Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care 60

Primary Care Integration Urgent Care Pharmaceuticals 60

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care 60

Primary Care Integration Urgent Care Pharmaceuticals 60

NASHP

MAY 10, 2024

This blog post summarizes both the Primary Care AHEAD requirements identified by CMS and additional strategic considerations for states. Primary Care AHEAD Overview and Requirements Primary Care AHEAD is a key component of the AHEAD Model. A core aspect is a focus on alignment between payers.

Primary Care 52

Primary Care Medicaid Medicare Hospitals 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. Medicare Shared Savings Program (MSSP) ACOs are an opportunity for home-based care providers to enter the space. Currently, roughly 13.2

Medicare 114

Medicare Accountable Care Home Care Accountability 114

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.

Medicare 122

Medicare Accountable Care Accountability Primary Care 122

Accountable Care Doctors

OCTOBER 21, 2020

“Doing more procedures is not the answer to quality care — it is building a system and a culture that puts the resources of the entire team at play in the correct way.”. We can take the time to have the important conversations about patient goals, including those about end-of-life care that were so important during the pandemic.

Primary Care 59

Primary Care Integration Remote Care Population Health 59

NASHP

AUGUST 5, 2024

Authority refers to the section of Medicaid regulations that the state used for the SPA. Eligible primary care practices must engage CHWs starting in 2024. The Massachusetts primary care sub-capitation model was launched in 2023 by MassHealth (Medicaid) as part of its broader ACO system. billable) encounter.”

Medicaid 52

Medicaid Primary Care Prevention Accountability 52

NASHP

OCTOBER 20, 2022

High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices. Yet, states often face barriers to integrated care including a lack of trust across agencies, privacy regulations that may hinder data sharing, and misaligned eligibility, enrollment, and referral systems.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

NASHP

DECEMBER 10, 2021

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. Idaho reimburses for CHW services through its Medicaid managed care (Primary Care Case Management) program.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

Home Health Care

DECEMBER 2, 2024

These closures often stem from unique challenges, including difficulties in complying with Medicare regulations and reimbursement policies. These actions included upfront payments to specific accountable care organizations (ACOs) to help them expand care to rural areas and serve historically underserved populations.

Telemedicine 111

Telemedicine Home Care Medicare Nursing 111

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 52

Medicaid Primary Care Prevention Nursing 52