Home Health Care

NOVEMBER 15, 2024

The Continuous Skilled Nursing Quality Improvement Act (S.4122) It would also require the Secretary of Health and Human Services to move to establish national quality standards of care for these services. Medicaid standards should reflect the unique work of nurses who provide complex one-on-one care to individuals at home.

Nursing 96

Nursing Quality Improvement Home Care Medicaid 96

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 86

Medicaid Quality Improvement Integration Population Health 86

NASHP

MARCH 22, 2024

States are increasingly turning to capitated Medicaid managed care programs to deliver long-term services and supports (LTSS) to individuals with complex needs. pdf On October 1, 2023, Virginia Medicaid combined its two managed care programs of Medallion 4.0

Medicaid 75

Medicaid Nursing Medicare Integration 75

NCQA

JUNE 27, 2023

More states are contracting with managed care organizations (MCO) to provide Medicaid long-term services and supports (LTSS). How do we know if MCOs are delivering equitable, high-quality care to people receiving LTSS? Accreditation helps accountability and ongoing quality improvement efforts of aging and disability networks.

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

NASHP

NOVEMBER 8, 2024

A growing trend in state health policy is developing capitated managed care programs to provide long-term services and supports (LTSS) to Medicaid beneficiaries who are older and/or have disabilities. Cardinal Care currently enrolls 90 percent of all Medicaid beneficiaries into MCOs.

Medicaid 52

Medicaid Nursing Quality Improvement Accountability 52

HIT Consultant

FEBRUARY 8, 2024

Elissa Toder, MBA, VP of Quality Improvement Strategy & Solutions at Reveleer In the ongoing transition to value-based care (VBC), provider contracting poses challenges for health plans and providers. In that case, the payer must invest resources in consolidating this data to manage quality measures effectively.

Quality Improvement 105

Quality Improvement Data Acquisition Medicaid Performance improvement 105

Healthcare ECONOMIST

SEPTEMBER 25, 2023

They find that: We did not find discontinuities in inpatient care quality across the Program eligibility threshold for Medicaid and uninsured patients; specifically, on all-cause mortality (beta = −0.04 Interestingly, the authors did find that there was some evidence of quality improvement among insured non-Medicaid patients.

Quality of Care 88

Quality of Care Medicaid Quality Improvement Hospitals 88

Healthcare It News

OCTOBER 12, 2023

In 2022, the Centers for Medicare & Medicaid Services introduced new CPT codes for remote care delivered via a digital care management platform that qualifies with the Federal Drug Administration as software as a medical device (SaMD). Another aspect of this approach is reimbursement.

Digital Care 233

Digital Care Physical Therapy Patient Experience Remote Care 233

NASHP

DECEMBER 16, 2022

States provide access to contraception under their Medicaid programs in various ways. Medicaid paid for 41% of all U.S. Public insurance programs, including Medicaid, the Children’s Health Insurance Program (CHIP), and the Indian Health Service (IHS) paid for over two-thirds (68%) of unintended births in 2010. births in 2021.

Medicaid 52

Medicaid Prevention Quality Improvement Hospitals 52

NASHP

NOVEMBER 15, 2021

Immunization Barriers in the United States: Targeting Medicaid Partnerships Fact Sheet: Using New and Existing Federal Funds to Modernize IIS. What tasks can support IIS interoperability, integration, and outreach with partner systems like Medicaid and Public health? What gaps can be filled to help facilitate public health activity?

Medicaid 52

Medicaid Quality Improvement Prevention Integration 52

NASHP

APRIL 17, 2023

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).

Medicaid 52

Medicaid Quality Assurance Quality Improvement Quality Review 52

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

NASHP

SEPTEMBER 27, 2024

As part of a continuum of home- and community-based services (HCBS), respite can improve families’ quality of life [4] , [5] and help improve outcomes, including promoting more stable living situations. [6] Additional state examples from Colorado and Massachusetts were gleaned from NASHP’s Respite Summit, held in February 2024.

Medicaid 59

Medicaid Nursing Medicare Quality Improvement 59

HIT Consultant

FEBRUARY 15, 2022

Medicaid, Medicare Advantage). public Medicaid, private PPO, Medicare Advantage). Health plans should approach quality improvement with a prioritized, targeted approach, first addressing the biggest pain points that were revealed within a deeper analytics exercise, such as access to care. – Geographic location.

Quality Improvement 98

Quality Improvement Medicare Medicaid Healthcare 98

p3care

MAY 31, 2024

Enhancing Quality By examining doctors’ performance, ACOs identify strengths and weaknesses in the service of healthcare delivery. It does not restrict itself to temporary or timely reporting only but fosters continuous quality improvement. Complying with all these regulations helps in avoiding penalties.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

Health Policy News

NOVEMBER 16, 2022

Mandatory Medicaid and Children’s Health Insurance Program (CHIP) Core Set Reporting In August 2022, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule, which, if promulgated, would.

Medicaid 52

Medicaid Medicare Quality Improvement 52

NASHP

APRIL 17, 2023

Performance measurement is a pillar of state Medicaid managed care quality improvement and oversight efforts, is often factored into plan payment, and supports public reporting. 42 Medicaid agencies collected at least one measure of behavioral health performance. In a few states we also used additional resources.

Medicaid 52

Medicaid Quality Assurance Quality Review Accountability 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 MHP Medicaid Health Plans. NCQA National Committee for Quality Assurance. Medicaid Reimbursement. Medicaid Reimbursement.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

GoMoHealth

OCTOBER 20, 2022

By Nakecia Taffa, Quality Improvement and Health Equity Director for GoMo Health. This led me to GoMo Health, where we create, activate and scale these improvements daily. While most managed care organizations go to great lengths to comply with Medicaid and Medicare mandates, many are still struggling to meet their goals.

Quality Improvement 87

Quality Improvement Medicaid Population Health Medicare 87

Home Health Care

MARCH 1, 2024

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. I’d say 90% of people that are currently served by PACE are eligible for Medicaid.

Medicaid 113

Medicaid Medicare Primary Care Quality Improvement 113

NASHP

SEPTEMBER 8, 2023

Over the past two years, the seven state teams that participated in the MCH PIP Policy Academy, comprised of officials from state Medicaid, public health, and other relevant agencies/groups (e.g., The state Medicaid agency is in the process of standing up this case management program based on input received during these sessions.

Medicaid 80

Medicaid Performance improvement Quality Improvement Accountable Care 80

NASHP

APRIL 15, 2022

CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports April 15, 2022 / by Allie Atkeson. Driven by challenges facing individuals with complex care needs, states are increasingly working to address the physical, behavioral, and social needs of their Medicaid beneficiaries. Download the report (PDF).

Medicaid 59

Medicaid Public Hospital Hospitals Nursing 59

HIT Consultant

JULY 13, 2022

. – Cohere’s collaborative UM platform will help GHP support value-based care delivery, reduce administrative costs, and lead the nation in aligning quality improvement initiatives across all its lines of business, including Commercial, Exchange, Medicare Advantage, and the newly expanded Medicaid.

Medicaid 98

Medicaid Quality Improvement Medicare 98

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

Healthcare It News

SEPTEMBER 18, 2024

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

Primary Care 207

Primary Care Health Data Hospitals Doctors 207

Home Health Care

MAY 19, 2022

Yet with roughly seven-and-a-half months to go, more questions about HHVBP’s broader impact on quality of care and patient access are starting to pop up. But payer partners want to be “wowed” by data, and evidence suggests that HHVBP mostly leads to relatively modest quality improvements.

Medicare 95

Medicare Regulations Quality Improvement Quality of Care 95

NASHP

SEPTEMBER 22, 2022

The federal government has boldly detailed nearly 350 actions that agencies overseeing Medicare and Medicaid, Veterans Affairs, housing, labor, and more will take over the next three years to support caregivers. Hartford Foundation.

Medicaid 111

Medicaid Care Transition Medicare Quality Improvement 111

HIT Consultant

OCTOBER 21, 2022

This work occurs alongside evaluating how to integrate the medical device into the hospital system’s diagnostic paradigms, including in relation to quality improvement programs. Conduct quality improvement programs and evaluate new technologies, for potential incorporation, to help from a compliance standpoint.

Hospitals 98

Hospitals Quality Improvement Medicaid Clinical Practice 98

Readiness Rounds

DECEMBER 4, 2024

How Can We Improve Quality and Patient Outcomes? What Are the Steps for Integration into Quality Improvement? How Can We Improve Data Management and Staff Training? One of the most transformative changes ahead is the CMS 2025 Age-Friendly Measures, introduced by the Centers for Medicare & Medicaid Services.

Quality Improvement 52

Quality Improvement Physical Therapy Integration Hospitals 52

Home Health Care

NOVEMBER 22, 2022

Government Accountability Office (GAO) has signed off on the home health payment rule finalized by the Centers for Medicare & Medicaid Services (CMS) last month. CMS argues that alternatives to mitigate the payment reductions would be contrary to the intent of the rule.

Medicare 85

Medicare Medicaid Quality Improvement Accountability 85

Briggs Healthcare

MAY 30, 2023

MEASURE RATIONALE: Findings from an environmental scan/literature review suggest there is a measurement gap for assessing discharges to non-institutional settings for high-risk and high-need populations across Medicaid. assisted living, adult family home, group home). The potential measure exclusions. a qualifying numerator event).

Medicaid 40

Medicaid Rehabilitation Quality Improvement Quality of Care 40

Sheppard Health Law

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts.

Medicare 98

Medicare Medicaid Integration Regulations 98

NASHP

OCTOBER 20, 2022

This substandard access to quality care can lead to poor health outcomes.[6]. have a special health care need, and an estimated 44 percent of CYSHCN are enrolled in Medicaid.[7] public health, Medicaid, mental health) and other stakeholders (e.g., Nearly 20 percent of children in the U.S.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

Briggs Healthcare

NOVEMBER 17, 2022

As the expanded HHVBP Model prepares to start the first performance year on January 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the November 2022 Pre-Implementation Performance Report (PIPR) to all active home health agencies (HHAs). Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare.

Quality Improvement 75

Quality Improvement Medicaid Medicare Healthcare 75

HIT Consultant

DECEMBER 5, 2023

According to new reporting rules from the Centers for Medicare & Medicaid Services (CMS), hospitals are expected to collect data about rates of hypo and hyperglycemia to accurately assess their facility’s ability to mitigate preventable patient harm. The time for change is now.

Hospitals 98

Hospitals Patient Safety Quality Improvement Prevention 98

GoMoHealth

JANUARY 2, 2022

A Value Based Quality Improvement System for Health Plans and Providers. HSX MarketStreet and GoMo Health® Announce Launch of Their New Data Activation Platform.

Life Sciences 91

Life Sciences Quality Improvement Integration Medicaid 91

Healthcare ECONOMIST

JANUARY 14, 2022

Most individuals in its catchment area were Medicaid or Medicare beneficiaries or uninsured, representing the densest noncommercial payor communities for nonpublic hospitals in the country. Before the merger, funding was lacking for technology and infrastructure investments to support quality improvement.

Hospitals 75

Hospitals Rehabilitation Accountability Quality Improvement 75