HIT Consultant

JULY 13, 2022

For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI).

Accountability 98

Accountability Accountable Care Primary Care Medicare 98

Fierce Healthcare

MARCH 19, 2024

The Centers for Medicare & Medicaid Services (CMS) has announced the ACO Primary Care Flex Model (ACO PC Flex Model), allowing eligible accountable care organizations to treat people with with | Accountable care organizations are largely supportive of CMS' new primary care model released Tuesday, they wish the agency would broaden its scope (..)

Primary Care 159

Primary Care Accountable Care Accountability Medicaid 159

Fierce Healthcare

AUGUST 24, 2023

The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) has saved a net $1.8 billion in 2022 for accountable care organizations, which is th | Accountable care organizations saved a net $1.8

Accountable Care 130

Accountable Care Accountability Medicare Medicaid 130

NASHP

AUGUST 5, 2024

CHWs are key to engagement, care coordination, and increasing access to clinical and support services for Medicaid enrollees from their communities. As such, states increasingly are pursuing Medicaid reimbursement options as part of a comprehensive CHW service financing approach, which is currently reliant on expiring grant programs.

Medicaid 52

Medicaid Primary Care Prevention Accountability 52

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

NOVEMBER 13, 2024

Medical Management, the home-based care company HarmonyCare raised $200 million in June. On Wednesday, it touted its success in the Accountable Care Organization (ACO) “REACH” Model, the successor to the The Global and Professional Direct Contracting Models (GPDC).

Primary Care 110

Primary Care Medicare Accountable Care Accountability 110

Healthcare It News

JANUARY 18, 2022

Social determinants of health are major contributors to health inequity and rising healthcare costs in vulnerable populations such as Medicaid beneficiaries. For example, training a predictive model on the general population may be inaccurate when used in a Medicare or Medicaid population.

Pharmaceuticals 353

Pharmaceuticals Accountable Care Accountability Medicaid 353

Home Health Care

AUGUST 25, 2023

And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care. Centers for Medicare & Medicaid Services (CMS) announced Thursday that MSSP saved Medicare $1.8

Medicare 98

Medicare Accountable Care Accountability Medicaid 98

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

Home Health Care

MAY 29, 2024

Similar MA grievances can be heard from beyond home health care as well. Centers for Medicare & Medicaid Services (CMS) has been collecting feedback on the MA program through a request for information (RFI) process. In response to the mounting criticism, the U.S.

Medicare 111

Medicare Rehabilitation Medicaid Accountable Care 111

Home Health Care

OCTOBER 20, 2021

Centers for Medicare & Medicaid Services (CMS) and its main innovation hub touted a “strategy refresh” on Wednesday. Among its key pillars, the refresh calls for greater payment and regulatory flexibilities supporting the provision of home- and community-based care. Officials from the U.S.

Accountable Care 98

Accountable Care Accountability Medicare Medicaid 98

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

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. Complying with all these regulations helps in avoiding penalties.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

p3care

FEBRUARY 10, 2021

From the next performance year (2021), Accountable Care Organizations (ACOs) expect different reporting requirements under the Medicare Shared Savings Program. CMS (Centers for Medicare and Medicaid Services) has recommended changes for ACO reporting criteria. The requirements are somewhat the same as for QPP MIPS.

Medicare 246

Medicare Accountable Care Accountability Medicaid 246

HIT Consultant

NOVEMBER 2, 2023

Lumeris stands out as the only value-based care enablement company with experience working across various patient populations, including those covered by Medicare Advantage, CMMI programs, commercial insurance, and Medicaid.

Accountable Care 52

Accountable Care Population Health Accountability Medicaid 52

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

Home Health Care

NOVEMBER 7, 2023

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. Currently, roughly 13.2 million Medicare fee-for-service beneficiaries are assigned to an ACO.

Medicare 114

Medicare Accountable Care Home Care Accountability 114

NASHP

SEPTEMBER 8, 2023

Over the past two years, the seven state teams that participated in the MCH PIP Policy Academy, comprised of officials from state Medicaid, public health, and other relevant agencies/groups (e.g., The state Medicaid agency is in the process of standing up this case management program based on input received during these sessions.

Medicaid 80

Medicaid Performance improvement Quality Improvement Accountable Care 80

Home Health Care

FEBRUARY 8, 2024

This article is a part of your HHCN+ Membership Home-based care providers avoiding the shift to value-based care are running out of time and excuses. Home health providers are already under the Home Health Value-Based Purchasing (HHVBP) Model, which is, by definition, a value-based care model. “In

Medicare 122

Medicare Accountable Care Accountability Primary Care 122

Home Health Care

MARCH 19, 2024

The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary model Tuesday – centered around primary care providers – that could offer home-based care providers more opportunity to dive into risk-based care. The model was another creation of the CMS Innovation Center.

Primary Care 85

Primary Care Medicare Accountable Care Medicaid 85

NASHP

JANUARY 11, 2024

An increasing number of states are authorizing Medicaid reimbursement for CHW services, and many are pursuing braided funding approaches — leveraging Medicaid authorities and other grant funding to create sustainable financing models that cover the array of CHW activities.

Medicaid 52

Medicaid Accountable Care Accountability Prevention 52

NASHP

JANUARY 11, 2024

An increasing number of states are authorizing Medicaid reimbursement for CHW services, and many are pursuing braided funding approaches — leveraging Medicaid authorities and other grant funding to create sustainable financing models that cover the array of CHW activities.

Medicaid 52

Medicaid Accountable Care Accountability Prevention 52

HIT Consultant

MARCH 15, 2023

A June 2022 report from Medicaid and CHIP Payment and Access Commission (MACPAC) further illuminated the issue, explicitly citing an extension of the financing through state Medicaid programs to drive health IT adoption as a decisive step to addressing gaps in access, outcomes data, and oversight.

Accountability 98

Accountability Accountable Care Medicaid Healthcare Innovation 98

Healthcare ECONOMIST

OCTOBER 22, 2021

Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Models should encourage lasting care delivery transformation.

Medicare 95

Medicare Accountable Care Accountability Medicaid 95

Sheppard Health Law

SEPTEMBER 11, 2023

On August 14, 2023, the Centers for Medicare & Medicaid Services (CMS) released guidance on changes to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model starting in performance year 2024 (PY2024). The changes came about in response to stakeholder and participant feedback.

Medicare 52

Medicare Accountable Care Medicaid Accountability 52

HIT Consultant

OCTOBER 30, 2023

Under the Medicare Shared Savings Program, a healthcare provider that is an Accountable Care Organization (ACO), ACO participant, or ACO provider or supplier would be deemed ineligible to participate in the program for a period of at least one year.

Medicare 98

Medicare Accountable Care Healthcare Providers Regulations 98

Healthcare ECONOMIST

MAY 1, 2023

First, admission directly into an NH for an SNF stay is not allowable within traditional Medicare, meaning that admission without entering the hospital requires private payment or Medicaid, for those already eligible. Second, hospital stays shorter than 3 days do not generate a Medicare-covered SNF stay. You can read the full article here.

Hospitals 78

Hospitals Medicare Nursing Accountable Care 78

Sheppard Health Law

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”).

Medicare 52

Medicare Accountable Care Primary Care Accountability 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

Home Health Care

JUNE 20, 2023

By the time Rinn takes over, the Centers for Medicare & Medicaid Services (CMS) will have proposed its home health payment rule for 2024, but the final rule will come after his time at VNAHG has begun. As a long-time member of the VNA family, I heartily welcome this opportunity to help move health care forward for all our communities.”

Nursing 98

Nursing Accountable Care Accountability Medicaid 98

NASHP

OCTOBER 16, 2023

“Palliative care is supported by a robust body of research. For purposes of Medicaid guidance, the state developed a Medi-Cal palliative care policy  with specific definitions of eligible conditions, services, and providers. Some are also testing alternative payment models designed for team-based care.

Medicaid 52

Medicaid Medicare Regulations Accountable Care 52

Accountable Care Doctors

MARCH 19, 2021

Kimura’s contributions as we chart a course toward care integration, new payment models, interoperability and transparent quality measures.”. Dr. Kimura is a practicing primary care internist with a specialization in clinical informatics.

Accountability 52

Accountability Accountable Care Primary Care Population Health 52

Home Health Care

AUGUST 3, 2022

The company made its first major splash on the public market when it acquired Caravan Health – an accountable care organization (ACO) manager – in February for $250 million. It has recently dealt with a bit of a shakeup, however.

Accountable Care 98

Accountable Care Accountability Medicaid Home Care 98

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

Home Health Care

FEBRUARY 10, 2022

The company signed an agreement to acquire Caravan Health, an accountable care organization (ACO) manager, for the price tag of $250 million. “It That’s what our company does for Medicare Advantage (MA) plans, Medicaid Managed care organizations and provider organizations involved in total risk contracts.”.

Accountable Care 59

Accountable Care Medicare Accountability Medicaid 59

Home Health Care

SEPTEMBER 15, 2023

Also based in Dallas, Steward Health Care operates 33 hospitals across Arizona, Arkansas, Florida, Massachusetts, Ohio, Pennsylvania and Texas. It is also one of the nation’s largest accountable care organizations, according to the company’s website. ” Tortorella joins the home health industry at an interesting time.

Urgent Care 115

Urgent Care Hospice Care Accountability Accountable Care 115

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