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Clinical IT leaders on meeting CMS' mandate for patient data access

Healthcare It News

Making health data more accessible to patients – not to mention doctors and health plans – is a priority for all hospitals and health systems today, as the final Centers for Medicare and Medicaid Services Interoperability Rule mandates patient access. Enterprise Taxonomy: Patient Access Quality Care Quality Improvement Care

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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. Executive Summary.

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Moving Forward With Person-Centered Outcome Measures

NCQA

PCOs Are Gaining Acceptance NCQA began developing PCO measures for older adults in Medicare plans, but in response to the groundswell of interest in meaningful measurement, expanded the measures to include behavioral health, serious illness, primary care and long-term services and supports.

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NCQA Fireside Chat: A Conversation With Kate McEvoy of NAMD

NCQA

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.

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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 ACO Accountable Care Organizations. MCO Managed Care Organizations. MCE Managed Care Entities. MHP Medicaid Health Plans.

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How PACE Could Cover More Older Adults

Home Health Care

Beyond geographic PACE expansion, the National PACE Association also sees a future where the model evolves to reach a larger demographic of seniors, including those that fall outside of the category of Medicaid-eligible. Traditionally, PACE cares for dual-eligible seniors in a given community. “We We refer to them as Medicare-only.

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State Approaches to Behavioral Health Measures in Medicaid Managed Care

NASHP

Performance measurement is a pillar of state quality improvement and oversight. 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).