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

SEPTEMBER 12, 2022

Medicare Advantage (MA) plans are often a pain in home health providers’ sides. In fact, that’s the ethos behind Frontpoint: to be a home health agency that specifically caters to MA, and does not rely on Medicare fee for service as its main revenue source. We want to go after Medicare Advantage,” Korte said.

Medicare 98

Medicare Home Care Patient Experience Hospitals 98

NCQA

MARCH 25, 2025

NCQAs person-centered outcome (PCO) measures continue to attract the interest of the quality improvement community: The measures were recently recommended for inclusion in the Merit-Based Incentive Payment System (MIPS) for Medicare. CMS will release the final list of measures in July.) Why Are PCO Measures Important?

Medicare 52

Medicare Primary Care Process improvement Quality Improvement 52

Briggs Healthcare

AUGUST 16, 2022

The Centers for Medicare and Medicaid Services (CMS) permits states to direct collected civil money penalty funds for quality improvement projects that enhance the quality of care and the quality of life for NF residents. Grant applications are available to stakeholders such as. academic institutions. .

Quality Improvement 52

Quality Improvement Medicaid Quality of Care Medicare 52

HIT Consultant

MARCH 12, 2025

an Healthcare AI company unveiled its 360-Degree Gap Closure Solution for Payers , a comprehensive platform designed to revolutionize risk adjustment and quality improvement for health plans. What You Should Know: – Innovaccer Inc.,

Quality Improvement 52

Quality Improvement Medicaid Integration Medicare 52

NCQA

NOVEMBER 6, 2024

Defining a person’s goals—and ensuring that the care provided is consistent with those goals—can reduce unwanted care and lead to meaningful improvement. Person-centered outcome measures are a standardized, transparent and flexible approach that can be used for quality improvement and value-based payment,” says Lawton.

Primary Care 59

Primary Care Medicare Quality Improvement Medicaid 59

Home Health Care

JULY 14, 2023

Centers for Medicare & Medicaid Services (CMS) published its home health proposed payment rule for 2024. This rewards agencies that have not invested in quality improvement programs, penalizes those that have, and makes it harder to set goals, measure progress and make any needed course corrections. —

Medicare 98

Medicare Home Care Rehabilitation Medicaid 98

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 306

Digital Care Physical Therapy Patient Experience Remote Care 306

p3care

MAY 31, 2024

It does not restrict itself to temporary or timely reporting only but fosters continuous quality improvement. Regulatory Compliance ACOS must adhere to rules set forth by government bodies such as CMS (Centers for Medicare and Medicaid Services). million people in 2024 along with Traditional Medicare associated with an ACO.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

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 305

Primary Care Health Data Hospitals Doctors 305

p3care

MAY 14, 2023

Rather, they are looking for opportunities to implement meaningful quality improvement activities. Are you ready to showcase your devotion to taking quality care to the next level? MIPS 2023 gives you the right direction to get engaged in quality improvement activities.

Quality Improvement 130

Quality Improvement Population Health Medicare Healthcare 130

Home Health Care

MAY 19, 2022

Medicare Advantage [plans] can see all of that information.”. 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. “If we do well under HHVBP, that should help prove the value of home health care,” one executive recently told me.

Medicare 111

Medicare Regulations Quality Improvement Quality of Care 111

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. In no way are these adjustments consistent with logic or the Medicare law on budget neutrality in the transition from the 2019 payment model to PDGM in 2020.

Medicare 105

Medicare Medicaid Quality Improvement Accountability 105

NCQA

APRIL 7, 2025

OKane also reflected on 35 years of quality improvement at NCQA, and announced her new Quality Talks podcast before joining Dr. Meena Seshamani, incoming Secretary of the Department of Health for Maryland, for a Fireside Chat about the future of health care quality. Be honest and transparent.

Prevention 52

Prevention Accountability Primary Care Quality Improvement 52

HIT Consultant

DECEMBER 20, 2022

Carallel already supports more than 400,000 Medicare Advantage and commercially insured members and their caregivers nationally. The company plans to use the new funding to expand its reach in both the Medicare Advantage and commercial markets. Adoption/Traction to Date. Reducing Stress in 90% of Caregivers.

Medicare 98

Medicare Quality Improvement Accountability Healthcare Providers 98

HIT Consultant

FEBRUARY 15, 2022

Given CMS’ recent decision to double the weight of experience-based quality measures used to calculate Medicare Advantage Star Ratings, harnessing the power of these two types of analytics applications together could become a key determinant of success in 2022 and beyond. Medicaid, Medicare Advantage). – Patient age.

Medicare 98

Medicare Quality Improvement Medicaid Healthcare 98

Healthcare ECONOMIST

OCTOBER 25, 2021

A white paper from Cannon and Pohida (2021) calls for applying “public option principles” to Medicare. The proposal should be called introducing a voucher system into Medicare. This is particularly true under Medicare. Who would have thought that the Cato Institute would call for a public option?

Medicare 96

Medicare Quality Improvement Integration 96

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

Home Health Care

FEBRUARY 20, 2024

Our missions, values and cultures are very similar – focused on employee and physician partnership, continuous quality improvement, and patient-centered care with a special concern for the poor and vulnerable. a Blue Cross Blue Shield insurer. The price tag was $3.7 In the deal, Health Care Service Corp.

Nursing 111

Nursing Medicare Quality Improvement Patient Experience 111

Healthcare ECONOMIST

JANUARY 27, 2023

First, they provide a nice overview of the program: The EOM is a voluntary 6-month, 2-sided, risk-based payment model for clinicians caring for Medicare patients with 7 common cancer types beginning on July 1, 2023, for 5 years. A New Approach to Cancer Bundled Payments in Medicare—The Enhancing Oncology Model. e224904-e224904).

Medicare 81

Medicare Quality Improvement Quality of Care Patient Experience 81

p3care

NOVEMBER 13, 2023

Overall, the new MIPS inventory has 106 improvement activities that have not been finalized yet. The title for this new IA is ‘“Practice-Wide Quality Improvement in MVPs’. Meanwhile, CMS has permanently removed 3 improvement activities, whereas 1 got a modification. CMS has a strategic reason behind this modification.

Medicare 130

Medicare Quality Improvement Hospitals Regulations 130

Healthcare ECONOMIST

APRIL 11, 2023

The authors begin with a nice summary of the disappointing results to date of hospital value-based purchasing in the US: Quality of care of German hospitals public reporting has led to modest improvements in health outcomes at best, ( Ryan et al. 2012 ) and improvement has been very slow. Levine et al. Papanicolas et al.

Hospitals 74

Hospitals Quality Improvement Quality of Care Medicare 74

Healthcare ECONOMIST

OCTOBER 4, 2021

MIPS is an approach for CMS to pay physicians caring for Medicare beneficiaries based not just on volume but on value. MIPS evaluates provider value along four dimensions: (1) quality, (2) improvement activities, (3) promoting interoperability, and (4) cost. How did Medicare physicians fare on the MIPS program?

Medicare 105

Medicare Quality Improvement Quality of Care Accountability 105

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

HIT Consultant

DECEMBER 15, 2022

In late September, the Senate Finance Committee released a bipartisan discussion draft bill that aims to address the nation’s crippling behavioral healthcare crisis by providing funding for 4,000 Medicare Graduate Medical Education psychiatry residencies over the next decade. She joined the Avel eCare team in 2019.

Telemedicine 98

Telemedicine Primary Care Remote Care Medicare 98

KHN

FEBRUARY 8, 2022

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.

Medicare 52

Medicare Hospital IT Hospitals Patient Safety 52

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.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

Home Health Care

DECEMBER 21, 2022

When Shara Cohen, Carallel’s CEO, joined the company in early 2021, the Centers for Medicare & Medicaid Services (CMS) had just introduced a supplemental benefit for caregiver support. Carallel currently works with over 400,000 Medicare Advantage and commercially insured members and caregivers across the country.

Medicare 97

Medicare Quality Improvement Home Care Medicaid 97

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 88

Quality Improvement Medicaid Medicare Population Health 88

p3care

MAY 2, 2022

MIPS (Merit-based Incentive Payment System) was launched by the Quality Payment Program (QPP) for the Medicare Part B healthcare providers. There are four categories in this category of QPP reporting , which are: Quality. Improvements Activities. Categories. Promoting Interoperability.

Nursing 130

Nursing Prevention Quality Improvement Regulations 130

Briggs Healthcare

MAY 4, 2023

CMS also restricts the use of algorithms such as InterQual, MCG, and similar products to equivalency with Medicare criteria, noting that these products cannot be used to change coverage criteria.

Medicare 40

Medicare Regulations Nursing Primary Care 40

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”). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule.

Medicare 52

Medicare Medicaid Accountability Integration 52

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

p3care

DECEMBER 6, 2021

MIPS (Merit-based Incentive Payment System) is a part of the Quality Payment Program (QPP), which came into effect in 2017. Its purpose was to move the Medicare part B providers to a performance-based payment system. Improvements Activities (IA). Categories. There are four categories in the MIPS program, which are.

Urgent Care 130

Urgent Care Healthcare Providers Medicare Quality Improvement 130

p3care

DECEMBER 6, 2021

MIPS (Merit-based Incentive Payment System) is a part of the Quality Payment Program (QPP), which came into effect in 2017. Its purpose was to move the Medicare part B providers to a performance-based payment system. Improvements Activities (IA). Categories. There are four categories in the MIPS program, which are.

Urgent Care 130

Urgent Care Healthcare Providers Medicare Quality Improvement 130

Home Health Care

MARCH 1, 2024

We refer to them as Medicare-only. I think one of the most important things that could happen to accelerate access to PACE would be to address some legislation that we have pending on Capitol Hill, relating to the Medicare Part D prescription drug premium. Traditionally, PACE cares for dual-eligible seniors in a given community. “We

Medicaid 124

Medicaid Medicare Primary Care Quality Improvement 124

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