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CMS unveils person-centered primary care model but excludes high-revenue ACOs

Fierce Healthcare

The Centers for Medicare & Medicaid Services (CMS) has announced the ACO Primary Care Flex Model (ACO PC Flex Model), allowing eligible accountable care organizations to treat people with with | Accountable care organizations are largely supportive of CMS' new primary care model released Tuesday, they wish the agency would broaden its scope (..)

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CMS’ ACO Primary Care Flex Model Could Offer Home-Based Care Providers’ Risk-Based Opportunity

Home Health Care

The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary model Tuesday – centered around primary care providers – that could offer home-based care providers more opportunity to dive into risk-based care. The model was another creation of the CMS Innovation Center.

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6 Success Strategies as CMS Drives More Accountable Care by 2030

HIT Consultant

For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). A primary care-led delivery model with enhanced virtual care and clinician access, supported by high-risk clinics.

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

NASHP

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. Executive Summary.

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Medicaid Financing of Midwifery Services: A 50-State Analysis

NASHP

by expanding the maternal health workforce through Medicaid payment initiatives and other policies to increase access to certified nurse-midwives (CNMs) and midwives. States have varying approaches across their Medicaid service delivery systems for how they finance and operationalize these services.

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Thinking Ahead on the AHEAD Model: Hospital Global Budgets 

NASHP

The model also requires Medicaid to establish a hospital global budget for participating hospitals for the first performance year of the model. This means there will be three hospital global budgets: Medicare, Medicaid, and commercial.

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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.