Healthcare It News

JANUARY 4, 2022

Progress toward accountable care is halting. Jerry Shultz, president of Lightbeam Health, whose population health management platform helps risk-bearing organizations manage the cost and quality demands of value-based reimbursement, would like to see a wholesale effort to improve the care delivery system writ large.

Hospitals 354

Hospitals Nursing Accountable Care Clinical Practice 354

NASHP

MAY 10, 2024

See the first blog post in the series covering governance and the second blog post describing hospital global budgets. Medicaid is required to participate by performance year one, and CMS encourages commercial payer participation and Medicare Advantage alignment. A core aspect is a focus on alignment between payers.

Primary Care 52

Primary Care Medicaid Medicare Integration 52

NASHP

JANUARY 19, 2024

Applicant states must identify a lead agency, which may be the Medicaid, public health, state insurance, or other agency with rate setting or budget authority. States may submit a joint application, but a lead agency must be identified that is ultimately accountable for the model. Will the answer differ for model components?

Primary Care 59

Primary Care Medicaid Population Health Hospitals 59

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. Strategic Objective 1: Drive Accountable Care.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

HIT Consultant

SEPTEMBER 14, 2023

By one estimate, healthcare improvements accounted for one-third of the economic growth of developed nations over the last century. Achieving health equity presents an urgent challenge that demands attention from all stakeholders. However, actual medical care accounts for 20% or less of what affects population health.

Health Data 113

Health Data Accountability Telemedicine Population Health 113

NASHP

AUGUST 31, 2023

Figure 1 displays a consolidated overview of the “Framework for Public Health-Health Care System Collaboration.” State leaders play a critical role in convening key internal and external partners, implementing engagement and input processes that foster shared ownership and accountability toward goals at the state and community levels.

Medicaid 52

Medicaid Accountability Public Health services Population Health 52

HIT Consultant

JULY 13, 2022

Initially, Innovaccer will address three distinct use cases in the public sector: – Population Health: Health agencies are launching innovative programs using SDoH to better address the needs of underserved populations and move toward a whole-person care approach. Public Sector Offering Address 3 Use Cases.

Population Health 52

Population Health Medicaid Private Healthcare Quality of Care 52

NASHP

AUGUST 23, 2021

Primary care case management (PCCM) programs are one of the oldest types of Medicaid managed care, but over time most states have shifted to use managed care organizations (MCOs) to deliver services to Medicaid participants. million Medicaid participants.

Primary Care 64

Primary Care Medicaid Accountability Quality Improvement 64

Healthcare It News

AUGUST 7, 2023

The passing of the Telehealth Expansion Act of 2023 shows the federal government’s commitment to health equity, emphasizing the importance of increasing access to quality healthcare for all citizens, regardless of location or socioeconomic status. According to the U.S.

Primary Care 214

Primary Care Telemedicine Accountability Remote Care 214

HIT Consultant

MARCH 28, 2023

The High Cost of Poor Behavioral Healthcare A recent study indicates 10% of patients account for 70% of the nation’s costs and that more than half of these patients have a diagnosed mental health disorder. It’s a question that has significant implications for quality of care as well as cost.

Quality of Care 98

Quality of Care Population Health Hospitals Medicaid 98

NASHP

DECEMBER 10, 2021

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. MHP Medicaid Health Plans. NIH National Institutes of Health. integrating?CHWs

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

p3care

OCTOBER 30, 2020

CMS (The Centers for Medicare and Medicaid Services) released the proposed rule for QPP MIPS 2021 via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). It contains six measures that focus on population health. ACO (Accountable Care Organization) Reporting. Quality Category: Weighs 50%.

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

NASHP

JUNE 22, 2023

Medicaid covers more than 40 percent of births nationally. Given the critical role that Medicaid plays in maternal health, there is a longstanding interest in the role of Medicaid service delivery systems to improve perinatal health outcomes. All Medicaid beneficiaries served by the practice are included.

Medicaid 59

Medicaid Prevention Accountability Medicare 59

GoMoHealth

OCTOBER 20, 2022

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. Measurable ROI and Improved Outcomes from a Postnatal Medicaid Digital Therapeutic Program.

Quality Improvement 79

Quality Improvement Medicaid Population Health Medicare 79

HIT Consultant

MAY 3, 2022

Social drivers of health, which impact a disproportionate number of non-white Americans who live below the poverty line, account for as much as 90% of individuals’ health outcomes. One recent study of Arizona Medicaid plan members with severe mental illness, compounded by other co-occurring conditions, illustrates this.

Healthcare 52

Healthcare Medicaid Population Health Medicare 52

HIT Consultant

APRIL 20, 2022

The overarching goal of VBC is to improve the patient experience, improve population health, and reduce per capita health costs. As part of this VBC mode l, hospitals and health systems must store, track, and analyze a large amount of quality-related data for compliance and reimbursement purposes.

Integration 98

Integration Primary Care Telemedicine Patient Experience 98

HIT Consultant

SEPTEMBER 12, 2022

percent of total reimbursements were based on population-based payments. By any account, FFS still reigns, even if APMs are growing. CMS has announced ambitious plans for new population-based ACO Reach, and higher penalties for providers remaining on MIPS/Fee-for-Service. However, only 6.7

Population Health 52

Population Health Pharmaceuticals Medicaid Healthcare 52

HIT Consultant

FEBRUARY 3, 2022

Founded in 2015, ConcertoCare deploys physician-led interdisciplinary teams— supported by its proprietary population health platform, Patient3D®, and clinical decision support tools — to manage the country’s most medically and socially complex and costly patients in ways that keep them in their homes and out of the hospital.

Home Care 52

Home Care Primary Care Population Health Medicare 52

Health Populi

OCTOBER 8, 2019

Thus, administrative complexity, which includes billing and coding waste, and physician time spent reporting on quality measures, accounted for the largest component of waste in American health care. Pricing failure as a waste-factor accounted for nearly another third of total waste in U.S. health care. medical spending.

Pharmaceuticals 104

Pharmaceuticals Life Sciences Medicare Accountability 104

NASHP

OCTOBER 20, 2022

This substandard access to quality care can lead to poor health outcomes.[6]. have a special health care need, and an estimated 44 percent of CYSHCN are enrolled in Medicaid.[7] In June 2022, NASHP convened a national forum with state health officials (e.g., Nearly 20 percent of children in the U.S.

Medicaid 98

Medicaid Integration Quality Improvement Accountability 98

NASHP

NOVEMBER 29, 2021

Development and ongoing updates of the State Community Health Worker Models Map would not be possible without the generous support of the Robert Wood Johnson Foundation and the National Center for Healthy Housing. Medicaid Reimbursement. Medicaid Reimbursement.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

Home Health Care

AUGUST 29, 2023

Since the start of his career as a primary care, internal medicine physician, Dr. Richard Feifer has sat at the intersection of geriatrics, population health and value-based payment models. We enroll them, and then we receive capitated payments for Medicare and Medicaid. We need greater partnerships vertically.

Nursing 81

Nursing Integration Primary Care Home Care 81

NASHP

MAY 8, 2023

Transformation at the agency or whole government level can also include establishing organizational policies that address health disparities, systemic and shared accountability, designing culturally appropriate health care, and diversifying decision-makers. Many are changing how government and state partners do business.

Medicaid 52

Medicaid Accountability Integration Accountable Care 52