Remove Accountable Care Remove Population Health Remove Prevention Remove Quality Improvement
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Managing Managed Care: Closing Gaps in Care for Payers, Providers and Members

GoMoHealth

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. 3,000 noncompliant for variety of preventive care screenings or follow-up.

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Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Sheppard Health Law

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.

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State Community Health Worker Models

NASHP

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. CDC Centers for Disease Control and Prevention. CHW Community Health Worker. CHA/P Community Health Aid/ Practitioner. PH-MCO Physical Health Managed Care Organization. PHW Pandemic Health Worker.

Medicaid 120
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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

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.

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Community Health Worker Models

NASHP

There are currently some Accountable Care Organizations (ACOs) that cover the cost of CHW services through Medicaid administrative payments. CHTs are multi-role teams (can include RNs, Health Coaches, Substance Abuse Specialists, RDs, Pharmacists, CHWs, etc.). Health promotion education to a member to prevent chronic illness.

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

NASHP

Figure 1 displays a consolidated overview of the “Framework for Public Health-Health Care System Collaboration.” A precondition of sustaining these partnerships is sustained investment in state and local public health capacity.

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Fifth Free Tool in Kidney Toolkit Helps Fight Kidney Disease

NCQA

Adding the Population Health Roadmap for Chronic Kidney Disease to our Kidney Health Toolkit means there’s a fifth free resource from NCQA to help manage chronic kidney disease (CKD) or end-stage renal disease (ESRD). Slowing or preventing disease progression is possible if the disease is treated early.