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CMS Medicaid Proposals Offer Transparency And Accountability, But Compensation Provision Could Cap Business For Cash-Strapped Providers

Home Health Care

The more than 400 pages of proposed rules, certainly, contain a whole lot of regulation and, frankly, improvements to the Medicaid program that do have the potential to assure greater access to Medicaid services for beneficiaries,” Darby Anderson, chief strategy officer for Addus Homecare Corporation (Nasdaq: ADUS), told Home Health Care News.

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How We Help Medicaid & Long-Term Services and Supports

NCQA

In July, NCQA will update these programs to further align with best practices and federal regulations. Here’s how states are harnessing these programs to improve oversight. Service Coordination and Monitoring: “MCOs did not adequately coordinate or monitor beneficiaries’ quality of care.”

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Dental Medical Loss Ratios: Understanding the Landscape in Massachusetts and Beyond

NASHP

The Affordable Care Act (ACA) requires health insurance plans to spend at least 80 to 85 percent (for large group plans) of an enrollee’s premium dollars on medical care and quality improvement rather than on administrative costs and profits. This is known as the Medical Loss Ratio (MLR).

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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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MIPS 2022 Measures for the Certified Nurse Midwife Category

p3care

There are four categories in this category of QPP reporting , which are: Quality. Improvements Activities. Each performance category accounts for a particular percentage of the overall MIPS score, which determines how much payment adjustment a clinician will receive for the following year’s performance.

Nursing 130
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The National Imperative to Improve Nursing Home Quality

Briggs Healthcare

In this context, with support from a coalition of sponsors, the National Academies of Sciences, Engineering, and Medicine (NASEM) formed the Committee on the Quality of Care in Nursing Homes to examine how the United States delivers, finances, regulates, and measures the quality of nursing home care.

Nursing 52
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Proposed Insurance Rules Call for Significant Changes for States and Insurance Markets

NASHP

Department of Health and Human Services (HHS) released its proposed Notice of Benefit and Payment Parameters for the 2023 plan year, the annual regulation governing health insurance plans and marketplaces for the upcoming year. Addressing disparities through quality improvement strategies (QIS). Prohibits QHP advertising.