Accountable Care, Primary Care and Quality Improvement

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

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. ii] Rural areas are highly likely to suffer from shortages of primary care and other providers.

Primary Care

Primary Care Medicaid Accountability Quality Improvement

CMMI Prioritizes Multi-Payer Alignment in New Models

NCQA

OCTOBER 31, 2023

The Innovation Center also released the Making Care Primary (MCP) model and the GUIDE model this year, innovative solutions to achieve multi-payer alignment and focus on populations that have historically been underfunded in health care.

Primary Care

Primary Care Quality Improvement Medicaid Accountable Care

State Community Health Worker Models

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. Acronym Guide. APM Alternative Payment Model. CBO Community Based Organization.

Medicaid

Medicaid Primary Care Prevention Nursing

Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease

NCQA

MARCH 22, 2023

As part of our drive to improve health equity , most toolkit resources are available in Spanish. Have you used the toolkit? Let us know how it’s going! We welcome your feedback. The post Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease appeared first on NCQA.

Primary Care

Primary Care Population Health Pharmaceuticals Accountable Care

Centers for Medicare and Medicaid Innovation Center: Equity and Vision

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. FOOTNOTES. [1]

Medicaid

Medicaid Medicare Accountable Care Accountability

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

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

Primary Care Integration Doctors Accountability

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

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

Primary Care Integration Doctors Accountability

Why aren’t alternative payment models working?

Healthcare ECONOMIST

SEPTEMBER 24, 2024

However, CMS has already had a number of integrated care initiatives such as accountable care organizations (e.g., Medicare Shared Savings Program) and the Multi-payer Advanced Primary Care Practice Demonstration. The authors also argue for more reimbursement for information sharing activities.

Accountability

Accountability Quality Improvement Accountable Care Integration

COVID-19 Lessons: A Path to a Better Health Care System

Accountable Care Doctors

OCTOBER 21, 2020

Recognize that primary care and prevention are the tools that will keep Americans healthy and build a health care system to support it. The patient experience also significantly improves when care is coordinated versus delivered piecemeal. Today, health care is a team sport.

Primary Care

Primary Care Integration Remote Care Population Health

Aligning the Interests of Employer Purchasers and Physicians to Accelerate Value

Accountable Care Doctors

FEBRUARY 1, 2021

demanding more transparency from insurers and other intermediaries.

Primary Care

Primary Care Accountability Patient Experience Integration

National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

OCTOBER 20, 2022

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. Data are central to both direct care coordination service provision, as well as care coordination system monitoring and quality improvement efforts.

Medicaid

Medicaid Integration Accountability Quality Improvement

Community Health Worker Models

NASHP

NOVEMBER 29, 2021

Idaho reimburses for CHW services through its Medicaid managed care (Primary Care Case Management) program. The PCCM program incentivizes primary care providers to incorporate CHWs into their care coordination model by offering a higher per-member per-month (PMPM) case management payment.

Medicaid

Medicaid Primary Care Prevention Nursing

Public Health Modernization Toolkit: Key Commitments, Priorities, and Strategies to Advance Collaboration between Public Health and Health Systems

NASHP

AUGUST 31, 2023

Interviewees shared a range of perspectives, including those of local health departments, the state’s sheriff’s association, the state medical society, community health centers, hospital and primary care associations, funders, a CBO, aging and assisted living partners, consumer advocacy groups, and legislators.

Medicaid

Medicaid Accountability Public Health services Population Health

CMS Unveils “Innovation in Behavioral Health” Model to Tackle Dual Mental and Physical Health Challenges

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

Medicaid Quality of Care Medicare Integration

Health Care Quality Digest

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

CMMI Prioritizes Multi-Payer Alignment in New Models

Trending Sources

State Community Health Worker Models

Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease

Centers for Medicare and Medicaid Innovation Center: Equity and Vision

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

Why aren’t alternative payment models working?

COVID-19 Lessons: A Path to a Better Health Care System

Aligning the Interests of Employer Purchasers and Physicians to Accelerate Value

National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

Community Health Worker Models

Public Health Modernization Toolkit: Key Commitments, Priorities, and Strategies to Advance Collaboration between Public Health and Health Systems

CMS Unveils “Innovation in Behavioral Health” Model to Tackle Dual Mental and Physical Health Challenges

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