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

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

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, 2023

What You Should Know: – Anthem Blue Cross and Blue Shield in Virginia and Aledade , the nation’s largest network of independent primary care, today announced an expansion of their collaboration to provide more Virginians with access to high-quality primary care.

Primary Care 52

Primary Care Medicare Medicaid Healthcare 52

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 ACO Accountable Care Organizations. MCO Managed Care Organizations. MCE Managed Care Entities. integrating?CHWs

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

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.

Hospitals 78

Hospitals Medicaid Medicare Primary Care 78

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. Humana is one of the largest insurers in the country, and has about 6 million Medicare Advantage (MA) members underneath its health plans.

Medicaid 45

Medicaid Medicare Home Care Performance improvement 45

NCQA

FEBRUARY 19, 2025

The program is sponsored by TennCarethe state Medicaid program in Tennesseeand was developed with technical assistance from NCQA. Were excited to share the story of Siloam Health , one of the first organizations to be accredited through the program.

Primary Care 59

Primary Care Medicaid Integration Population Health 59

HIT Consultant

NOVEMBER 8, 2023

Reimbursement Barriers and Healthcare Inequality: – 44% of surveyed centers do not accept Medicaid, disproportionately affecting underserved communities. – Only 65% of practices accept commercial insurance, making it difficult for those unable to pay upfront costs to access care. We are failing our children as a nation.

Primary Care 111

Primary Care Medicaid Healthcare Population Health 111

Health Blawg

FEBRUARY 19, 2018

Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine. Health Care Law and Consulting. Join the conversation on Twitter at #HarlowOnHC. David Harlow. The Harlow Group LLC. You should follow me on Twitter: @healthblawg.

Healthcare 113

Healthcare Population Health Healthcare Innovation Accountability 113

HIT Consultant

APRIL 20, 2022

The overarching goal of VBC is to improve the patient experience, improve population health, and reduce per capita health costs. As part of this VBC mode l, hospitals and health systems must store, track, and analyze a large amount of quality-related data for compliance and reimbursement purposes.

Integration 98

Integration Primary Care Telemedicine Patient Experience 98

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

Home Health Care

JULY 3, 2024

The urgent care service line will be added to Lifespark COMPLETE, Lifespark’s value-based population health business. The Minnesota-based company provides home health, home care, hospice, primary care and senior living, among other services. Those services are offered to a wide range of patients.

Urgent Care 111

Urgent Care Hospitals Primary Care Population Health 111

Health Populi

JUNE 22, 2022

The last chart from the Commonwealth Fund 2022 State Scorecard talks about the rate of uninsurance by state — think ZIP code or personal GPS — calling out the fact that a dozen Governors did not expand Medicaid to accommodate ACA health plan enrollment for their health citizens. The Fund’s bottom line.

Primary Care 115

Primary Care Medicaid Integration Population Health 115

Home Health Care

AUGUST 8, 2022

CVS Health has been overt about its efforts to reach further into the home; it has been targeting traditional home health agencies, and it was reportedly interested in primary care provider One Medical (Nasdaq: ONEM). Walgreens, however, is CVS Health’s most similar peer based on the services and products it offers.

Primary Care 98

Primary Care Medicare Accountable Care Population Health 98

Health Populi

MARCH 26, 2018

News’ Chairman, believes that this project will give, “citizens, community leaders and policy-makers the tools to assess health in their communities and develop a blueprint for positive change” with learnings that can translate to less-healthy communities. In addition, lower stress in the workplace also improves health status.

Primary Care 63

Primary Care Population Health Medicaid Hospitals 63

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 2: Advance Health Equity.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

HIT Consultant

OCTOBER 5, 2023

. – Ounce Community Health Workers (CHW) currently serve more than 2,000 D.C. residents, helping them enroll in Medicaid, apply for energy assistance, schedule PCP and pediatrician appointments, avoid eviction, and connect with community resources for transportation and nutritious food, among many other services.

Medicaid 98

Medicaid Primary Care Healthcare Integration 98

HIT Consultant

NOVEMBER 10, 2021

Although many companies had plans on the books to advance telemedicine, the crisis revealed that virtual care is not only possible but in many cases is also preferred by patients. This shift to hybrid care could ameliorate some of the major problems in the U.S. healthcare system. For instance, the U.S. About Larry English.

Healthcare 105

Healthcare Patient Experience Urgent Care Population Health 105

HIT Consultant

JUNE 13, 2023

The first-of-its-kind platform will simplify and enhance the entire patient journey—from getting to a primary care appointment to accessing critical prescriptions and groceries. Providers and payers, including Medicare and Medicaid, lack the visibility and infrastructure to execute on these programs effectively.

Patient Experience 98

Patient Experience Primary Care Population Health Medicaid 98

NASHP

MARCH 1, 2024

This project aims to assist states in progressing their unique health system transformation efforts toward the overarching goals of better health access and outcomes and minimized cost growth. Examples include moving toward capitated payments, prioritizing primary care, and focusing on broad population health goals.

Primary Care 59

Primary Care Population Health Hospitals Medicaid 59

HIT Consultant

DECEMBER 20, 2021

Equality Health Logo. What You Should Know: Equality Health receives an infusion of capital from Governor Jeb Bush-led firm to accelerate its national expansion of the company’s value-based primary care platform. Reimagining the New Frontier of Value-Based Care.

Primary Care 52

Primary Care Population Health Medicaid Medicare 52

NASHP

JANUARY 19, 2024

Applicant states must identify a lead agency, which may be the Medicaid, public health, state insurance, or other agency with rate setting or budget authority. The Medicaid agency does not have to be the lead agency, but if it is not, it must be identified as a sub-recipient as part of the application.

Primary Care 59

Primary Care Medicaid Population Health Hospitals 59

Home Health Care

APRIL 7, 2022

This step will make it simpler for clients to connect with the broad expertise and innovative capabilities across our businesses, so we can help them improve population health, reduce the cost of care and make health care work better for everyone.”. Mike Mikan, Optum’s first CEO, said at the time.

Population Health 115

Population Health Medicaid Medicare Integration 115

Home Health Care

DECEMBER 20, 2023

It also has a number of care-at-home programs under its roof, including home health care, primary care, hospital at home and more. Patient care is provided through a partnership with Castell, Intermountain’s population health entity. “We The program’s readmission rate is roughly 7%.

Hospitals 85

Hospitals Nursing Primary Care Population Health 85

Cloud Blogs

FEBRUARY 28, 2022

Passed in 2016, The Cures Act requires that electronic health record (EHR) systems provide patient-facing application programming interfaces (APIs) to maintain federal certifications. Shortage of primary care professionals, unequal access to care. Thus, VBC sits at a pivotal juncture. Heightened cybersecurity threats.

Integration 133

Integration Healthcare Quality of Care Regulations 133

NASHP

DECEMBER 8, 2023

The Centers for Medicare & Medicaid Services (CMS) recently released its latest total cost of care model, the Advancing All-Payer Health Equity Approaches and Development (AHEAD) model with the goals of slowing growth in health care costs, improving population health, and advancing health equity.

Primary Care 52

Primary Care Population Health Medicaid Medicare 52

NCQA

OCTOBER 31, 2023

“ It’s a marathon, not a sprint ,” said Liz Fowler, Director at the Center of Medicare and Medicaid Innovation (CMMI), during a recent Fireside Chat with NCQA Executive Vice President Eric Schneider. And then we’re also developing an approach for certification based on quality improvement and patient experience.”

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

Health Populi

FEBRUARY 4, 2024

The combination of Kaiser Permanente and Geisinger to form Risant Health will be a test of how Kaiser can build a national brand while embedding its approach to a regional health system that has been geographically boxed-in in central Pennsylvania. Re-building a community health system from an innovative blueprint.

Primary Care 90

Primary Care Medicare Prevention Medicaid 90

NASHP

MARCH 22, 2024

It presents state examples and key considerations for state officials via an organizing framework broken down by major components of the delivery system (from primary care to community-based and home-based services and supports) and reflecting essential principles for a modern system.

Urgent Care 64

Urgent Care Medicaid Integration Primary Care 64

HIT Consultant

JUNE 7, 2024

What You Should Know: – Pediatrics Associates , the leading private pediatric primary care group in the US, has partnered with Innovaccer Inc., – The collaboration aims to leverage AI and data analytics to improve the quality of care for Pediatrics Associates’ over 1.5 million patients across 7 states.

Quality of Care 52

Quality of Care Population Health Primary Care Medicaid 52

HIT Consultant

FEBRUARY 4, 2024

Nate Favini, Chief Medical Officer at Pair Team What You Should Know: – Pair Team , a leader in virtual and community-based care for high-risk Medicaid patients, announced today the appointment of its first-ever Chief Medical Officer, Dr. Nate Favini , alongside two other strategic leadership additions.

Population Health 52

Population Health Medicaid Primary Care Integration 52

Health Populi

JUNE 27, 2022

Health Populi’s Hot Points: Castlight examined the commercial medical claims even more granularly, looking into differences between higher-income workers compared with lower-income communities.

Prevention 125

Prevention Primary Care Medicaid Medical Services 125

Home Health Care

NOVEMBER 12, 2021

Most of the pilots and initiatives I’ll speak about today are in the New York market, specifically when we talk about incorporating home care in the broader sense and addressing the social determinants of health for our population. We are working with a large, regional health plan in the city.

Home Care 98

Home Care Medicaid Primary Care Hospitals 98

Home Health Care

FEBRUARY 10, 2022

The company partners with both health plans and health systems to deliver various types of care to patients in their homes. Currently, Signify has partnerships with roughly 2,500 post-acute care facilities. The organization didn’t have a solution for these payers to go beyond episodes of care, according to De Brantes.

Accountable Care 59

Accountable Care Medicare Accountability Medicaid 59