Accountability, Medicaid and Performance improvement

State Oversight and Innovations in Medicaid-Managed Long-Term Services and Supports (MLTSS) Serving Older Adults and People with Disabilities

NASHP

MARCH 22, 2024

States are increasingly turning to capitated Medicaid managed care programs to deliver long-term services and supports (LTSS) to individuals with complex needs. pdf On October 1, 2023, Virginia Medicaid combined its two managed care programs of Medallion 4.0

Medicaid

Medicaid Nursing Medicare Integration

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care

NASHP

OCTOBER 22, 2021

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Delivery system transformation: Leading states such as Minnesota have long used Medicaid MCO contracts to address the needs of complex populations and those with serious illness.

Medicaid

Medicaid Hospice Care Integration Regulations

States Build Capacity to Address Maternal Mortality through Policy Innovations

NASHP

SEPTEMBER 8, 2023

Over the past two years, the seven state teams that participated in the MCH PIP Policy Academy, comprised of officials from state Medicaid, public health, and other relevant agencies/groups (e.g., The state Medicaid agency is in the process of standing up this case management program based on input received during these sessions.

Medicaid

Medicaid Performance improvement Quality Improvement Accountable Care

Expanding the Perinatal Workforce through Medicaid Coverage of Doula and Midwifery Services

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

Medicaid

Medicaid Nursing Regulations Hospitals

First Do No Harm

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

Patient Safety Medicaid Medicare Quality of Care

States Advancing Equitable Maternal Health Policy Highlighted at #NASHPCONF22

NASHP

OCTOBER 27, 2022

States identified postpartum coverage, support for people with substance use disorder (SUD), Medicaid coverage of doula services, and payment policies as critical policy levers to address maternal mortality. As of October 2022, 26 states and Washington DC have extended Medicaid postpartum coverage to 12 months.

Medicaid

Medicaid Prevention Performance improvement Medicare

Final Rule Gives Home Health Agencies Breathing Room for HHVBP, Medicare Sequestration

Home Health Care

NOVEMBER 7, 2021

Centers for Medicare & Medicaid Services (CMS) is that the model will now begin Jan. BKD is a Springfield, Missouri-based accounting services firm that provides billing and revenue cycle outsourcing services. A significant difference between the finalized expansion of HHVBP and the original proposal from the U.S.

Medicare

Medicare Performance improvement Medicaid Quality of Care

Voices: Beth Ann Longo, Associate Director, Department of Research, The Joint Commission

Home Health Care

OCTOBER 28, 2022

Longo : There are nearly 11,000 home health agencies that report data to the Centers for Medicare and Medicaid Services. Longo : Focus on the structures, systems and processes that support quality and patient safety, performance improvement and link to health outcomes.

Patient Safety

Patient Safety Performance improvement Quality Improvement Accountability

How State Medicaid Programs Serve Children and Youth in Foster Care

NASHP

MAY 17, 2022

How State Medicaid Programs Serve Children and Youth in Foster Care May 17, 2022 / Veronnica Thompson. State Medicaid programs provide coverage of a variety of delivery models for CYFC. The specific structure and program features of a state’s Medicaid delivery system may affect how health care is provided to CYFC.

Medicaid

Medicaid Integration Medicare Primary Care

Opportunities for Aligning Prescription Drug Affordability Boards and Cost-Growth Benchmarks

NASHP

NOVEMBER 15, 2021

In states such as Massachusetts, there is also a threat of a targeted performance improvement plan for entities determined to be cost drivers. Engagement of Stakeholders: PDABs and cost-growth benchmarks create a forum for convening and holding accountable the stakeholders involved in the high costs of health care.

Accountability

Accountability Pharmaceuticals Performance improvement Hospitals

Primary Care Case Management in Medicaid: A Strategy for Supporting Primary Care in Rural Areas

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. The strategies discussed here were developed for PCCM programs.

Primary Care

Primary Care Medicaid Accountability Quality Improvement

Behavioral Health System Modernization along the Continuum

NASHP

MARCH 22, 2024

States such as Texas, Wyoming , and New Jersey are adopting Medicaid reimbursement of collaborative care services and are addressing capacity to transition to CoCM. Integration of Substance Use Services and Supports States can align long siloed approaches to primary care, mental health, and substance use services through integration efforts.

Medicaid

Medicaid Integration Primary Care Nursing

Sustainability and Value: State Palliative Care Reimbursement Strategies

NASHP

AUGUST 24, 2023

There are a number of strategies state health officials can use as they build sustainable access to palliative care services in their Medicaid programs. Target Populations That Could Benefit from Palliative Care Services Use data to identify Medicaid enrollees with serious illness. Make the case for improved care and reduced costs.

Medicaid

Medicaid Quality Assurance Quality of Care Hospitals

Summary of State Legislative Efforts Aimed at Health Care Transformation Reforms

NASHP

DECEMBER 8, 2023

The bill also included a requirement that the HPC’s annual public hearings address the state’s ability to meet the new primary care spending targets and extended the performance improvement plan and HPC reporting provisions to the primary care targets.

Primary Care

Primary Care Medicaid Medicare Hospitals

Medical Device Warranty Credits With Al Brander| Episode 55

Vie Healthcare

OCTOBER 28, 2022

In this episode, Lisa Miller, founder of VIE Healthcare and CEO of Spendmend, and Jim Cagliostro, VIE’s Clinical Operations Performance Improvement Expert, interviewed Al Brander to explore in detail the challenges and financial risks of managing medical device warranties. The simple shipping label that keeps vendors accountable.

Hospitals

Hospitals Nursing Accountability Medicare

Administration Strengthens Oversight of Nation’s Poorest-Performing Nursing Homes

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. Below is an excerpt from that Press Release.

Nursing

Nursing Accountability Quality Improvement Quality of Care

Exposing Healthcare Fraud with Jonathan Tycko| E. 68

Vie Healthcare

MAY 4, 2023

And as you know, obviously a huge percentage of healthcare spending is funded through Medicare, Medicaid, Tricare, the VA system, and these are all programs that are covered by the False Claims Act. So the actual amount of fraud is probably some multiple of that. And that’s just the federal government, right?

Healthcare

Healthcare Nursing Hospitals Doctors

Taking Back The Business of Healthcare with Preston Alexander| E. 67

Vie Healthcare

APRIL 26, 2023

Since 1999, VIE has been a recognized leader in healthcare costs, hospital purchase services, healthcare benchmarking, supply chain management, and performance improvement. You can learn more about VIE Healthcare Consulting at viehealthcare.com. Jim (19:07): Okay, Preston, I love what you put out there on LinkedIn.

Healthcare

Healthcare Nursing Hospitals Doctors

Health Care Quality Digest

State Oversight and Innovations in Medicaid-Managed Long-Term Services and Supports (MLTSS) Serving Older Adults and People with Disabilities

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care

Trending Sources

States Build Capacity to Address Maternal Mortality through Policy Innovations

Expanding the Perinatal Workforce through Medicaid Coverage of Doula and Midwifery Services

First Do No Harm

States Advancing Equitable Maternal Health Policy Highlighted at #NASHPCONF22

Final Rule Gives Home Health Agencies Breathing Room for HHVBP, Medicare Sequestration

Voices: Beth Ann Longo, Associate Director, Department of Research, The Joint Commission

How State Medicaid Programs Serve Children and Youth in Foster Care

Opportunities for Aligning Prescription Drug Affordability Boards and Cost-Growth Benchmarks

Primary Care Case Management in Medicaid: A Strategy for Supporting Primary Care in Rural Areas

Behavioral Health System Modernization along the Continuum

Sustainability and Value: State Palliative Care Reimbursement Strategies

Summary of State Legislative Efforts Aimed at Health Care Transformation Reforms

Medical Device Warranty Credits With Al Brander| Episode 55

Administration Strengthens Oversight of Nation’s Poorest-Performing Nursing Homes

Exposing Healthcare Fraud with Jonathan Tycko| E. 68

Taking Back The Business of Healthcare with Preston Alexander| E. 67

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