HIT Consultant

SEPTEMBER 24, 2024

What You Should Know: – Wider Circle , which builds peer-driven communities nationwide to help people improve their health and quality of life through trusted connections, announced a partnership with CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst CHPMD).

Medicaid 52

Medicaid Primary Care Prevention Medicare 52

Home Health Care

APRIL 30, 2024

This article is a part of your HHCN+ Membership Now that the Medicaid Access Rule has been finalized , home-based care’s company leaders have had time to digest it, and consider what it means for the future of the space. Here’s what six of them had to say.

Home Care 111

Home Care Medicaid Accountability Quality Improvement 111

NCQA

JUNE 28, 2024

The Centers for Medicare & Medicaid Services (CMS) recently announced two major updates to Medicaid regulations. This blog will delve into their significance and key policy implications for states and managed care organizations (MCO). Ensure Payment Adequacy for HCBS Direct Care Workers.

Medicaid 59

Medicaid Regulations Care Transition Primary Care 59

HIT Consultant

NOVEMBER 7, 2024

Jeff Geier, Cyber Security Leader at Pivotalogic California’s bold new CalAIM Medicaid transformation program is restructuring what partnership for health looks like across the state. By integrating medical and social care, the full spectrum of a patient’s needs can be better addressed, leading to a more effective healthcare ecosystem.

Medicaid 52

Medicaid Integration Quality of Care Healthcare Innovation 52

NASHP

MAY 21, 2024

Children and youth with chronic illness, behavioral and special health care needs, and medical complexities often require specialized care, prescription medications, medical technology and equipment, and increased care coordination, and can have unmet health care needs. percent) using public health insurance (e.g.,

Medicaid 52

Medicaid Measurable Quality Prevention Quality of Care 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. which serves children, pregnant women, and adults, and CCC+ — into one program called Cardinal Care.

Medicaid 52

Medicaid Nursing Quality Improvement Accountability 52

NASHP

OCTOBER 2, 2023

To address the housing needs of Medicaid beneficiaries, states can leverage a variety of Medicaid authorities, including through the state plan, a variety of waivers, and managed care arrangements, to cover housing-related services under state Medicaid programs.

Medicaid 72

Medicaid Performance improvement Nursing Integration 72

Home Health Care

MAY 25, 2023

Centers for Medicare & Medicaid Services (CMS) recently published two proposed rules that have major implications for home-based care providers. The provision may also lead to providers dropping Medicaid services. “As Wolfe believes that even providers that don’t work under Medicaid could see the impact of this provision.

Medicaid 98

Medicaid Law Firms Medicare Home Care 98

Sheppard Health Law

FEBRUARY 12, 2024

HRSN Initiatives : In the interest of increasing the accessibility and quality of care to address HRSN, the Demonstration Amendment seeks to improve integration between primary care providers and community-based organizations. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2

Medicaid 52

Medicaid Primary Care Hospitals Integration 52

HIT Consultant

OCTOBER 18, 2023

What You Should Know: – Waymark , a San Francisco, CA-based Medicaid provider enablement company raises $42M in new financing to scale technology-enabled, community-based care for primary care providers and their patients enrolled in Medicaid programs.

Medicaid 52

Medicaid Primary Care Quality of Care Hospitals 52

Home Health Care

NOVEMBER 15, 2024

It would also require the Secretary of Health and Human Services to move to establish national quality standards of care for these services. The care provided by continuous skilled nursing allows patients to remain at home while getting the care they need,” Hassan said in an April press release.

Nursing 119

Nursing Quality Improvement Home Care Medicaid 119

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? The post How We Help Medicaid & Long-Term Services and Supports appeared first on NCQA.

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

NASHP

APRIL 20, 2023

State Medicaid agencies are taking proactive steps to ensure quality of care and access to behavioral health services. After New Hampshire determines how much of the withheld funds MCOs earn in a category, the Medicaid agency uses any unearned funds to create an incentive pool for that category.

Medicaid 96

Medicaid Quality Improvement Quality of Care Integration 96

NASHP

MARCH 14, 2022

Strengthening Care for People with Serious Illness Seven Steps for Building a Community-Based Palliative Care Benefit Within Medicaid. People with complex or life-threatening conditions often need extra support to manage symptoms and make critical decisions about their care and quality of life. March 14, 2022.

Medicaid 94

Medicaid Rehabilitation Quality Assurance Patient Experience 94

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. California does cover skilled nursing facility care in its MLTSS program, but most personal care services (in-home supportive services) are provided under FFS.

Medicaid 75

Medicaid Nursing Medicare Integration 75

Sheppard Health Law

NOVEMBER 15, 2021

The report stems from a survey of Medicaid directors from 37 states and relevant stakeholder interviews, providing insight into states’ telehealth oversight efforts as of January and February 2020, before the expansion of telehealth due to the COVID-19 pandemic.

Medicaid 52

Medicaid Quality of Care Medicare 52

NASHP

OCTOBER 22, 2021

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Comprehensive care coordination. billion on chronic obstructive pulmonary disease (COPD) per year. Assessment and management of pain and other symptoms.

Medicaid 102

Medicaid Hospice Care Regulations Integration 102

p3care

MAY 31, 2024

Performance Improvement ACOs do not restrict themselves to certain defined goals instead, they take a holistic approach focusing on overall patient outcomes, cost efficiency, and quality of care. This becomes a specific reason for comprehensible improvements in patient care.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

Home Health Care

OCTOBER 2, 2024

When this verified visit data is collected and analyzed, states can use it to help identify and reduce Medicaid fraud, which drains resources from the system and hinders care delivery to those in need. Medicaid-funded personal care services were required to comply with EVV statutes by Jan.

Home Care 112

Home Care Medicaid Quality of Care Prevention 112

NASHP

MAY 17, 2022

How State Medicaid Programs Serve Children and Youth in Foster Care May 17, 2022 / Veronnica Thompson. Children and youth in foster care (CYFC) often benefit from targeted services and supports. Yet, many receive fragmented or limited access to care, contributing to higher rates of unmet health needs. [1]

Medicaid 64

Medicaid Integration Medicare Primary Care 64

Healthcare It News

JANUARY 10, 2023

The virtual care services will be delivered without copays, out-of-pocket costs or deductibles for families with active insurance or Medicaid coverage. WHY IT MATTERS. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org.

Primary Care 274

Primary Care Quality of Care Telemedicine Prevention 274

Briggs Healthcare

MAY 30, 2023

acute care hospital, long-term acute care hospital [LTAC], skilled nursing facility [SNF], inpatient rehabilitation facility [IRF]) to their home (e.g., The proposed Discharge to Home concept is distinct from existing rebalancing measures, as its sole focus is on home discharge as a signal of quality.

Medicaid 40

Medicaid Rehabilitation Quality Improvement Quality of Care 40

Briggs Healthcare

FEBRUARY 9, 2022

The Medicare and Medicaid certification of providers and suppliers in a State whose oversight process is substantially deficient may be jeopardized if CMS cannot ensure that the regulatory minimum health and safety standards have been met.

Medicaid 52

Medicaid Medicare Regulations Quality of Care 52

Home Health Care

JUNE 17, 2024

This article is a part of your HHCN+ Membership The Medicaid Access Rule has been heralded by home care providers as a mostly good rule with one misguided piece: the 80-20 provision. Billing rates have already soared in private-pay home care since the COVID-19 pandemic, which has forced providers to get creative.

Home Care 115

Home Care Medicaid Medicare Quality of Care 115

NCQA

NOVEMBER 15, 2024

About Health Plan Ratings and Public Comment NCQA’s Health Plan Ratings evaluate the quality of care provided by commercial, Medicare Advantage and Medicaid health plans. NCQA seeks comments on proposed measure changes for: 2025 Health Plan Ratings, using results from HEDIS Measurement Year 2024.

Quality Assurance 52

Quality Assurance Medicaid Medicare Quality of Care 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 86

Medicaid Quality Improvement Integration Population Health 86

Sheppard Health Law

OCTOBER 27, 2022

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program.

Medicaid 96

Medicaid Nursing Medicare Quality of Care 96

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

Home Health Care

OCTOBER 27, 2023

Centers for Medicare & Medicaid Services (CMS) that evaluated the first six years of HHVBP before the national expansion at the beginning of 2023. The HHVBP Model was implemented to incentivize home health agencies to improve the quality of care they provide to Medicare beneficiaries.

Medicare 113

Medicare Quality of Care Nursing Medicaid 113

HIT Consultant

SEPTEMBER 24, 2024

What You Should Know: – Wider Circle , which builds peer-driven communities nationwide to help people improve their health and quality of life through trusted connections, announced a partnership with CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst CHPMD).

Medicare 52

Medicare Medicaid Primary Care Prevention 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

Readiness Rounds

DECEMBER 4, 2024

One of the most transformative changes ahead is the CMS 2025 Age-Friendly Measures, introduced by the Centers for Medicare & Medicaid Services. These forward-thinking guidelines are set to redefine care for older adults, emphasizing streamlined data collection, enhanced reporting, and performance improvement strategies.

Quality Improvement 52

Quality Improvement Physical Therapy Integration Hospitals 52

HIT Consultant

FEBRUARY 9, 2023

Czekai, MPH, VP of Strategic Partnerships at Cohere Health The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients. Electronic PA is surely a good starting point, but it is not enough.

Medicaid 98

Medicaid Medicare Quality of Care Patient Experience 98

Home Health Care

OCTOBER 4, 2022

If the home health payment rule for 2023 is finalized by the Centers for Medicare & Medicaid Services (CMS) as proposed, it will likely affect quality of care. This article is a part of your HHCN+ Membership. There are a few reasons why. . Sign up for HHCN + to read this exclusive content.

Quality of Care 98

Quality of Care Medicaid Medicare 98

Home Health Care

OCTOBER 28, 2024

Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS) for sicker enrollees. This helps ensure that plans receive sufficient payments to cover increased care costs and that enrollees have access to plans.

Medicare 111

Medicare Medicaid Quality of Care 111

Home Health Care

SEPTEMBER 18, 2024

Still, that experience as a patient inspired my passion for home care and shaped our mission to deliver the highest quality of care to families in the region. Some of this care will be paid for through Medicaid or privately by families, but funding for home care is a pressing issue that needs to be addressed.

Home Care 98

Home Care Quality of Care Hospice Care Medicare 98

HIT Consultant

SEPTEMBER 27, 2024

This wide gap indicates substantial variability in perceived quality of care and ease of access. – Convenience and Barriers: Patients primarily choose telehealth for convenience (65%), quick access to care (46%), and coverage for their condition (30%).

Quality of Care 105

Quality of Care Doctors Patient Experience Medicaid 105