Accountability, Accountable Care, Primary Care and Regulations

Thinking Ahead on the AHEAD Model: Primary Care AHEAD

NASHP

MAY 10, 2024

This blog post summarizes both the Primary Care AHEAD requirements identified by CMS and additional strategic considerations for states. Primary Care AHEAD Overview and Requirements Primary Care AHEAD is a key component of the AHEAD Model. A core aspect is a focus on alignment between payers.

Primary Care

Primary Care Medicaid Medicare Hospitals

How CMS’ Goal To Enroll All Medicare Beneficiaries In ACOs Could Impact Home-Based Care Providers

Home Health Care

NOVEMBER 7, 2023

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. Medicare Shared Savings Program (MSSP) ACOs are an opportunity for home-based care providers to enter the space. Currently, roughly 13.2

Medicare

Medicare Accountable Care Home Care Accountability

In Rapidly Changing Value-Based Care Landscape, Home-Based Care Providers Facing Crunchtime

Home Health Care

FEBRUARY 8, 2024

This article is a part of your HHCN+ Membership Home-based care providers avoiding the shift to value-based care are running out of time and excuses. Home health providers are already under the Home Health Value-Based Purchasing (HHVBP) Model, which is, by definition, a value-based care model.

Medicare

Medicare Accountable Care Accountability Primary Care

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Updates and FAQs: Developing and Implementing a Medicaid State Plan Amendment to Authorize Community Health Worker Reimbursement

NASHP

AUGUST 5, 2024

Authority refers to the section of Medicaid regulations that the state used for the SPA. Eligible primary care practices must engage CHWs starting in 2024. The Massachusetts primary care sub-capitation model was launched in 2023 by MassHealth (Medicaid) as part of its broader ACO system.

Medicaid

Medicaid Primary Care Prevention Accountability

State Community Health Worker Models

NASHP

DECEMBER 10, 2021

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. RAE Regional Accountable Entity. Acronym Guide. APM Alternative Payment Model. CBO Community Based Organization.

Medicaid

Medicaid Primary Care Prevention Nursing

National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

OCTOBER 20, 2022

High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices. Yet, states often face barriers to integrated care including a lack of trust across agencies, privacy regulations that may hinder data sharing, and misaligned eligibility, enrollment, and referral systems.

Medicaid

Medicaid Integration Accountability Quality Improvement

Community Health Worker Models

NASHP

NOVEMBER 29, 2021

The Department of Health Care Policy and Financing (the Medicaid program administrator) does not specifically require the Regional Accountable Entities (RAEs), care coordinating entities contracted with Colorado’s Medicaid program, or other managed care entities to cover CHW services, nor does the Department pay for CHW services under FFS.

Medicaid

Medicaid Primary Care Prevention Nursing

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

Will Vertical Integration Kill the Primary Care Practice?

Health Blawg

APRIL 8, 2018

The Humana-Kindred deal, the existing United Health Care conglomerate with insurer and provider services, and other providers under the payor umbrella, are further exemplars of this approach — becoming “ payviders ,” to cite the neologism favored by one of my recent podcast guests.

Primary Care

Primary Care Integration Urgent Care Pharmaceuticals

COVID-19 Lessons: A Path to a Better Health Care System

Accountable Care Doctors

OCTOBER 21, 2020

The COVID-19 pandemic has upended health care in America, and as of this writing, is still raging on. A quick snapshot reveals how decades-long investments by CAPP groups to better integrate their care delivery systems is paying off. Continue to encourage the migration of care from the health care campus to the home.

Primary Care

Primary Care Integration Remote Care Population Health

Health Care Quality Digest

Thinking Ahead on the AHEAD Model: Primary Care AHEAD

How CMS’ Goal To Enroll All Medicare Beneficiaries In ACOs Could Impact Home-Based Care Providers

Webinars

Trending Sources

In Rapidly Changing Value-Based Care Landscape, Home-Based Care Providers Facing Crunchtime

Webinars

Updates and FAQs: Developing and Implementing a Medicaid State Plan Amendment to Authorize Community Health Worker Reimbursement

State Community Health Worker Models

National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

Community Health Worker Models

Will Vertical Integration Kill the Primary Care Practice?

Will Vertical Integration Kill the Primary Care Practice?

Will Vertical Integration Kill the Primary Care Practice?

Will Vertical Integration Kill the Primary Care Practice?

Will Vertical Integration Kill the Primary Care Practice?

Will Vertical Integration Kill the Primary Care Practice?

Will Vertical Integration Kill the Primary Care Practice?

COVID-19 Lessons: A Path to a Better Health Care System

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