Accountable Care, Healthcare and Quality Improvement

Managing Managed Care: Closing Gaps in Care for Payers, Providers and Members

GoMoHealth

OCTOBER 20, 2022

Partnering with Managed Care Organizations and Provider Networks to reduce costs and better manage utilization of health services. By Nakecia Taffa, Quality Improvement and Health Equity Director for GoMo Health. Then COVID-19 shined a spotlight on our broken healthcare system and its’ struggling infrastructure.

Quality Improvement

Quality Improvement Medicaid Population Health Medicare

States Build Capacity to Address Maternal Mortality through Policy Innovations

NASHP

SEPTEMBER 8, 2023

After discussion with IDPH, Illinois Department of Healthcare and Family Services (HFS) also established a prenatal and postpartum care HEDIS (Healthcare Effectiveness Data and Information Set) measure performance improvement project for Medicaid managed care organizations (MCOs) to identify and close a health disparity gap.

Medicaid

Medicaid Performance improvement Quality Improvement Accountable Care

Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Sheppard Health Law

OCTOBER 27, 2021

The five strategic objectives for advancing this systemwide transformation include (1) Drive Accountable Care, (2) Advance Health Equity, (3) Support Innovation, (4) Address Affordability, and (5) Partner to Achieve System Transformation. Strategic Objective 3: Support Care Innovations.

Medicaid

Medicaid Medicare Accountable Care Accountability

Is Mandatory Participation in Medicare Demonstrations Necessary?

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

Medicare Medicaid Accountable Care Quality Improvement

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

Accountable Care Doctors

AUGUST 31, 2021

In our fragmented healthcare system, providers seldom have the opportunity to speak directly with employers, even though these employers pay for much of the healthcare expenses in this country. Our vision and values synch up nicely with many employers who are concerned about the cost and quality of healthcare for their employees.

Primary Care

Primary Care Integration Doctors Accountability

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

Accountable Care Doctors

AUGUST 31, 2021

In our fragmented healthcare system, providers seldom have the opportunity to speak directly with employers, even though these employers pay for much of the healthcare expenses in this country. Our vision and values synch up nicely with many employers who are concerned about the cost and quality of healthcare for their employees.

Primary Care

Primary Care Integration Doctors Accountability

State Community Health Worker Models

NASHP

DECEMBER 10, 2021

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. CHWs are included for health promotion, comprehensive transitional care, individual and family support services, and referral to community and social supports. Acronym Guide. APM Alternative Payment Model.

Medicaid

Medicaid Primary Care Prevention Nursing

National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

OCTOBER 20, 2022

As a result, services were better aligned and the MCOs referred CYSHCN to the Title V CYSHCN program for care coordination given the program staff’s expertise in serving this population. Data are central to both direct care coordination service provision, as well as care coordination system monitoring and quality improvement efforts.

Medicaid

Medicaid Integration Quality Improvement Accountability

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

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

Medicaid Quality of Care Integration Medicare

Community Health Worker Models

NASHP

NOVEMBER 29, 2021

CHWs are included for health promotion, comprehensive transitional care, individual and family support services, and referral to community and social supports. In addition, Coordinated Care Organizations are required to include traditional healthcare workers, like CHWs, on their care teams.

Medicaid

Medicaid Primary Care Prevention Nursing

Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease

NCQA

MARCH 22, 2023

Continuous improvement is the larger goal of quality measurement. Kidney damage is permanent, and CKD can be a significant detriment to quality of life. Sources and Inspiration We developed the Roadmap in partnership with Bayer Healthcare Pharmaceuticals, Inc. DaVita Integrated Kidney Care.

Primary Care

Primary Care Population Health Pharmaceuticals Accountable Care

Public Health Modernization Toolkit: Key Commitments, Priorities, and Strategies to Advance Collaboration between Public Health and Health Systems

NASHP

AUGUST 31, 2023

While these essential commitments are a necessary pre-condition to sustain basic public health system capacity, specific priorities and strategies for better engaging healthcare system partners on shared public health priorities are outlined in the sections below.

Medicaid

Medicaid Accountability Public Health services Population Health

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

NASHP

AUGUST 23, 2021

“Health Care Access in Rural Areas: Evidence that Hospitalization for Ambulatory Care-Sensitive Conditions in the United States May Increase with the Level Of Rurality.” Rural Healthcare Workforce. www.ruralhealthinfo.org/topics/health-care-workforce#characteristics. [vi] Health Place. 2009 Sep;15(3):731-40. 2008.12.007.

Primary Care

Primary Care Medicaid Accountability Quality Improvement

COVID-19 Lessons: A Path to a Better Health Care System

Accountable Care Doctors

OCTOBER 21, 2020

As providers continue to apply lessons learned from their experience with the COVID-19 pandemic to their delivery models and reimbursement structures, it is clear more must be done to promote value in healthcare.

Primary Care

Primary Care Integration Remote Care Population Health

Health Care Quality Digest

Managing Managed Care: Closing Gaps in Care for Payers, Providers and Members

States Build Capacity to Address Maternal Mortality through Policy Innovations

Trending Sources

Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Is Mandatory Participation in Medicare Demonstrations Necessary?

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

CAPP Shares Insights of Employer Dialogues at WHCC and SIIA

State Community Health Worker Models

National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

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

Community Health Worker Models

Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease

Public Health Modernization Toolkit: Key Commitments, Priorities, and Strategies to Advance Collaboration between Public Health and Health Systems

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

COVID-19 Lessons: A Path to a Better Health Care System

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