Sequence Health

FEBRUARY 20, 2025

Effective communication during care transitions, along with proper medication reconciliation, is vital for preventing readmissions and improving overall patient outcomes. Effective discharge planning involves ensuring that patients understand their care instructions and have the necessary resources to manage their health at home.

Hospitals 52

Hospitals Care Transition Primary Care Prevention 52

Home Health Care

SEPTEMBER 3, 2021

All of these capabilities support better care transitions, which Fischer calls “one of the biggest gaps in health care.”. Upon discharge of a patient, their primary care physician will get a CCD that can be 300-to-500 pages of details no one is interested in,” Fischer says. “We

Primary Care 98

Primary Care Care Transition Hospitals Nursing 98

HIT Consultant

MARCH 8, 2022

The goal of the PHE was to help low-income people receive appropriate preventive and primary care during the pandemic without disruptions in coverage. There has never been a greater need for state and federal health and human services agencies to collaborate and take decisive action nowto be prepared.

Medicaid 98

Medicaid Primary Care Care Transition Federal Healthcare 98

Home Health Care

NOVEMBER 29, 2023

It’s a wide-ranging home-based care strategy at UnitedHealth Group, and includes home-based primary care, palliative care, home health care, personal care and infusion, among various other services. Nearly every leader on stage at least mentioned the home in their presentations. million home visits per year.

Home Care 116

Home Care Care Transition Hospitals Primary Care 116

HIT Consultant

FEBRUARY 15, 2023

Today, physicians, patients and payers benefit from virtual care options that can be scaled to provide users with access to a wide range of providers, healthcare services and diagnostics that enable remote monitoring and testing which is especially important for chronic condition management.

Telemedicine 98

Telemedicine Urgent Care Primary Care Prevention 98

Cloud Blogs

AUGUST 2, 2023

Enhance health team coordination and collaboration Care coordination is a complex process involving multiple stakeholders, including primary care physicians, specialists, nurses, and allied healthcare professionals. Modern care management platforms facilitate seamless collaboration and information sharing among care teams.

Quality of Care 90

Quality of Care Healthcare Care Transition Primary Care 90

HIT Consultant

SEPTEMBER 30, 2021

. – Using data analytics to drive high-touch, high-impact outreach to the most at-risk individuals, Wayspring’s SUD home model delivers community-based peer support, behavioral health services, and primary care.

Care Transition 52

Care Transition Primary Care Hospitals 52

HIT Consultant

DECEMBER 15, 2021

What You Should Know: – Bamboo Health announced that it has expanded its care coordination partnership with Oak Street Health intended to arm the network of value-based primary care centers (for Medicare) with an additional level of resources for managing real-time patient event notifications.

Urgent Care 52

Urgent Care Primary Care Care Transition Patient Experience 52

Sheppard Health Law

DECEMBER 12, 2022

CMS’s 2021 report explained that “[i]n 2019, Medicare beneficiaries saw an average of 50 percent more specialists in the outpatient setting than in 2000, doubling the number of physicians with whom primary care providers must coordinate care. Create Financial Incentives within Primary Care for Specialist Engagement.

Accountable Care 52

Accountable Care Accountability Medicare Primary Care 52

NASHP

DECEMBER 10, 2021

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. MassHealth ACOs, which are part of their managed care delivery system, serve about 1 million MassHealth members.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

NCQA

JUNE 28, 2024

NCQA LTSS Distinction standards require MCOs t o identi fy individuals who might be susceptible to unplanned care transitions, which may entail reassessing the service plan. (S The Managed Care Rule affects Medicaid and Children’s Health Insurance Program enrollees, and requires states to: Adopt Appointment Wait Time s.

Medicaid 59

Medicaid Regulations Care Transition Primary Care 59

NASHP

JUNE 22, 2022

Shared Plan of Care. Care Coordination Workforce. Care Transitions. health plans, providers, families of CYSHCN) in using, adapting, and implementing the National Care Coordination Standards for CYSHCN to develop or improve care coordination systems. Primary care clinical goal (dated).

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

NASHP

NOVEMBER 17, 2023

As a guiding framework, Pu presented an organizing framework for conceptualizing the home-based medical care landscape organized by intensity of care need and whether the care was long term, urgent, or acute , as seen below.

Medicaid 64

Medicaid Nursing Primary Care Hospitals 64

Sheppard Health Law

OCTOBER 27, 2021

Strategic Objective 1: Drive Accountable Care. The National Academy of Medicine reported that high-quality primary care forms the foundation of a high-functioning health system and is key to improving the experience of patients and care teams, as well as population health, and reducing costs. [1] FOOTNOTES. [1]

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

NASHP

AUGUST 5, 2024

Maine’s Primary Care Plus Initiative (PCPlus) is an alternative payment model (APM) through MaineCare, Maine’s Medicaid program, that provides a higher per-member per-month (PMPM) rate for a whole-person care approach that includes care delivery requirements such as care coordination, health and oral screenings, and care transition.

Medicaid 52

Medicaid Primary Care Prevention Accountability 52

NASHP

MAY 17, 2022

In 2007, 29 states provided health care services to children in child welfare through MMC. [24] managed care organizations, primary care case management, prepaid ambulatory health plans, and prepaid inpatient health plans) to serve some or all CYFC. personal care items or electronics). One-time financial stipends.

Medicaid 64

Medicaid Integration Medicare Primary Care 64

NASHP

AUGUST 9, 2021

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends screening pregnant women for SUD in multiple settings, including the emergency department, OB/GYN visits, primary care visits, and well-child visits. [15] SBIRT) [22] in multiple health settings, including emergency rooms and pediatric primary care.

Medicaid 52

Medicaid Prevention Primary Care Hospitals 52

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

HIT Consultant

JUNE 22, 2022

With the right technology, providers can monitor patients across the continuum, identify when patients present to the ED, intervene in a timely manner, and reroute patients to a less costly level of care. Reduce hospital admissions. For both patients and providers, trips to an ED, or even just a short hospital stay, are costly.

Hospitals 98

Hospitals Medicare Primary Care Care Transition 98

Healthcare Leadership

APRIL 24, 2023

Over the past decade we have seen more and more specialization and levels of care introduced. We now have telehealth visits, retail clinics, direct-primary-care, and more. More fragmentation = more transitions. More transitions = more issues. Naylor M, Keating SA.

Care Transition 52

Care Transition Nursing Primary Care General Practice 52