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Cervical Cancer: Early Detection Is Key

NCQA

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. Learn more by visiting the National Cancer Institutes website.

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How Essen Health Care used an AI virtual care assistant to make thousands of patient calls in just days

Healthcare It News

The New York State Health Home program is designed for the neediest Medicaid patients and aims to reduce overall healthcare costs by decreasing inpatient costs (and utilization) by addressing social determinants of health such as housing, transportation and food. THE PROBLEM.

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New NCQA Research Shows Variation in Antibiotic Prescribing

NCQA

Census regions to determine plans’ geographic location, and looked at results for commercial, Medicare and Medicaid products. NCQA’s antibiotics website includes a list of high-performing health plans that meet HEDIS criteria of smart prescribing and overuse prevention. What’s Next?

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State Community Health Worker Models

NASHP

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 CDC Centers for Disease Control and Prevention. MHP Medicaid Health Plans. NCQA National Committee for Quality Assurance.

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Reducing Bias in Algorithms: Spotlight on Pennsylvania

NASHP

As states continue developing their health equity strategies, an emerging consideration is how commercial algorithms that are used by states’ Medicaid managed care organizations to inform clinical care decisions may exhibit significant bias. . Pennsylvania has taken steps to better understand how to mitigate the racial bias of algorithms.

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State Approaches to Behavioral Health Measures in Medicaid Managed Care

NASHP

In addition, starting in 2024, federal rules will require states to report performance on some measures, including some behavioral health measures, to the Centers for Medicare & Medicaid Services (CMS). 1] All but one of these Medicaid agencies collected at least one measure of behavioral health performance.

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

NASHP

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.