Healthcare Leadership Council

MAY 25, 2022

Crippen, former director of the Congressional Budget Office and currently a Healthcare Leaddership Council consultant, that should be a catalyst for discussion on a critical element of the Center for Medicare and Medicaid Innovation’s future direction.

Medicare 75

Medicare Medicaid Accountable Care Quality Improvement 75

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

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

Healthcare It News

FEBRUARY 2, 2023

This system allows the creation of Medicare-compliant GP management plans and team care arrangements, which can be automatically shared with the care team.

Primary Care 201

Primary Care Quality Improvement Prevention Medicare 201

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

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

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

p3care

DECEMBER 10, 2020

MACRA MIPS (The Medicare Access and CHIP Reauthorization Act of 2015 – Merit-based Incentive Payment System) is a program that caters to physician finances under Medicare. Not only that, but it determines the quality of care within hospitals, practices, and clinics should meet certain standards. Key Elements of QPP MIPS.

Quality of Care 246

Quality of Care Medicare Quality Improvement Medicaid 246

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

Healthcare It News

OCTOBER 19, 2022

The new company will be led by CEO Dave Kerwar, who has previously served as chief product officer at Mount Sinai Health System, where he developed IT-driven direct-to-consumer, direct-to-employer and population health programs focused on quality improvement and cost efficiencies. ON THE RECORD.

Hospitals 314

Hospitals Home Care Population Health Quality Improvement 314

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 76

Medicare Quality Improvement Quality of Care Patient Experience 76

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

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

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

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

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 58

Hospitals Quality Improvement Quality of Care Medicare 58

Briggs Healthcare

SEPTEMBER 15, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The original Home Health Value‐Based Purchasing (HHVBP) Model provided financial incentives to home health agencies for quality improvement based on their performance relative to other agencies in their state.

Medicare 52

Medicare Quality Improvement Quality of Care Healthcare 52

Briggs Healthcare

MAY 9, 2023

During the virtual conference, which attracted 10,000 attendees, CMS released a National Quality Strategy (NQS) handout , which outlines the goals and objectives, and actions taken within the NQS’s four priority areas: equity and engagement; outcomes and alignment; safety and resiliency, and interoperability and scientific advancement.

Quality Improvement 52

Quality Improvement Medicaid Medicare Hospitals 52

Briggs Healthcare

FEBRUARY 24, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The 2023 CMS Quality Conference, brought to you by the Centers for Medicare & Medicaid Services, is the premier health care quality conference focused on improving quality, equity, and innovation. Register here.

Quality Improvement 52

Quality Improvement Medicaid Medicare Healthcare 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. 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

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.

Quality Improvement 98

Quality Improvement Medicare Medicaid Healthcare 98

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

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 96

Quality Improvement Medicaid Population Health Medicare 96

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

HIT Consultant

MARCH 12, 2024

Value-based care focuses on rewarding quality outcomes over treatment volume, aiming to improve patient care and reduce costs. PQS: A Leader in Pharmacy Quality Improvement PQS plays a vital role in connecting healthcare payers and providers.

Patient Safety 52

Patient Safety Quality Improvement Medicare Healthcare 52

NCQA

OCTOBER 31, 2023

“ It’s a marathon, not a sprint ,” said Liz Fowler, Director at the Center of Medicare and Medicaid Innovation (CMMI), during a recent Fireside Chat with NCQA Executive Vice President Eric Schneider. And then we’re also developing an approach for certification based on quality improvement and patient experience.”

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

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 92

Medicare Quality Improvement Integration 92

Briggs Healthcare

SEPTEMBER 18, 2023

CMS will release the Health Equity Confidential Feedback Reports through the Internet Quality Improvement & Evaluation System (iQIES) reports folders. The PAC Health Equity Confidential Feedback Reports will stratify the DTC and MSPB measures by dual-enrollment status and race/ethnicity.

Rehabilitation 40

Rehabilitation Quality Improvement Medicare Medicaid 40

NCQA

NOVEMBER 22, 2024

The use of clinical data to measure health care quality in close to real-time creates new value for health plans, including: More complete, accurate and generally higher quality rates. Improved ability to drive meaningful quality improvement programs with better data. Reduced costs of quality measurement.

Quality Improvement 59

Quality Improvement Quality Leadership Measurable Quality Integration 59

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

Briggs Healthcare

MARCH 8, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The Centers for Medicaid and Medicare Services (CMS) is migrating MDS submissions and reporting to a new system, the internet Quality Improvement and Evaluation System (iQIES) beginning April 17, 2023.

Quality Improvement 40

Quality Improvement Nursing Medicaid Medicare 40

HIT Consultant

APRIL 26, 2023

About the Race and Ethnicity Stratification Learning Network The Race and Ethnicity Stratification Learning Network was convened in late-2022 to develop a greater understanding and resources to support the stratification of quality performance data and use of stratified data to advance health equity.

Quality Assurance 52

Quality Assurance Quality Improvement Medicaid Medicare 52

Briggs Healthcare

APRIL 12, 2023

The updated CMS 855A form must be sent by the Medicare Administrative Contractors (MACs) to the appropriate State Agency rather than to the CMS Location. Additionally, these same demographic data are displayed on the public reporting websites such as the Provider Data Catalog (PDC).

Rehabilitation 52

Rehabilitation Quality Improvement Nursing Medicare 52

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

Briggs Healthcare

AUGUST 9, 2023

Contacts and Additional Resources The PSR is available to download in Microsoft Excel format from the Internet Quality Improvement and Evaluation System (iQIES). Overview 2. Background 3. PSR File Contents and Descriptions 4. Section I.B of this guide provides instructions on how to access your facility’s PSR in iQIES.

Quality Improvement 40

Quality Improvement Nursing Medicare Medicaid 40

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 258

Digital Care Physical Therapy Patient Experience Remote Care 258