NASHP

MARCH 22, 2024

State Medicaid programs, behavioral health authorities, public health, departments of insurance, human and social service agencies, departments of education, departments of corrections, housing, and employment can collaborate to align overlapping efforts, align policies, and braid funding and accountability mechanisms.

Accountability 52

Accountability Medicaid Primary Care Quality Improvement 52

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 78

Medicaid Performance improvement Quality Improvement Accountable Care 78

NCQA

OCTOBER 31, 2023

“ It’s a marathon, not a sprint ,” said Liz Fowler, Director at the Center of Medicare and Medicaid Innovation (CMMI), during a recent Fireside Chat with NCQA Executive Vice President Eric Schneider. And then we’re also developing an approach for certification based on quality improvement and patient experience.”

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

NASHP

APRIL 15, 2022

CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports April 15, 2022 / by Allie Atkeson. Driven by challenges facing individuals with complex care needs, states are increasingly working to address the physical, behavioral, and social needs of their Medicaid beneficiaries. Download the report (PDF).

Medicaid 57

Medicaid Public Hospital Hospitals Nursing 57

GoMoHealth

OCTOBER 20, 2022

By Nakecia Taffa, Quality Improvement and Health Equity Director for GoMo Health. 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.

Quality Improvement 80

Quality Improvement Medicaid Population Health Medicare 80

Home Health Care

NOVEMBER 22, 2022

Government Accountability Office (GAO) has signed off on the home health payment rule finalized by the Centers for Medicare & Medicaid Services (CMS) last month. CMS argues that alternatives to mitigate the payment reductions would be contrary to the intent of the rule.

Medicare 87

Medicare Quality Improvement Medicaid Accountability 87

Healthcare ECONOMIST

JANUARY 14, 2022

Most individuals in its catchment area were Medicaid or Medicare beneficiaries or uninsured, representing the densest noncommercial payor communities for nonpublic hospitals in the country. Before the merger, funding was lacking for technology and infrastructure investments to support quality improvement. Information technology.

Hospitals 65

Hospitals Rehabilitation Quality Improvement Accountability 65

Briggs Healthcare

OCTOBER 19, 2021

population, NH residents account for nearly 33% of all COVID-19 deaths. The Center for Medicare and Medicaid Services implemented sweeping telemedicine (TM) regulatory relief in an effort to reduce COVID-19 spread in NHs. “Nursing homes (NHs) have been at the frontline of the COVID-19 pandemic. Despite representing <1% of the U.S.

Telemedicine 52

Telemedicine Nursing Health Science Quality Improvement 52

NASHP

FEBRUARY 27, 2024

This report is one section of State Strategies to Leverage Medicaid Managed Care Contracting for Investments in Health and Housing Alignment. For more information on financing housing-related services, please visit our Medicaid and Housing toolkit. Flexible services are not Medicaid-covered services, nor are they an entitlement.

Medicaid 40

Medicaid Quality Improvement Accountable Care Accountability 40

NASHP

MARCH 22, 2024

In addition to expanding Medicaid, North Carolina’s FY2024 budget allocates over $835 million for mental health and substance abuse investments under Medicaid. They focus on crucial areas such as managed care contracting, achieving coverage parity, and enhancing workforce capacity to improve both quality and access to care.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

HIT Consultant

OCTOBER 21, 2022

This work occurs alongside evaluating how to integrate the medical device into the hospital system’s diagnostic paradigms, including in relation to quality improvement programs. Sepsis accounts for the highest in-patient deaths and costs and is additionally the most under-reimbursed for diagnosis and treatment.

Hospitals 98

Hospitals Quality Improvement Medicaid Clinical Practice 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. NCQA National Committee for Quality Assurance. integrating?CHWs

Medicaid 120

Medicaid Primary Care Prevention Nursing 120

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] public health, Medicaid, mental health) and other stakeholders (e.g., Nearly 20 percent of children in the U.S.

Medicaid 98

Medicaid Integration Quality Improvement Accountability 98

Home Health Care

APRIL 30, 2024

This article is a part of your HHCN+ Membership Now that the Medicaid Access Rule has been finalized , home-based care’s company leaders have had time to digest it, and consider what it means for the future of the space. Here’s what six of them had to say.

Home Care 73

Home Care Medicaid Accountability Quality Improvement 73

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 40

Patient Safety Medicaid Medicare Quality of Care 40

Sheppard Health Law

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts (§ 422.107).

Medicare 52

Medicare Medicaid Accountability Integration 52

NASHP

MAY 26, 2023

It is one of the most desired caregiver services , and Medicaid is one policy lever to fund it. Through Medicaid’s federal-state partnership and under a variety of home and community-based services (HCBS) coverage authorities, states have the flexibility to design HCBS to meet the long-term care needs of their populations.

Medicaid 119

Medicaid Nursing Regulations Integration 119

Home Health Care

OCTOBER 28, 2022

How did you measure the quality of that data and quantify those values in a comparable and accessible way? Longo : There are nearly 11,000 home health agencies that report data to the Centers for Medicare and Medicaid Services. The relationship between higher star ratings and accreditation seems to reflect that commitment to quality.

Patient Safety 77

Patient Safety Performance improvement Quality Improvement Accountability 77

NCQA

OCTOBER 26, 2023

But you can use it for quality improvement. I am impressed by the leadership of state Medicaid officials on health equity. They are some of the most dedicated and effective people working to advance quality. We also have a group of early adopters. Like digital transformation, equity cannot be achieved alone.

Medicaid 52

Medicaid Quality Improvement Accountability Integration 52

Healthcare Leadership Council

MAY 25, 2022

Crippen, former director of the Congressional Budget Office and currently a Healthcare Leaddership Council consultant, that should be a catalyst for discussion on a critical element of the Center for Medicare and Medicaid Innovation’s future direction.

Medicare 75

Medicare Medicaid Accountable Care Quality Improvement 75

NASHP

NOVEMBER 29, 2021

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.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

Briggs Healthcare

APRIL 5, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare On April 17, 2023, the Centers for Medicare & Medicaid Services (CMS) will transition to the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) record submissions and reports.

Accountability 52

Accountability Nursing Medicare Quality Improvement 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. million Medicaid enrollees.

Primary Care 62

Primary Care Medicaid Accountability Quality Improvement 62

Healthcare ECONOMIST

OCTOBER 4, 2021

The Government Accountability Office (GAO) last week published a report evaluating the Merit-based Incentive Payment System (MIPS). MIPS evaluates provider value along four dimensions: (1) quality, (2) improvement activities, (3) promoting interoperability, and (4) cost.

Medicare 89

Medicare Quality Improvement Quality of Care Accountability 89

NASHP

AUGUST 31, 2023

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

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 52

Medicaid Integration Primary Care Nursing 52

Sheppard Health Law

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts.

Medicare 98

Medicare Medicaid Integration Regulations 98

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 57

Medicaid Prevention Accountability Medicare 57

HIT Consultant

JANUARY 22, 2024

What You Should Know: – The Centers for Medicare & Medicaid Services (CMS) has taken a bold step towards improving care for individuals with both mental health conditions and substance use disorders (SUD), announcing the “ Innovation in Behavioral Health (IBH)” Model.

Medicaid 97

Medicaid Quality of Care Integration Medicare 97

NASHP

MARCH 28, 2022

State Medicaid-funded long-term services and supports (LTSS) systems are not well-positioned to compete for this shrinking pool of workers. Responsible for 43 percent of all LTSS expenditures , state Medicaid programs have a major role to play in responding to this crisis. These funds must be spent before March 31, 2024.

Nursing 98

Nursing Medicaid Home Care Rehabilitation 98

Home Health Care

AUGUST 15, 2022

of the Medicare fee-for-service population, homebound seniors aged 70 and older accounted for 11% of Medicare spending in 2015, according to the study. In light of these findings, the homebound represent a critically important population to target for quality improvement and reductions in Medicare spending.”.

Medicare 99

Medicare Primary Care Medicaid Quality Improvement 99

NASHP

DECEMBER 20, 2022

This approach requires significant coordination among policymakers from across state systems – behavioral health, Medicaid, courts, and corrections – to share resources, align policies, and develop clear protocols for programming. D)(1) of these regulations, or are treated for an opioid overdose.

Medicaid 52

Medicaid Prevention Integration Hospitals 52

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 40

Nursing Accountability Quality Improvement Quality of Care 40

Sheppard Health Law

NOVEMBER 13, 2023

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). 2] A NOMNC ordinarily outlines the appeal process as well as a deadline by which an enrollee should submit his/her appeal. [3]

Medicare 59

Medicare Medicaid Regulations Integration 59

NASHP

JUNE 22, 2022

public health, Medicaid, mental health) and other stakeholders (e.g., health plans, providers, families of CYSHCN) in using, adapting, and implementing the National Care Coordination Standards for CYSHCN to develop or improve care coordination systems. State Medicaid agencies. Oversee and incentivize quality care.

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

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

Briggs Healthcare

MARCH 1, 2022

million people live in over 15,500 Medicare- and Medicaid-certified nursing homes across the nation. Research also suggests that, despite depriving residents of quality care, private equity-owned nursing homes actually led to an uptick in Medicare costs , too. Nursing homes will be held accountable if they fail to meet this standard.

Quality of Care 40

Quality of Care Nursing Accountability Medicaid 40