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

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 363

Pharmaceuticals Accountable Care Accountability Medicaid 363

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 89

Medicare Accountable Care Accountability Medicaid 89

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 109

Medicare Rehabilitation Medicaid Accountable Care 109

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

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

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 93

Accountable Care Accountability Medicare Medicaid 93

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

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

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 93

Medicare Accountable Care Home Care Accountability 93

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 113

Medicare Accountable Care Accountability Primary Care 113

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 77

Primary Care Medicare Accountable Care Medicaid 77

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

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

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

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 Integration 52

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

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

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 88

Nursing Accountable Care Accountability Medicaid 88

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 88

Medicare Accountable Care Accountability Medicaid 88

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 73

Hospitals Medicare Nursing Accountable Care 73

HIT Consultant

NOVEMBER 16, 2022

Edifecs and Empowered-Home announced a partnership to provide automated prior authorizations to medical associations, Accountable Care Organizations (ACOs), Independent Physician Associations (IPAs), medical groups, and home healthcare agencies. Edifecs Partners with Empowered-Home to Deliver Automated Prior Authorizations.

Physical Therapy 98

Physical Therapy Integration Accountable Care Rehabilitation 98

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 89

Accountable Care Accountability Medicaid Home Care 89

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

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 100

Urgent Care Hospice Care Accountability Accountable Care 100

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

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 58

Accountable Care Medicare Accountability Medicaid 58

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. CBCM Community Based Care Management Program. MCO Managed Care Organizations.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

Home Health Care

JUNE 16, 2022

Centers for Medicare & Medicaid Services (CMS) decrease the number of Medicare alternative payment models, and instead design models to work together more harmoniously. MedPAC examined rural beneficiaries’ and MUA-based individuals’ access to care. In June 2021, MedPAC recommended that the U.S.

Medicare 84

Medicare Medicaid Accountable Care Accountability 84

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 114

Accountability Population Health Medicaid Accountable Care 114

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). Now, it’s time to look into details of (Centers for Medicare and Medicaid Services) CMS-published Proposed Rule. Let’s get started!

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

GoMoHealth

OCTOBER 20, 2022

While most managed care organizations go to great lengths to comply with Medicaid and Medicare mandates, many are still struggling to meet their goals. Decreased gaps in care and population disparities : closed gaps in care for engaged members of a U.S. Billing, coding, and reimbursement opportunities captured.

Quality Improvement 88

Quality Improvement Medicaid Population Health Medicare 88

HIT Consultant

AUGUST 23, 2022

The Center for Medicare and Medicaid Services (CMS) is leading the charge in value-based-care, with recent updates, including the CY 2023 Medicare Advantage Rate Notice to its CY 2023 Physician Fee Schedule (PFS) Proposed Rule.

Medicare 98

Medicare Accountable Care Medicaid Hospitals 98

HIT Consultant

NOVEMBER 22, 2021

Health Fidelity’s technology uncovers insights that enable better care planning and more complete revenue capture; giving health plans and providers the ability to succeed in risk-sharing arrangements across Medicare Advantage, Affordable Care Act (ACA), Medicaid, and Accountable Care Organization programs.

Accountable Care 52

Accountable Care Medicaid Medicare Accountability 52