HIT Consultant

SEPTEMBER 24, 2024

Using an actuarially validated model, Wider Circle has reduced plan attrition by 50%, decreased inpatient visits, and generated over $100 in monthly value per Medicare Advantage and Medicaid member. This approach helps healthcare partners reduce costs, enhance the quality of care, and foster sustainable health improvements.

Medicare 52

Medicare Medicaid Primary Care Prevention 52

HIT Consultant

JANUARY 25, 2024

What You Should Know: The Ohio State University Wexner Medical Center a nd CVS Accountable Care, part of CVS Health® (NYSE: CVS), today announced the creation of an accountable care organization (ACO) to improve the quality of care for Medicare beneficiaries by Ohio State providers in central Ohio.

Medicare 90

Medicare Accountable Care Accountability Quality of Care 90

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

HIT Consultant

JUNE 2, 2022

What You Should Know: – CareMax , a tech-enabled provider of value-based care to seniors announced an agreement to acquire the Medicare value-based care business of Steward Health Care System for a combination of cash and stock. – CareMax will pay $25 million in cash and issue 23.5

Medicare 95

Medicare Primary Care Quality of Care Accountability 95

HIT Consultant

NOVEMBER 21, 2023

a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year. What You Should Know: NextGen Healthcare, Inc.

Medicare 52

Medicare Population Health Accountable Care Quality of Care 52

Healthcare ECONOMIST

OCTOBER 24, 2022

That is the connection made between Medicare Advantage (MA) Star Ratings under the Quality Bonus Program (QBP) and Garrison Keillor well-known segment on the Prairie Home Companion in a recent paper by Teno and Ankuda (2022). The Affordable Care Act in 2010 mandated the creation of the 5-star rating system for MA plans.

Medicare 71

Medicare Quality of Care 71

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 136

Medicare Hospital IT Hospitals Patient Safety 136

HIT Consultant

JANUARY 2, 2024

Ed Park, CEO at Devoted Health What You Should Know: – Devoted Health , a leading provider of all-in-one healthcare for Medicare beneficiaries, has secured $175M in Series E funding, demonstrating continued investor confidence in its mission to revolutionize senior care.

Medicare 52

Medicare Quality of Care Integration Healthcare 52

HIT Consultant

APRIL 16, 2024

What You Should Know: – inVio Health Network and CVS Accountable Care Organization, a division of CVS Health , have announced a collaboration to participate in the new Medicare Accountable Care Organization (ACO) REACH program.

Accountable Care 52

Accountable Care Accountability Medicare Population Health 52

Home Health Care

NOVEMBER 7, 2021

Centers for Medicare & Medicaid Services (CMS) is that the model will now begin Jan. more room to breathe, Valerie Cornett, chief of strategy and innovation at MAC Legacy, told Home Health Care News. Broadly, HHVBP has many supporters among the home health industry due to its ability to boost quality scores and Medicare savings.

Medicare 105

Medicare Performance improvement Medicaid Quality of Care 105

Healthcare ECONOMIST

MARCH 7, 2022

Three management and culture capacity measures assessed learning and team culture (nine items), capacity for innovation (six items), and depression care management (six items) because effective depression care requires high practice orientation to learning and teamwork.15 Capabilities were then rescaled to range between 0 and 1.

Medicare 68

Medicare Quality of Care Prevention Hospitals 68

Home Health Care

AUGUST 4, 2023

Here is a look at three steps providers can take to improve their QAPI approach, fix their VBP scores and boost their Medicare payments. The post How to Improve Your VBP Scores and Boost Medicare Payments appeared first on Home Health Care News. But how will they do it?

Medicare 98

Medicare Performance improvement Quality Assurance Quality Improvement 98

Home Health Care

MARCH 28, 2022

Florida Blue Medicare — the state’s Blue Cross and Blue Shield Medicare plan — is collaborating with Emcara Health to offer eligible members access to home-based primary care. The collaboration reflects how payers are increasingly turning to in-home care organizations of all shapes and sizes.

Primary Care 98

Primary Care Medicare Home Care Nursing 98

Briggs Healthcare

JULY 25, 2023

In addition, it covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries, including Part D. In addition, it covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries, including Part D. This Data Book is packed with information and charts.

Medicare 52

Medicare Ambulatory Care Rehabilitation Quality of Care 52

Home Health Care

NOVEMBER 7, 2024

On Thursday, CEO Barb Jacobsmeyer said the company would be closing or consolidating certain locations that are underperforming, specifically when it comes to traditional Medicare business in home health care. When Enhabit spun off of Encompass Health (NYSE: EHC), its home health revenue mix was dominated by traditional Medicare.

Medicare 110

Medicare Quality of Care Medicaid Hospitals 110

Home Health Care

OCTOBER 27, 2023

In the first six years of the Home Health Value‐Based Purchasing (HHVBP) Model demonstration, the nine participating states saved Medicare $1.38 Centers for Medicare & Medicaid Services (CMS) that evaluated the first six years of HHVBP before the national expansion at the beginning of 2023. billion, a 1.9%

Medicare 113

Medicare Quality of Care Nursing Medicaid 113

Briggs Healthcare

JUNE 21, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The Medicare Payment Advisory Commission (MedPAC) has released its June 2023 Report to the Congress: Medicare and the Health Care Delivery System. You may go to our website at www.medpac.gov to view the 10 chapters of the report, or follow the links below.

Medicare 52

Medicare Rehabilitation Accountability Quality of Care 52

Healthcare It News

JANUARY 10, 2023

The Connecticut Children's Care Network, with 37 independent pediatric practices and more than 200 pediatric primary care providers in Connecticut and Massachusetts, has a mission to improve the quality of care and health outcomes for infants, children and adolescents. Email: afox@himss.org.

Primary Care 274

Primary Care Quality of Care Telemedicine Prevention 274

Healthcare ECONOMIST

AUGUST 23, 2021

In 2008, the Centers for Medicare & Medicaid Services (CMS) implemented the Hospital-Acquired Conditions Present on Admission (HAC-POA) program. The goal of this program was to reduce the frequency of high-cost complications among Medicare beneficiaries.

Medicare 74

Medicare Hospitals Medicaid Quality of Care 74

Home Health Care

AUGUST 7, 2024

NYSE: EHAB) has decided to walk away from certain Medicare Advantage (MA) payers – and namely UnitedHealth Group’s (NYSE: UNH) UnitedHealthcare. Specifically, Enhabit President and CEO Barb Jacobsmeyer expressed the company’s support for the Preserving Access to Home Health Care Act , which would help stop payment cuts. “Our

Medicare 116

Medicare Quality of Care Home Care Healthcare 116

Home Health Care

SEPTEMBER 3, 2022

Seniors on Medicare Advantage health plans may not always be receiving high quality care, a new study shows. The study’s authors concluded that paying higher premiums is not always necessary when seniors are trying to receive high quality care from an MA plan.

Medicare 119

Medicare Quality of Care Accountability Medicaid 119

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.

Quality of Care 246

Quality of Care Medicare Quality Improvement Medicaid 246

Home Health Care

AUGUST 8, 2024

NYSE: EHAB) CEO Barb Jacobsmeyer said Wednesday that the company would terminate its contract with the country’s largest Medicare Advantage (MA) payer , UnitedHealth Group’s (NYSE UNH) UnitedHealthcare. When it spun off of Encompass Health (NYSE: EHC), close to 80% of its business was tied to traditional Medicare.

Medicare 111

Medicare Quality of Care Accountability Nursing 111

Home Health Care

JULY 17, 2024

. – Just 33% of respondents reported that “the majority” of their members are discharged to “high-performing” post-acute care facilities. – 43% of respondents expressed “moderate confidence” that their members receive the appropriate level of care post-discharge. Currently, over half of Medicare beneficiaries are under an MA plan.

Medicare 111

Medicare Quality of Care Integration Hospitals 111

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

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

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

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

p3care

FEBRUARY 10, 2021

From the next performance year (2021), Accountable Care Organizations (ACOs) expect different reporting requirements under the Medicare Shared Savings Program. CMS (Centers for Medicare and Medicaid Services) has recommended changes for ACO reporting criteria. Compact MIPS Quality Measure Set. Quality of Care by ACOs.

Medicare 246

Medicare Accountable Care Accountability Medicaid 246

Home Health Care

OCTOBER 11, 2024

That was the one-word response a home health provider left for the Centers for Medicare & Medicaid Services’ (CMS) during the comment period on the 2025 home health proposed payment rule. The result of amputation resulted in significantly higher expense to Medicare than paying for adequate wound care wound cost.

Medicare 111

Medicare Nursing Hospitals Regulations 111

p3care

JULY 2, 2023

Centers for Medicare & Medicaid Services (CMS) Promoting Interoperability (PI) Programs Merit-based Incentive Payment System (MIPS) Third-party ONC-Authorized Certification Bodies (ONC-ACBs) ONC-ACBs are authorized by the ONC to evaluate health IT solutions. Afterward, they implement strategies to enhance the quality of care they deliver.

Performance improvement 237

Performance improvement Healthcare Providers Quality of Care Integration 237

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

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

HIT Consultant

APRIL 1, 2024

Improperly billed for services: The government alleges that TRG billed Medicare for radiology services performed by a radiologist located in the UK, which violates program regulations. The allegations against TRG raise concerns about the quality of care patients may have received and the potential misuse of federal healthcare funds.

Quality of Care 97

Quality of Care Regulations Federal Healthcare Healthcare Providers 97

Meditech

MAY 26, 2022

Hospital patient experience surveys, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), measure the quality of care given by a hospital, which influences patient satisfaction and retention.

Patient Experience 104

Patient Experience Quality of Care Medicare Hospitals 104

Home Health Care

JUNE 14, 2024

A group of bipartisan lawmakers this week reintroduced legislation aimed at curtailing restrictive – and often flawed – prior-authorization processes within Medicare Advantage (MA). As it has been to most other parts of health care, prior authorization has long been problematic for home health providers and patients.

Medicare 111

Medicare Hospitals Quality of Care Medicaid 111

Home Health Care

MARCH 16, 2023

Back in January, the Medicare Payment Advisory Commission (MedPAC) voted unanimously to recommend a 7% payment cut for home health agencies in 2024. Broadly, the report covers Medicare payment policy, including the Medicare fee-for-service payment systems for home health care. in 2020 and 15.4% This was a historic high.

Medicare 105

Medicare Quality of Care Hospitals 105