Healthcare ECONOMIST

SEPTEMBER 24, 2024

For instance, risk adjustment occurs based on patient characteristics and social determinants of health collected before the start of an episode; the authors argue that risk adjustment could take into account clinical or social needs changes during an episode. The authors also argue for more reimbursement for information sharing activities.

Accountability 40

Accountability Quality Improvement Accountable Care Integration 40

Accountable Care Doctors

AUGUST 31, 2021

These discussion forums generated many promising and innovative solutions including improving healthcare by integrating behavioral health with primary care, pursuing strategies for reducing low-value care and increasing high-value care, and developing better metrics for measuring performance in alternative payment models.

Primary Care 52

Primary Care Integration Doctors Accountability 52

Accountable Care Doctors

AUGUST 31, 2021

These discussion forums generated many promising and innovative solutions including improving healthcare by integrating behavioral health with primary care, pursuing strategies for reducing low-value care and increasing high-value care, and developing better metrics for measuring performance in alternative payment models.

Primary Care 52

Primary Care Integration Doctors Accountability 52

Sheppard Health Law

OCTOBER 27, 2021

The five strategic objectives for advancing this systemwide transformation include (1) Drive Accountable Care, (2) Advance Health Equity, (3) Support Innovation, (4) Address Affordability, and (5) Partner to Achieve System Transformation. Strategic Objective 3: Support Care Innovations.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

Accountable Care Doctors

OCTOBER 21, 2020

The COVID-19 pandemic has upended health care in America, and as of this writing, is still raging on. A quick snapshot reveals how decades-long investments by CAPP groups to better integrate their care delivery systems is paying off. The patient experience also significantly improves when care is coordinated versus delivered piecemeal.

Primary Care 59

Primary Care Integration Remote Care Population Health 59

NASHP

OCTOBER 20, 2022

Partnerships are strongest when they are based on a collective impact model, focusing on a common vision and developing shared accountability. As a result, services were better aligned and the MCOs referred CYSHCN to the Title V CYSHCN program for care coordination given the program staff’s expertise in serving this population.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

Accountable Care Doctors

FEBRUARY 1, 2021

Employers also collectively shoulder the biggest share of national health care costs, which regularly rise faster on an annual basis than overall inflation. demanding more transparency from insurers and other intermediaries.

Primary Care 52

Primary Care Accountability Patient Experience Integration 52

HIT Consultant

OCTOBER 26, 2021

As utilization, measured by visits to primary care and specialist doctors, dipped during the pandemic, providers who had invested largely in value-based care were better able to weather the storm and the economic downturn by having a consistent source of revenue despite low utilization. Another benefit of RPM?

Remote Care 52

Remote Care Healthcare Doctors Primary Care 52

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

NASHP

MARCH 22, 2024

Integrated Primary and Behavioral Health Care A modern behavioral health system of care is fully integrated into the continuum of health care services, including primary and specialty care settings, and extends into homes and communities to ensure holistic and coordinated support.

Medicaid 52

Medicaid Integration Primary Care Nursing 52

Home Health Care

AUGUST 15, 2022

of the Medicare fee-for-service population, homebound seniors aged 70 and older accounted for 11% of Medicare spending in 2015, according to the study. In light of these findings, the homebound represent a critically important population to target for quality improvement and reductions in Medicare spending.”.

Medicare 116

Medicare Primary Care Medicaid Quality Improvement 116

NASHP

JUNE 22, 2022

On the other hand, a health plan may use the guide to implement a high-quality screening and assessment process through primary care providers. Recruit providers to support system improvements. Conduct research on best practices for care coordination. Support quality improvement efforts. Social needs.

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

NASHP

DECEMBER 10, 2021

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. NCQA National Committee for Quality Assurance. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. RAE Regional Accountable Entity. Acronym Guide. SPA State Plan Amendment.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

Patient Safety Movement

APRIL 1, 2023

Five conditions account for 39% of serious misdiagnosis-related harms: stroke, myocardial infarction, aortic aneurysm/dissection, spinal cord compression/injury, and venous thromboembolism. These figures are also consistent with diagnostic errors and harm rates in primary care and inpatient settings.

Patient Safety 52

Patient Safety Doctors Prevention Hospitals 52

NASHP

NOVEMBER 29, 2021

The Department of Health Care Policy and Financing (the Medicaid program administrator) does not specifically require the Regional Accountable Entities (RAEs), care coordinating entities contracted with Colorado’s Medicaid program, or other managed care entities to cover CHW services, nor does the Department pay for CHW services under FFS.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

NASHP

DECEMBER 20, 2022

Now, Oregon’s specialty court program and its staff will receive state-specific guidance, education, training, and peer review, among other quality improvement strategies. Connect individuals to health care access prior to release. Support drug court budgets with cross-systems resources. Leverage policy to support MOUD.

Medicaid 52

Medicaid Prevention Hospitals Integration 52

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

The IBH Model aims to bridge the gap between behavioral and physical health by: Empowering community-based behavioral health practices: These practices, including mental health centers, opioid treatment programs, and safety net providers, will become the central point of care, offering integrated services for both mental and physical health needs.

Medicaid 97

Medicaid Quality of Care Integration Medicare 97

Sheppard Health Law

JANUARY 5, 2022

First, issuers may only count provider incentive and bonus payments as claims expense if they are “tied to clearly defined, objectively measurable, and well-documented clinical or quality improvement standards.” Second, issuers only may count expenditures directly related to activities that improve healthcare quality.

Primary Care 52

Primary Care Quality Improvement Accountability Healthcare Quality 52