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

Home Health Care

AUGUST 30, 2021

Centers for Medicare and Medicaid Services (CMS). The overall goal of the program is to improve patient care and curb health care costs. Currently, CommonSpirit Health operates more than 1,000 care sites and 142 hospitals across 21 states. Plus, it boasts an average quality score of 98%.

Medicare 116

Medicare Rehabilitation Home Care Accountable Care 116

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

HIT Consultant

MARCH 15, 2023

They could better assess addiction risk and make the best judgment on the type of care delivered. If providers could easily and securely access dynamic and actionable behavioral health data, they could develop more effective treatment plans based on a patient’s complete history.

Accountability 98

Accountability Accountable Care Medicaid Healthcare Innovation 98

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

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.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

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

NASHP

SEPTEMBER 8, 2023

from maternal-related causes , with more than 80 percent of these deaths being preventable. Factors that can lead to a pregnancy-related death include access to care and timeliness of diagnoses. 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

Healthcare ECONOMIST

MAY 5, 2024

ACO includes patients attributable to accountable care organizations (ACO), such as those participating in the Medicare Shared Savings Program (MSSP). 2020 algorithm). The authors also use information from encounter claims on whether a patient chart review took place.

Medicare 111

Medicare Accountability Accountable Care Prevention 111

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. 3,000 noncompliant for variety of preventive care screenings or follow-up. 3,000 noncompliant for variety of preventive care screenings. 6,000 members.

Quality Improvement 88

Quality Improvement Medicaid Medicare Population Health 88

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

JANUARY 31, 2022

“It really goes back to this idea of powering care programs into the home. MedArrive coordinates in-person care for health systems, Accountable Care Organizations (ACOs) and physician group partners via emergency medical services (EMS) professionals, nurses and community health workers, among others.

Telemedicine 52

Telemedicine Prevention Accountable Care Accountability 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

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

DECEMBER 15, 2021

NASHP recently updated a 50-state scan that identifies state approaches to supporting the CHW workforce and catalogues CHW Medicaid financing strategies (see text box 1). Evidence indicates that Medicaid spending on CHW services produces both improved health outcomes and a return on investment.

Medicaid 52

Medicaid Accountable Care Accountability Quality Assurance 52

NASHP

JULY 11, 2022

The demands of the pandemic have made it clear that the public health system cannot work in a silo to do the foundational public health work of communicable disease prevention; maternal, child, and family health services; access to and linkage with clinical care; and preventing chronic disease and injury.

Medicaid 52

Medicaid Population Health Prevention Accountability 52

NASHP

NOVEMBER 29, 2021

Medicaid Reimbursement. Medicaid Reimbursement. Alabama does not reimburse for CHW services through its Medicaid program. Alaska Medicaid reimburses for CHW services through MCOs as authorized under the state plan. Arizona does not currently reimburse for CHW services through its Medicaid program.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

NASHP

AUGUST 31, 2023

This feedback, along with state-collected health data, helped shape Oregon’s five priority areas : institutional bias; adversity, trauma, and toxic stress; behavioral health; access to equitable preventive services; and economic drivers of health.

Medicaid 52

Medicaid Accountability Public Health services Population Health 52

Home Health Care

OCTOBER 11, 2021

Over the course of the last 12 months, we’ve continued to bring in more and more advanced diagnostic and preventative services alongside our in-home health evaluations,” he said. “I We know that in an episode of care model, about 45% of the readmissions occur after 30 days,” Boumenot said.

Accountable Care 52

Accountable Care Medicare Accountability Medicaid 52

NASHP

AUGUST 24, 2023

There are a number of strategies state health officials can use as they build sustainable access to palliative care services in their Medicaid programs. Target Populations That Could Benefit from Palliative Care Services Use data to identify Medicaid enrollees with serious illness.

Medicaid 52

Medicaid Quality Assurance Quality of Care Hospitals 52

HIT Consultant

MAY 26, 2023

The partnership will be activated with an initial focus on migrating clinical workflows to NeuroFlow’s registry, or caseload management tool, providing care team members with the ability to track and measure patient progress in between appointments and improve resource allocation.

Integration 52

Integration Patient Experience Life Sciences Hospitals 52

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

DECEMBER 2, 2024

Delivering person-centered care requires addressing a wide range of needs, from primary and preventive services to the management of chronic conditions, acute episodes of care, and social and behavioral health needs, as noted by the Centers for Medicare & Medicaid Services (CMS).

Telemedicine 111

Telemedicine Home Care Medicare Nursing 111

NASHP

MAY 8, 2023

North Carolina In 2015, North Carolina’s legislature passed Session Law 2015-245 (with amendments in 2016 and 2018) to implement managed care in the Medicaid program. Healthy Opportunity Pilots evaluate providing non-medical evidence-based interventions to Medicaid enrollees in need of services related to SDOH.

Medicaid 52

Medicaid Accountability Accountable Care Integration 52

Home Health Care

FEBRUARY 14, 2025

Indeed, CMS is pushing for all Medicare fee-for-service beneficiaries to be enrolled in some form of value-based care arrangement by 2030. The executives also spoke about gaining greater control over multiple settings in order to better coordinate care and manage population health.

Medicare 45

Medicare Nursing Accountable Care Accountability 45