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CMS is Taking Action to Address Benefit Integrity Issues Related to Hospice Care

Briggs Healthcare

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare Effective oversight and enforcement are important to protect the integrity of the Medicare program, especially for vulnerable, seriously ill individuals and their families. Unfortunately, hospices are profiting from fraud at the expense of beneficiaries far too often.

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Bridges Health Partners Highmark BCBS Form Commercial Value-Based Care Agreement

HIT Consultant

What You Should Know: Bridges Health Partners LLC (Bridges) , a Clinically Integrated Network, and Highmark Blue Cross Blue Shield (Highmark) entered into a multi-year Value-Based Agreement for Highmark’s Commercial membership in Western Pennsylvania. Established in 2017 through a collaboration between Independence Health System, St.

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UnitedHealthcare Donates $2.85M for Direct Service Workers in Indiana

HIT Consultant

These donations are part of UnitedHealthcare’s commitment to making a positive impact on the lives of the most underserved and, particularly, the population aging at home. Indiana University School of Medicine Geriatrics — $500,000 for a Project ECHO initiative and Learning Collaborative to share know-how among providers.

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Future Leader: Vijay Kedar, Co-Founder, CEO, Tomorrow Health

Home Health Care

The program is designed to recognize up-and-coming industry members who are shaping the next decade of home health, hospice care, senior housing, skilled nursing, and behavioral health. Vijay Kedar, the co-founder and CEO of Tomorrow Health, has been named a 2023 Future Leader by Home Health Care News.

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Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care

NASHP

Well-coordinated care that anticipates and manages the symptoms and stressors of serious illness can help people with these and other complex conditions reduce pain and suffering , avoid receiving treatment that does not align with their wishes , and prevent overutilization of care. The state and U.S.

Medicaid 100
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WelbeHealth’s Michael Le On The Future Of Innovative At-Home Care Models

Home Health Care

This article is a part of your HHCN+ Membership In the broader at-home care space, Dr. Michael Le is considered an innovator. As the co-founder and former chief medical officer of Landmark Health, he was integral in helping build a company that would eventually catch the eye of UnitedHealth Group’s (NYSE: UNH) Optum.

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Sustainability and Value: State Palliative Care Reimbursement Strategies

NASHP

It is increasingly clear that any program’s ability to improve care value is critically reliant on targeting the right patients — not too many, not too few, but the right ones.” — Diane E. The state began implementation of palliative care legislation with an analysis of state Medicaid claims and encounter data.