Signify Health announced it has reached an agreement to acquire Caravan Health , a leader in enabling accountable care organizations (ACOs) to succeed in value-based care payment. Together, the companies form one of the largest networks of at-risk providers in the U.S.

Accountable Care 52

Accountable Care Primary Care Accountability Medicare 52