Healthcare It News

OCTOBER 31, 2022

Through the secure collection, documentation, reporting, access and use of data across provider types, ONC aims to address health inequities that have their root causes in poverty and racism. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org. Healthcare IT News is a HIMSS publication.

Private Healthcare 340

Private Healthcare Population Health Medicaid Medicare 340

HIT Consultant

NOVEMBER 22, 2024

Expand Medicaid: Establish a federal fallback option to cover the millions of uninsured individuals in states that have not expanded Medicaid. Promote Continuous Coverage: Allow states to maintain continuous Medicaid eligibility for adults for 12 months to prevent gaps in coverage.

Medicaid 98

Medicaid Prevention Doctors Healthcare 98

HIT Consultant

JULY 16, 2024

Anish Sebastian, CEO and Co-founder, Babyscripts A discussion of technology and the Medicaid population inevitably raises the topic of the digital divide — that is, the gap between people who have access to modern information and communications technology (ICTs) and those who don’t. “We

Medicaid 105

Medicaid Digital Care Accountability Medicare 105

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. How do care management interventions to mitigate SDOH as a risk for undesired health outcomes work?

Pharmaceuticals 363

Pharmaceuticals Accountable Care Accountability Medicaid 363

HIT Consultant

DECEMBER 23, 2024

This shift means that plans need robust data systems to integrate social risk information alongside clinical data, enabling more precise population health management. Impact of SDOH Interventions on Cost Savings: Addressing SDOH not only improves health outcomes but also significantly reduces healthcare costs.

Medicare 97

Medicare Population Health Integration Regulations 97

Healthcare It News

APRIL 13, 2023

They are asking providers to identify cancer patients and families who may qualify as ACP program enrollees, which includes households with Medicaid recipients and other federal subsidy programs, to provide them with the information they need to connect their patients with the Gilda's Club team supporting ACP enrollment.

Healthcare Providers 288

Healthcare Providers Healthcare Population Health Medicaid 288

Healthcare It News

AUGUST 29, 2022

Regional and national health plans, employers, and Fortune 500 organizations use Galileo to help improve population health. More than 85% of patients report improved health after receiving care from Galileo. His goal is to help remove language as a barrier for access to healthcare for the 53 million U.S. Spanish speakers.

Telemedicine 261

Telemedicine Primary Care Medicaid Urgent Care 261

HIT Consultant

NOVEMBER 5, 2024

These successful projects evolved further into Medicaid demonstration programs and in 2005, the Deficit Reduction Act authorized two more avenues for states to offer a self-directed option. In 2010, the Affordable Care Act officially and broadly authorized self-directed services for Medicaid recipients. Today, more than 1.5

Medicaid 97

Medicaid Healthcare Population Health 97

Home Health Care

DECEMBER 5, 2024

We know that most adults want to age in place at home, which is the right place as its proven to be better for overall health and well-being and more cost-effective than an institutionalized setting, Help at Home President Tim ORourke told Home Health Care News.

Home Care 110

Home Care Nursing Prevention Integration 110

Healthcare It News

JANUARY 4, 2022

Jerry Shultz, president of Lightbeam Health, whose population health management platform helps risk-bearing organizations manage the cost and quality demands of value-based reimbursement, would like to see a wholesale effort to improve the care delivery system writ large. Here's what they had to say.

Hospitals 362

Hospitals Nursing Accountable Care Clinical Practice 362

Healthcare Success

FEBRUARY 10, 2025

You just said, you know, when we started looking at value-based care more broadly on the population-side population health, like how do we keep people out of the hospital? And not everybody is, you know, super inclined to take care of their health. Dennis Jolley - UW Health (he/him) You know, for the Medicare or Medicaid?

Healthcare 171

Healthcare Primary Care Doctors Hospitals 171

NASHP

SEPTEMBER 2, 2021

The successful candidate will lead and manage initiatives designed to support state policymakers in COVID-19 pandemic response, modernizing state public health systems, and integrating public health, social services, and comprehensive health system transformation (with a Medicaid focus).

Population Health 59

Population Health Medicaid Integration 59

NCQA

JULY 16, 2024

In our recent Fireside Chat, we brought together two forward-looking health care leaders united in their commitment to quality and their passion for improving care for Medicaid populations. 1115 waivers are special demonstrations that allow states to pilot new Medicaid approaches outside federal program rules.

Medicaid 98

Medicaid Quality Improvement Integration Population Health 98

HIT Consultant

OCTOBER 11, 2024

Neena Patel, MHA, CSM, VP of Client Success at Chordline As population health initiatives for Medicare and Medicaid members pick up steam, one of the biggest obstacles to care transformation remains a lack of trust among healthcare’s key stakeholders. Yet too often, analytics platforms are not designed with users in mind.

Population Health 98

Population Health Medicare Medicaid Primary Care 98

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). It contains six measures that focus on population health. In this article, we dissect changes that are expected to appear in MIPS 2021.

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

Home Health Care

SEPTEMBER 6, 2023

The Centers for Medicare & Medicaid Services (CMS) unveiled a new state-focused demonstration model Tuesday. One of the model’s primary objectives is to shift health care spending and utilization more toward primary and community-based care. The AHEAD Model could do the same.

Primary Care 116

Primary Care Population Health Medicare Medicaid 116

HIT Consultant

NOVEMBER 12, 2024

The Medicaid population, who typically benefits from progress last, still grapples with harmful biases within the healthcare system that pose extreme barriers to care. For the Medicaid population, receiving this type of care is more challenging and increasingly necessary. The CDC found that in 2020, 18.4%

Medicaid 52

Medicaid Population Health Doctors Telemedicine 52

NCQA

MARCH 18, 2025

Dr. David Kelley Chief Medical Officer, Pennsylvania Department of Human Services, Office of Medical Assistance Programs A champion of Medicaid transformation, Dr. Kelley has spearheaded initiatives to improve access and outcomes for underserved populations and create more equitable health care systems. million people.

Quality Improvement 52

Quality Improvement Telemedicine Population Health Primary Care 52

Sheppard Health Law

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration.

Medicaid 59

Medicaid Accountability Nursing Population Health 59

NCQA

JANUARY 15, 2025

But the screening rate was 55% for Medicaid plans, highlighting the need for more screening education and support. The good news is that unnecessary screenings reached an all-time low in 2023: 0.42% for commercial plans and 0.40% for Medicaid plans.

Quality Assurance 59

Quality Assurance Medicaid Quality of Care Population Health 59

Healthcare ECONOMIST

APRIL 3, 2024

Pharmacy plan quality is vital since approximately 85% of the US population has prescription drug coverage through public (e.g., Medicare , Medicaid) or commercial (e.g., aligns with key plan/population health priorities, usability (i.e., aligns with key plan/population health priorities, usability (i.e.,

Medicaid 88

Medicaid Population Health Medicare Prevention 88

HIT Consultant

OCTOBER 18, 2021

– Papa and Uber are working together to mitigate social isolation and negative health outcomes among Medicare and Medicaid recipients as well as those with employer health plans. The partnership advances Papa’s and Uber Health’s shared missions to support population health among vulnerable communities.

Population Health 95

Population Health Medicaid Medicare 95

HIT Consultant

JANUARY 9, 2024

What You Should Know: – Buckeye Health Plan and Cityblock are teaming up to provide integrated, community-based care to approximately 10,000 underserved Medicaid recipients in the Cleveland-Akron-Canton area.

Medicaid 64

Medicaid Primary Care Integration Prevention 64

HIT Consultant

NOVEMBER 30, 2022

Significant Growth Anticipated for Medicaid and Capitation Contracts: Most respondents report strategic plans to expand their VBC contracts over the next three years. VP of population health. Key Themes and Ideas Regarding Value-Based Care Reimbursement 2022. The product would be a replacement.

Population Health 98

Population Health Medicaid Medicare Integration 98

Sheppard Health Law

JANUARY 20, 2023

Research has indicated that healthcare systems that connect patients to basic resources have observed improvements in population health metrics, fostered trust with their patient base, and experienced reduced hospitalization costs. ILOSs must advance the objectives of the Medicaid program.

Medicaid 52

Medicaid Regulations Federal Healthcare Medicare 52

HIT Consultant

JULY 10, 2024

What You Should Know: – Alliance Health , a managed care organization serving over 137,000 Medicaid beneficiaries in North Carolina, announced a new partnership with Cityblock , a value-based healthcare provider for Medicaid and dually eligible individuals. ”

Medicaid 59

Medicaid Integration Primary Care Healthcare Providers 59

Home Health Care

NOVEMBER 21, 2024

Prior to joining CVS, he was chief population health officer of Mass General Brigham, one of the largest health care systems in Massachusetts. New CEO takes over The Partnership for Medicaid Home-Based Care Michelle Martin is set to take the helm as CEO of the Partnership for Medicaid Home-Based Care (PMHC). “On

Medicaid 45

Medicaid Medicare Home Care Performance improvement 45

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 HRSA Health Resources and Services Agency. MHP Medicaid Health Plans. NIH National Institutes of Health.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

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. million Medicaid enrollees.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

HIT Consultant

JANUARY 16, 2024

These factors can significantly impact their ability to effectively manage their condition and achieve optimal health outcomes. – Recognizing this critical need, the Medicaid Innovation Collaborative (MIC) has launched pilot programs in Iowa, Kentucky, and New York, targeting these very issues with innovative tech-enabled solutions.

Medicaid 52

Medicaid Healthcare Population Health 52

HIT Consultant

SEPTEMBER 7, 2022

Artificial intelligence (AI) has emerged as a powerful tool for making population health analytics more accurate and interventions more effective. Sensitivity to a wider range of factors that can impact population health, including SDOH, cultural and community issues, is key to minimizing both coding and data-driven bias.

Population Health 98

Population Health Health Analytics Quality Assurance Medicaid 98

NASHP

FEBRUARY 27, 2024

This is one section of State Strategies to Leverage Medicaid Managed Care Contracting for Investments in Health and Housing Alignment. For more information on financing housing-related services, please visit our Medicaid and Housing toolkit. See the full resource guide. Government. For more information, please visit HRSA.gov.

Medicaid 52

Medicaid Population Health 52

HIT Consultant

FEBRUARY 26, 2025

What You Should Know: – PointClickCare , a healthcare technology platform, and MassHealth, the Massachusetts Medicaid program launches a new Behavioral Health Treatment and Referral Platform.

Accountable Care 52

Accountable Care Accountability Medicaid Hospitals 52

NASHP

APRIL 29, 2024

The model also requires Medicaid to establish a hospital global budget for participating hospitals for the first performance year of the model. This means there will be three hospital global budgets: Medicare, Medicaid, and commercial. A state’s lead agency must recruit commercial payers and hospitals to participate.

Hospitals 78

Hospitals Medicaid Medicare Primary Care 78

HIT Consultant

NOVEMBER 7, 2024

Jeff Geier, Cyber Security Leader at Pivotalogic California’s bold new CalAIM Medicaid transformation program is restructuring what partnership for health looks like across the state.

Medicaid 52

Medicaid Integration Quality of Care Healthcare Innovation 52

HIT Consultant

MAY 21, 2024

What You Should Know: – Cityblock , a value-based healthcare provider specializing in Medicaid, announced a new partnership with Sunshine Health , a Florida managed care plan. – The partnership expands Centene Corporation’s , Sunshine Health’s parent company, existing relationship with Cityblock. .

Medicaid 52

Medicaid Primary Care Prevention Hospitals 52

HIT Consultant

JULY 25, 2024

Expanding access and community health: Addressing healthcare disparities and improving overall population health. Portfolio companies will benefit from mentorship and guidance from top-tier clinicians and healthcare management professionals within Ochsner Health.

Population Health 98

Population Health Patient Experience Medicaid Healthcare 98