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

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

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

Cloud Blogs

FEBRUARY 28, 2022

Today, regulatory and market forces have led to improved transparency and enhanced consumerization, changing the face of healthcare. These shifting priorities have catalyzed the desire to track patient outcomes and cost-savings for improved quality of care.

Integration 127

Integration Healthcare Quality of Care Regulations 127

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

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

HIT Consultant

MARCH 17, 2024

Jay Ackerman, CEO, Reveleer The momentum of value-based care (VBC) is poised to accelerate. 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.

Quality Improvement 64

Quality Improvement Medicare Quality of Care Regulations 64

NCQA

JULY 16, 2024

Despite ongoing challenges such as workforce limitations and federal support for staffing, Medicaid programs have made strides in improving access and quality of behavioral health services. Peggy emphasized that without standardized measures, states miss the opportunity for benchmarking, mutual learning and driving quality improvement.

Medicaid 86

Medicaid Quality Improvement Integration Population Health 86

Briggs Healthcare

AUGUST 22, 2022

The American Academy of Hospice and Palliative Medicine (AAHPM) developed this implementation guide to help palliative care teams implement and collect data for two patient-reported outcome performance measures (PROPMs) for quality improvement (QI) and regulatory reporting efforts. Description of the Measures.

Patient Experience 52

Patient Experience Quality Improvement Medicare Quality of Care 52

NASHP

MARCH 22, 2024

All states, with the exception of California and Virginia, have created at least one separate MLTSS program targeted toward adults 65 and older or individuals dually eligible for Medicare and Medicaid (dual eligibles). utilization review, quality improvement, and claims) to improve communication and information sharing across teams.

Medicaid 75

Medicaid Nursing Medicare Integration 75

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. Cleamon Moorer Jr.,

Home Care 98

Home Care Medicaid Accountability Quality Improvement 98

Cloud Blogs

FEBRUARY 28, 2022

Today, regulatory and market forces have led to improved transparency and enhanced consumerization, changing the face of healthcare. These shifting priorities have catalyzed the desire to track patient outcomes and cost-savings for improved quality of care.

Integration 73

Integration Healthcare Quality of Care Regulations 73

Briggs Healthcare

MARCH 9, 2023

On May 16, 2022, HHS announced the funding opportunity of nearly $15 million for a three-year federal grant to establish a Substance Abuse and Mental Health Services Administration (SAMHSA) program that will strengthen the delivery of behavioral health care to residents of nursing homes and other long-term care facilities.

Nursing 52

Nursing Prevention Performance improvement Medicaid 52

Lexis Nexis

JUNE 30, 2022

The federal government is preparing to implement more rigorous benchmarks for health plan quality ratings based increasingly on how members perceive their interactions with the healthcare system. Consider the highly competitive Medicare Advantage space. Quality varies from member to member. to meet their own needs.

Quality of Care 52

Quality of Care Medicare Quality Improvement Medicaid 52

Briggs Healthcare

MARCH 20, 2023

and Jonathan Blum, Centers for Medicare & Medicaid Services – names you may recognize from CMS National Stakeholder Calls. As the nation’s largest payer for health care, the Centers for Medicare & Medicaid Services’ (CMS) mission in our National Quality Strategy includes ensuring everyone is safe when they receive care.

Patient Safety 40

Patient Safety Medicaid Medicare Quality of Care 40

NASHP

OCTOBER 20, 2022

Federal agencies have also prioritized and supported advancing integrated care. For example, the Centers for Medicare & Medicaid Services Innovation Center is currently supporting the Integrated Care for Kids (InCK) model across seven sites in six states. Assessing existing strategies, capacity, and gaps.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

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 concept is intended for use at the state level, with the goal of providing data to facilitate quality improvement and planning on HCBS placement of inpatient facility discharges.

Medicaid 40

Medicaid Rehabilitation Quality Improvement Quality of Care 40

HIT Consultant

OCTOBER 26, 2021

As patients move from the acute to post-acute care setting, they are often discharged without the proper tools to successfully support their transition of care. In fact, 57% of Medicare patients are released from the hospital without any post-discharge monitoring. Another benefit of RPM?

Remote Care 52

Remote Care Healthcare Doctors Primary Care 52

NASHP

JUNE 22, 2023

paid for by Medicaid, there is growing interest in exploring how Medicaid service delivery systems can be adapted to help improve maternal health outcomes.[5] 6] VBPs, or alternative payment models, focus on reimbursement based on the quality of care provided as well as rewarding lower cost. Accessed May 1, 2023.

Medicaid 59

Medicaid Prevention Accountability Medicare 59

NASHP

AUGUST 23, 2021

Lack of Access to Specialists Associated with Mortality and Preventable Hospitalizations of Rural Medicare Beneficiaries.” Health Care Access in Rural Areas: Evidence that Hospitalization for Ambulatory Care-Sensitive Conditions in the United States May Increase with the Level Of Rurality.” iv] Johnston, K. Wen, and K.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

NASHP

AUGUST 31, 2023

Recent hub priorities include addressing maternal health outcome disparities, improving access to cancer screening and treatment, and preventing tobacco use, among other focus areas. The Alzheimer’s dashboard projects Alzheimer-related Medicare claims through 2040.

Medicaid 52

Medicaid Accountability Public Health services Population Health 52

NASHP

MARCH 22, 2024

North Carolina’s comprehensive behavioral health approach included efforts to increase uptake of CoCM through additional training and practice supports and Medicaid rate increases to 120% of Medicare rates for behavioral health providers. An action plan dashboard tracks targets. CMS’s Birth to 5: Watch Me Thrive!

Medicaid 52

Medicaid Integration Primary Care Nursing 52

NASHP

MARCH 29, 2024

5 Compared to white, non-Hispanic CYSHCN, CYSHCN who are Black or Latinx are at particular risk of receiving infrequent, low-quality care, 6 while American Indian and Alaska Native CYSHCN are less likely to be able to access specialty treatment or receive culturally sensitive services. 25] Centers for Medicare and Medicaid Services.

Medicaid 124

Medicaid Quality of Care Quality Assurance Nursing 124

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

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. Monitor and evaluate quality improvement and outcomes and address barriers to care. Implement Medicaid benefit.

Medicaid 59

Medicaid Nursing Hospitals Regulations 59

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”). The UM committee was established in April 2023 in the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F).

Medicare 59

Medicare Medicaid Regulations Integration 59

HIT Consultant

JANUARY 22, 2024

What You Should Know: – The Centers for Medicare & Medicaid Services (CMS) has taken a bold step towards improving care for individuals with both mental health conditions and substance use disorders (SUD), announcing the “ Innovation in Behavioral Health (IBH)” Model.

Medicaid 97

Medicaid Quality of Care Integration Medicare 97

Briggs Healthcare

OCTOBER 25, 2022

Today’s announcement is part of a series of new actions the Biden-Harris Administration is taking to increase accountability of bad actors in the nursing home industry, improve the quality of nursing homes and make them safer. and face increasingly severe enforcement actions if improvement is not demonstrated.

Nursing 40

Nursing Accountability Quality Improvement Quality of Care 40

Briggs Healthcare

MARCH 1, 2022

million people live in over 15,500 Medicare- and Medicaid-certified nursing homes across the nation. Research also suggests that, despite depriving residents of quality care, private equity-owned nursing homes actually led to an uptick in Medicare costs , too. More than 1.4

Quality of Care 40

Quality of Care Nursing Accountability Medicaid 40