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

Cloud Blogs

FEBRUARY 28, 2022

In 2020, the Centers for Medicaid and Medicare Services (CMS) issued additional rules requiring that payors and providers who receive CMS funds make health information more accessible. Overall, regulators have made clear their intention to eliminate barriers to interoperability and provide patients greater control of their healthcare.

Integration 129

Integration Healthcare Quality of Care Regulations 129

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

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

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

Home Health Care

JULY 14, 2023

Centers for Medicare & Medicaid Services (CMS) published its home health proposed payment rule for 2024. CMS’ proposal to increase oversight and regulation specific to home health and hospice M&A activity will likely have impacts on the M&A landscape in 2024 and beyond. At the end of last month, the U.S.

Medicare 98

Medicare Home Care Rehabilitation Medicaid 98

HIT Consultant

MARCH 17, 2024

The Centers for Medicare and Medicaid Services (CMS) has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030, a notable increase from the mere 7% recorded in 2021 by Bain Research. Jay Ackerman, CEO, Reveleer The momentum of value-based care (VBC) is poised to accelerate.

Quality Improvement 64

Quality Improvement Medicare Quality of Care Regulations 64

NASHP

MARCH 22, 2024

State Medicaid programs, behavioral health authorities, public health, departments of insurance, human and social service agencies, departments of education, departments of corrections, housing, and employment can collaborate to align overlapping efforts, align policies, and braid funding and accountability mechanisms.

Accountability 52

Accountability Medicaid Primary Care Quality Improvement 52

Cloud Blogs

FEBRUARY 28, 2022

In 2020, the Centers for Medicaid and Medicare Services (CMS) issued additional rules requiring that payors and providers who receive CMS funds make health information more accessible. Overall, regulators have made clear their intention to eliminate barriers to interoperability and provide patients greater control of their healthcare.

Integration 76

Integration Healthcare Quality of Care Regulations 76

Briggs Healthcare

MARCH 9, 2023

Funded by the Centers for Medicare & Medicaid Services (CMS), this program will establish a Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions (Center of Excellence). The training and technical assistance provided by the COENF will be free of charge.

Nursing 52

Nursing Prevention Medicaid Performance improvement 52

HIT Consultant

JULY 19, 2023

To serve the unique requirements of a sensitive industry that is bound by stringent regulations, we require a customized healthcare system that grants legitimacy to all participants within the blockchain. Doesn’t that sound like what the healthcare industry is in need of most? What is Proof of Competence (PoC)?

Healthcare 75

Healthcare Doctors Rehabilitation Healthcare Providers 75

NASHP

MARCH 22, 2024

As major purchasers, administrators, and regulators of behavioral health treatment and supports, states play a critical role in system transformation. In addition to expanding Medicaid, North Carolina’s FY2024 budget allocates over $835 million for mental health and substance abuse investments under Medicaid.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

Sheppard Health Law

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts (§ 422.107).

Medicare 52

Medicare Medicaid Accountability Integration 52

NASHP

MARCH 22, 2024

States such as Texas, Wyoming , and New Jersey are adopting Medicaid reimbursement of collaborative care services and are addressing capacity to transition to CoCM. Integration of Substance Use Services and Supports States can align long siloed approaches to primary care, mental health, and substance use services through integration efforts.

Medicaid 52

Medicaid Integration Primary Care Nursing 52

Lexis Nexis

JULY 20, 2022

To remediate these care gaps, payers must improve their ability to access data by making significant changes to their health IT infrastructure. Gaps in care have exploded due to the pandemic and federal regulation spurring advances in interoperability is here to stay.

Prevention 52

Prevention Medicare Medicaid Health Data 52

NASHP

MARCH 24, 2025

Introduction Within the nursing home landscape, a primary role of state agencies is to oversee Medicaid payments and regulate nursing homes. As of 2022, 24 states operated Medicaid nursing home value-based payment (VBP) programs. per Medicaid resident per day depending on a facilitys STRIVE staffing ratio. Averages file.

Medicaid 52

Medicaid Nursing Quality of Care Accountability 52

NCQA

DECEMBER 18, 2024

How NCQA’s Work Supports This Goal NCQA created the Race and Ethnicity Stratification Learning Network to investigate the challenges and opportunities of using race and ethnicity data for quality improvement, to gather insights on how plans are overcoming challenges and to get an early look at HEDIS measures stratified by race and ethnicity.

Quality Assurance 52

Quality Assurance Accountability Quality Improvement Pharmaceuticals 52

NASHP

MARCH 29, 2024

Approaches include allowing family caregivers to receive Medicaid reimbursement , providing culturally competent trainings and peer supports, making respite care more accessible for caregivers, and offering behavioral health supports for caregivers. recruitment, consultation resources, Medicaid reimbursement, etc.).

Medicaid 124

Medicaid Quality of Care Quality Assurance Nursing 124

NASHP

MARCH 11, 2022

The experience of the four study states (Arizona, New York, Oregon, and Pennsylvania) indicates that payment is an effective lever for improving the delivery of SUD treatment for Medicaid beneficiaries. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.

Medicaid 59

Medicaid Integration Quality Improvement Primary Care 59

NASHP

JUNE 22, 2022

public health, Medicaid, mental health) and other stakeholders (e.g., health plans, providers, families of CYSHCN) in using, adapting, and implementing the National Care Coordination Standards for CYSHCN to develop or improve care coordination systems. State Medicaid agencies. Oversee and incentivize quality care.

Care Transition 52

Care Transition Medicaid Doctors Regulations 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

NASHP

DECEMBER 20, 2022

This approach requires significant coordination among policymakers from across state systems – behavioral health, Medicaid, courts, and corrections – to share resources, align policies, and develop clear protocols for programming. D)(1) of these regulations, or are treated for an opioid overdose. .):

Medicaid 52

Medicaid Prevention Hospitals Integration 52

NASHP

NOVEMBER 29, 2021

Medicaid Reimbursement. Medicaid Reimbursement. Alabama does not reimburse for CHW services through its Medicaid program. Alaska Medicaid reimburses for CHW services through MCOs as authorized under the state plan. Arizona does not currently reimburse for CHW services through its Medicaid program.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

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”).

Medicare 98

Medicare Medicaid Integration Regulations 98

NASHP

DECEMBER 23, 2022

With more than 40 percent of births financed by Medicaid, the Centers for Medicare & Medicaid Services (CMS) has developed an action plan that corresponds with goals outlined in the White House blueprint. Implement Medicaid benefit. Monitor and evaluate quality improvement and outcomes and address barriers to care.

Medicaid 59

Medicaid Nursing Hospitals Regulations 59

Briggs Healthcare

AUGUST 9, 2022

The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls (Volume 9, Issue 4). As of 12/30/21, the new CNA regulations require the CNA instructor to take a four-hour update training every five years. Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare. on August 15, 2022.

Quality Improvement 40

Quality Improvement Nursing Medicare Regulations 40

NASHP

MARCH 28, 2022

State Medicaid-funded long-term services and supports (LTSS) systems are not well-positioned to compete for this shrinking pool of workers. Responsible for 43 percent of all LTSS expenditures , state Medicaid programs have a major role to play in responding to this crisis. These funds must be spent before March 31, 2024.

Nursing 98

Nursing Medicaid Home Care Rehabilitation 98

Sheppard Health Law

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). Request for Comments on the Rewards and Incentives Program Regulations for Part C Enrollees.

Medicare 52

Medicare Primary Care Medicaid Quality Improvement 52

NASHP

MAY 8, 2023

Source: Centers for Medicare & Medicaid Services Health Disparities : Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. 34 The ACA’s data collection requirements also do not extend to the private insurance market.

Medicaid 52

Medicaid Regulations Prevention Medicare 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

Sheppard Health Law

NOVEMBER 13, 2023

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). Please refer to our January 5, 2023 , November 4, 2022 and May 16, 2022 blog posts for more information.

Medicare 59

Medicare Medicaid Regulations Integration 59

NASHP

JANUARY 24, 2025

On January 13, 2025, the Centers for Medicare and Medicaid Services (CMS) released its latest Notice of Benefit and Payment Parameters , the annual rule governing policies related to qualified health plans (QHPs) and the health insurance marketplaces.

Regulations 52

Regulations Accountability Patient Safety Quality Improvement 52

Sheppard Health Law

APRIL 27, 2022

The five barriers are: Nondiscrimination in HHS: Civil Rights Protections and Language Access —This area focuses on increasing meaningful access to Medicare, Medicaid, and other federally assisted programs for Limited English proficiency. HHS is working to expand postpartum care via CHIP and Medicaid and identifying ways to improve such care.

Hospitals 52

Hospitals Medicaid Pharmaceuticals Quality Improvement 52