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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. ii] Rural areas are highly likely to suffer from shortages of primary care and other providers.

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CMMI Prioritizes Multi-Payer Alignment in New Models

NCQA

The Innovation Center also released the Making Care Primary (MCP) model and the GUIDE model this year, innovative solutions to achieve multi-payer alignment and focus on populations that have historically been underfunded in health care.

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Conceptual Framework and Strategic Considerations for Modernizing Behavioral Health Systems

NASHP

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.

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Homebound Seniors Remain Disproportionately Costly For Medicare

Home Health Care

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.”.

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CMS Unveils “Innovation in Behavioral Health” Model to Tackle Dual Mental and Physical Health Challenges

HIT Consultant

The IBH Model aims to bridge the gap between behavioral and physical health by: Empowering community-based behavioral health practices: These practices, including mental health centers, opioid treatment programs, and safety net providers, will become the central point of care, offering integrated services for both mental and physical health needs.

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Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease

NCQA

As part of our drive to improve health equity , most toolkit resources are available in Spanish. Have you used the toolkit? Let us know how it’s going! We welcome your feedback. The post Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease appeared first on NCQA.

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CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

Accountable Care Doctors

These discussion forums generated many promising and innovative solutions including improving healthcare by integrating behavioral health with primary care, pursuing strategies for reducing low-value care and increasing high-value care, and developing better metrics for measuring performance in alternative payment models.