HIT Consultant

JANUARY 27, 2025

Personalized Treatment Plans Traditional treatments often rely on standardized protocols that fail to account for the unique characteristics of individual patients. Lets explore how AI is enabling this evolution and what it means for patients, providers, and the broader healthcare ecosystem.

Healthcare 99

Healthcare Life Sciences Pharmaceuticals Public Hospital 99

Home Health Care

JANUARY 22, 2025

The expanded HHVBP model builds on the success of the original model, which improved total performance scores among home health agencies by an average of 4.6%, according to the Center for Medicare and Medicaid Services (CMS). Based on the success of the original model, the U.S.

Medicare 77

Medicare Hospitals Quality of Care Nursing 77

p3care

OCTOBER 30, 2020

CMS (The Centers for Medicare and Medicaid Services) released the proposed rule for QPP MIPS 2021 via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). For instance, CMS asks physicians to focus on the quality of care rather than the volume of patients. ACO (Accountable Care Organization) Reporting.

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

NASHP

OCTOBER 22, 2021

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Comprehensive care coordination. billion on chronic obstructive pulmonary disease (COPD) per year. Assessment and management of pain and other symptoms.

Medicaid 102

Medicaid Hospice Care Regulations Integration 102

p3care

MAY 31, 2024

An ACO (Accountable Care Organization) works for the better care of patients. Consider it as a group that combines hospitals, doctors, and other healthcare specialists for the sake of providing healthcare and is a team in care decisions. This becomes a specific reason for comprehensible improvements in patient care.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

NCQA

OCTOBER 29, 2024

By Brett Kay, Director, Healthcare Quality Strategy, Strategic Customer Group, J&J Innovative Medicine Although there are many ways to measure the quality of care patients receive, not many focus on what patients want and need from the healthcare system, beyond a clinical outcome. Centers for Medicare and Medicaid.

Accountability 52

Accountability Medicaid Medicare Quality of Care 52

NCQA

DECEMBER 18, 2024

Goal 2: Equip health care systems and expand effective and sustainable interventions. Lack of standardized performance measures makes it difficult to hold health systems and clinicians accountable for equitable care. NCQA believes that high-quality care is equitable care.

Quality Assurance 52

Quality Assurance Accountability Quality Improvement Pharmaceuticals 52

Home Health Care

OCTOBER 2, 2024

However, years after nationwide implementation, EVV still remains a burden for home care providers. It holds caregivers accountable for their schedules, ensuring that their work is completed on time and in its entirety. The app sends the necessary information from their devices to their agency’s home care software.

Home Care 113

Home Care Medicaid Quality of Care Prevention 113

NASHP

FEBRUARY 17, 2025

As detailed in KFFs 20232024 Medicaid budget survey , around 32 states in FY 2023 raised rates for behavioral health services, followed by 34 states in FY 2024, with 26 states planning further increases in FY 2025. percent increase in billing for certain SUD procedure codes (H0015 and H0035). percent to 72.3

Medicaid 52

Medicaid Rehabilitation Hospitals Telemedicine 52

NASHP

MARCH 22, 2024

States are increasingly turning to capitated Medicaid managed care programs to deliver long-term services and supports (LTSS) to individuals with complex needs. California does cover skilled nursing facility care in its MLTSS program, but most personal care services (in-home supportive services) are provided under FFS.

Medicaid 75

Medicaid Nursing Medicare Integration 75

HIT Consultant

APRIL 16, 2024

What You Should Know: – inVio Health Network and CVS Accountable Care Organization, a division of CVS Health , have announced a collaboration to participate in the new Medicare Accountable Care Organization (ACO) REACH program. CVS Accountable Care contributes its extensive experience and resources.

Accountable Care 52

Accountable Care Accountability Medicare Population Health 52

Home Health Care

SEPTEMBER 3, 2022

The study from RAND Corporation, a nonprofit research organization, looked at 15 different quality measures from patients on MA plans during 2016 and 2017 and found that the quality of care was only slightly better when compared to plans that didn’t have any monthly premiums.

Medicare 119

Medicare Quality of Care Accountability Home Care 119

Home Health Care

OCTOBER 18, 2022

The taxpayer dollars that fund Medicare and Medicaid are meant to support the delivery of health care services most suitable for beneficiaries,” Mike Stapleton, acting special agent in charge at the U.S. We are determined to safeguard the integrity of our nation’s health care systems.”. Gray said in the statement.

Tricare 105

Tricare Medicare Medicaid Integration 105

Healthcare ECONOMIST

JULY 18, 2022

The Oncology Care Model (OCM) is dead. The Oncology Care Model was a voluntary, alternative payment model (APM), that “ included financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients.

Medicaid 98

Medicaid Quality of Care Accountability Patient Experience 98

Home Health Care

AUGUST 25, 2021

Centers for Medicare & Medicaid Services (CMS) is sure to add more fuel to the fire for the “Choose Home” initiative and other movements aiming to bring more care into the home. 31, 2020, accounting for the majority of the COVID-19 pandemic in the U.S. A recently published study by the U.S.

Nursing 111

Nursing Home Care Medicare Accountability 111

NCQA

JUNE 27, 2023

More states are contracting with managed care organizations (MCO) to provide Medicaid long-term services and supports (LTSS). How do we know if MCOs are delivering equitable, high-quality care to people receiving LTSS? Earning LTSS Distinction shows plans’ commitment to providing the best possible care.

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

HIT Consultant

APRIL 11, 2023

The RAND study published in the Journal of the American Medical Association found that in August 2022 audio-only visits still accounted for 1 in 5 primary care visits and 2 in 5 behavioral health visits among people who received care at Federally Qualified Health Centers in California.

Primary Care 96

Primary Care Medicaid Quality of Care Accountability 96

Home Health Care

JULY 5, 2022

Hospital readmissions are regularly viewed as an indicator of the quality of care patients receive. The Centers for Medicare & Medicaid Services (CMS) calculates annual readmission rates, and if those rates are higher than national averages, hospitals are financially penalized.

Hospitals 105

Hospitals Primary Care Nursing Quality of Care 105

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 84

Accountability Medicare Home Care Quality of Care 84

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

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. However, actual medical care accounts for 20% or less of what affects population health. By comparing quality-of-care data with population, income, and ethnicity across the U.S.,

Health Data 115

Health Data Telemedicine Accountability Doctors 115

HIT Consultant

MAY 2, 2023

Andy Auerbach, Chief Revenue Officer of SafeRide Health As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Regulations Medicare Integration 96

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 2: Advance Health Equity.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 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. Broadly, HHVBP is a Medicare demonstration that aims to tie reimbursement to quality of care.

Medicare 85

Medicare Medicaid Quality of Care Primary Care 85

Health Populi

JULY 13, 2020

The EIU VBHC framework addresses four aspects of how technology can underpin value-based care: Ensuring standardization. Driving efficiency and accountability. gross domestic product in 2020, the Centers for Medicare and Medicaid Services calculated. Capturing and sharing interoperable and transparent data. of the U.S.

Primary Care 110

Primary Care Medicare Accountability Hospitals 110

HIT Consultant

MARCH 28, 2023

It’s a question that has significant implications for quality of care as well as cost. 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.

Quality of Care 98

Quality of Care Population Health Hospitals Medicaid 98

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 Medicare Primary Care 52

Briggs Healthcare

MARCH 2, 2022

“The purpose of this primer is to provide updated information to the patient safety community about the challenges of ensuring the safe care of older adults in Medicare and Medicaid certified nursing homes (NHs) associated with the COVID-19 pandemic, and the federal and state efforts taken to mitigate these challenges.

Nursing 75

Nursing Patient Safety Quality of Care Regulations 75

Home Health Care

NOVEMBER 7, 2021

Centers for Medicare & Medicaid Services (CMS) is that the model will now begin Jan. more room to breathe, Valerie Cornett, chief of strategy and innovation at MAC Legacy, told Home Health Care News. BKD is a Springfield, Missouri-based accounting services firm that provides billing and revenue cycle outsourcing services.

Medicare 105

Medicare Performance improvement Medicaid Quality of Care 105

NASHP

JANUARY 12, 2024

During the pandemic and with the support of federal American Rescue Plan Act (ARPA) funds, many states increased Medicaid payment rates for these workers with one-time pay increases or bonuses. In 2024, people with Medicare and Medicaid coverage (i.e.,

Medicaid 64

Medicaid Nursing Accountability Medicare 64

HIT Consultant

OCTOBER 20, 2023

According to a study in the Journal of the American Geriatric Society , non-fatal falls cost an estimated $50 billion in medical expenses, while fatal falls account for an estimated $754 million. can be attributed to falls, including approximately six percent of Medicare and eight percent of Medicaid expenditures. Previously Dr.

Rehabilitation 105

Rehabilitation Pharmaceuticals Prevention Biotechnology 105

Home Health Care

JUNE 9, 2022

“We’re seeing a massive shift to value-based care versus our previous form of care, which was volume-based,” says Erika Sessions, director of compliance and policy development for online caregiver training platform CareAcademy. That will ultimately benefit the quality of care.”. This article is sponsored by CareAcademy.

Care Transition 105

Care Transition Quality of Care Accountability Home Care 105

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., Training CHWs in core components of care coordination.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

Home Health Care

MARCH 7, 2025

She emphasized that a reputation for quality is a differentiator for BrightStar in the marketplace, and is backed up by the company’s nurse-led clinical model, Joint Commission accreditation of agencies, and services spanning personal care, Medicare-certified home health and senior living.

Home Care 59

Home Care Medicare Regulations Quality of Care 59

Home Health Care

APRIL 27, 2023

Over the last decade, Putman — now CEO of Continuous — has relied heavily on building strong relationships with payers, accountable care organizations (ACOs) and care management companies. When Putman started, the revenue breakdown was about 60% Medicare and 40% managed care. That number has increased by over 30% since.

Home Care 97

Home Care Physical Therapy Medicare Accountable Care 97

Home Health Care

OCTOBER 7, 2024

Taking on Frette’s former role as CFO, Chad Derner will manage Accra’s accounting and billing departments, oversee all financial activities and operations and provide strategic guidance to leadership. Derner joins Accra with 25 years of experience in finance and accounting, the last 16 of which have been in leadership. “I

Home Care 105

Home Care Integration Primary Care Accountability 105