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How does changing capitation share impact service provision in mixed reimbursement environments?

Healthcare ECONOMIST

There has been much research showing that fee-for-service (FFS) leads to increased provision of medical services and capitation leads to decreased provision of medical services. Second, a large share of health care provision in the US is under mixed reimbursement schemes.

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Debate Continues Around Scope of Practice Expansion for APPs

Sheppard Health Law

Proponents of APP independent practice focus on the overall healthcare system impact, emphasizing APPs’ ability to compensate for primary care provider shortages in underserved communities and to drive lower health care costs, as well as to free up physician time for more advanced medical services.

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Primary Care Case Management in Medicaid: A Strategy for Supporting Primary Care in Rural Areas

NASHP

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. However, as of 2018, 13 states still delivered services through PCCM programs to about 5.5

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The Stage is Set: California Finalizes OHCA Regulations Requiring Notice and Review of Material Healthcare Transactions in 2024

Sheppard Health Law

For parties wishing to avoid going through the CMIR process, it may be advisable to attempt to close transactions in advance of the April 1, 2024 date. OHCA Published Near-Final Draft of Regulations Requiring Notice and Review of Material Healthcare Transactions in 2024 , published 12/6/23. [2]

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How State Medicaid Programs Serve Children and Youth in Foster Care

NASHP

In 2007, 29 states provided health care services to children in child welfare through MMC. [24] managed care organizations, primary care case management, prepaid ambulatory health plans, and prepaid inpatient health plans) to serve some or all CYFC. personal care items or electronics).