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Q&A: Using an Alternative Payment Model to Support Community Health Worker Sustainability in Maine’s Primary Care Plus Program

NASHP

As states are seeking sustainable financing models and partnerships that offer continued support for the CHW services beyond the COVID-19 pandemic, many are exploring Medicaid reimbursement models. The goal of the PCPlus initiative is to provide primary care practices with more flexibility in care delivery while reducing inefficiencies.

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Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Sheppard Health Law

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. Strategic Objective 1: Drive Accountable Care.

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State Community Health Worker Models

NASHP

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs ACO Accountable Care Organizations. CBCM Community Based Care Management Program. MHP Medicaid Health Plans.

Medicaid 122
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Community Health Worker Models

NASHP

Medicaid Reimbursement. Medicaid Reimbursement. Alabama does not reimburse for CHW services through its Medicaid program. Alaska Medicaid reimburses for CHW services through MCOs as authorized under the state plan. Arizona does not currently reimburse for CHW services through its Medicaid program.

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How State Medicaid Programs Serve Children and Youth in Foster Care

NASHP

How State Medicaid Programs Serve Children and Youth in Foster Care May 17, 2022 / Veronnica Thompson. Children and youth in foster care (CYFC) often benefit from targeted services and supports. Yet, many receive fragmented or limited access to care, contributing to higher rates of unmet health needs. [1]

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CMS Announces Strategy on Value-Based Payments for Specialty Care

Sheppard Health Law

The Centers for Medicare & Medicaid Services (CMS) Innovation Center continues to move forward with its “strategic refresh” initiative. Through this shift, CMS aims to examine and enhance payments for specialty care provided to Medicare beneficiaries. Value-Based Care and ACOs.

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What Hospital Success Looks Like Under Value-Based Care

HIT Consultant

With the right technology, providers can monitor patients across the continuum, identify when patients present to the ED, intervene in a timely manner, and reroute patients to a less costly level of care. As touched on above, post-acute care delivered in the SNF setting accounts for a significant portion of Medicare fee-for-service costs.