Fierce Healthcare

SEPTEMBER 14, 2023

A comparison between two different types of dual-eligible special needs plans (D-SNPs) as well as non-dual-eligible special needs Medicare Advantage (MA) plans in a recent

Integration 306

Integration Medicare 306

Healthcare It News

MARCH 30, 2022

Department of Health and Human Services Office of Inspector General released a study examining how Medicare beneficiaries used telehealth during the first year of the COVID-19 pandemic. "Telehealth was critical for providing services to Medicare beneficiaries during the first year of the pandemic," read the report.

Medicare 239

Medicare Medicaid Integration Quality of Care 239

Healthcare ECONOMIST

AUGUST 8, 2023

On the one hand, integration may beneficial to consumers. However, the authors also note that there are two pathways through which the integration could leave consumers worse off: (i) input foreclosure and (ii) customer foreclosure. ” The pre-post analysis compares changes in premiums for vertically integrated plans (i.e.,

Pharmaceuticals 81

Pharmaceuticals Integration Accountability Medicare 81

HIT Consultant

FEBRUARY 23, 2023

What You Should Know: – Apixio , a leading AI platform that powers value-based care launches its new Apicare Post-Visit™ offering, an EHR-integrated intelligent workflow solution for health plans and providers.

Integration 98

Integration Medicare Process improvement Medicaid 98

Fierce Healthcare

APRIL 4, 2024

Supplemental benefits are a critical tool for insurers to stand out in a crowded market — particularly Medicare Advantage — and a new partnership aims to make it simpler for plans to integrate a gr | Supplemental benefits are a critical tool for insurers to stand out in a crowded market — particular Medicare Advantage — and a new partnership aims to (..)

Medicare 182

Medicare Integration 182

HIT Consultant

MAY 1, 2024

. · Previously, Upperline Health’s specialists in podiatry, vascular care, chronic care management, and preventative health grappled with incomplete patient medical histories dispersed across disparate systems and modalities, particularly as the Medicare beneficiary population seeking specialist care burgeoned.

Integration 52

Integration Accountable Care Primary Care Accountability 52

Home Health Care

AUGUST 19, 2022

Integrated Home Care Services hires new CEO. Integrated Home Care Services Inc. Indeed, the appointment comes on the heels of Integrated Home Care Services’ national expansion efforts. Currently, Integrated Home Care Services delivers home-based care to over 2.2 He will be part of the Medicare Innovation team.

Home Care 94

Home Care Integration Medicare Medicaid 94

HIT Consultant

OCTOBER 24, 2023

What You Should Know: – UnitedHealthcare and RUSH Health announced a new relationship that will give UnitedHealthcare Medicare Advantage plan members network access to all RUSH Health locations in Illinois for the first time, effective immediately. – The multi-year agreement, effective Oct.

Medicare 52

Medicare Prevention Hospitals Integration 52

Briggs Healthcare

APRIL 21, 2022

The primary updates in this CR include updating the Medicare Program Integrity Contractor investigative timeliness requirement and removing all references to the Incentive Rewards Program Tracking Database. On April 21, 2022, CMS posted Change Request 12700 – Transmittal 11358 which is effective May 23, 2022.

Integration 52

Integration Medicare Healthcare 52

HIT Consultant

NOVEMBER 18, 2021

What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best plan and support them through their healthcare journey. Redesigning The Medicare Experience. Improved Medicare Plan Performance.

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Medicare Integration Healthcare 98

Fierce Healthcare

JANUARY 8, 2024

Clover Assistant, a web application integrated into electronic health records showing a patient's medical history, may encourage a patient to adhere to medication, a new study by Clover Health clai | Clover Health is stressing how Clover Assistant improves medication adherence rates for its members.

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Medicare Integration 225

Home Health Care

MARCH 6, 2024

In 2023, Medicare Advantage (MA) plan members represented more than half of all Medicare beneficiaries for the first time. The post UnitedHealthcare, Humana, Aetna Continue To Outgain Peers In Medicare Advantage appeared first on Home Health Care News. Seniors have more options than ever when choosing MA plans.

Medicare 52

Medicare Home Care Regulations Medicaid 52

Sheppard Health Law

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. 3d 1, 18 n.19

Medicare 105

Medicare Medicaid Accountability Integration 105

HIT Consultant

OCTOBER 13, 2022

Medicare Advantage Plan for LGBTQ+ Older Adults. – SCAN Health Plan will offer the SCAN Affirm plan to members in California’s Los Angeles and Riverside Counties. . – SCAN Health Plan will offer the SCAN Affirm plan to members in California’s Los Angeles and Riverside Counties.

Medicare 98

Medicare Urgent Care Integration Healthcare 98

HIT Consultant

AUGUST 11, 2022

What You Should Know: – Ellipsis Health and Ceras Health today announced a partnership that will integrate Ellipsis Health’s breakthrough technology that uses the human voice as a biomarker for mental health and wellbeing into Ceras’ clinical monitoring platform.

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Integration Medicare Health Data Healthcare 98

Cloud Blogs

FEBRUARY 28, 2022

In 2020, the Centers for Medicaid and Medicare Services (CMS) issued additional rules requiring that payors and providers who receive CMS funds make health information more accessible. It empowers users to take a giant leap towards continuous, integrated care. These goals require increasingly data-driven approaches to care.

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Integration Healthcare Quality of Care Regulations 140

HIT Consultant

JANUARY 2, 2024

Ed Park, CEO at Devoted Health What You Should Know: – Devoted Health , a leading provider of all-in-one healthcare for Medicare beneficiaries, has secured $175M in Series E funding, demonstrating continued investor confidence in its mission to revolutionize senior care.

Medicare 52

Medicare Quality of Care Integration Healthcare 52

Briggs Healthcare

JANUARY 4, 2022

The Payment Integrity Information Act of 2019 (PIIA) requires improper payment reporting in the HHS AFR. The Centers for Medicare & Medicaid Services (CMS) measures the Medicare Fee-for-Service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program.

Medicare 104

Medicare Medicaid Integration Healthcare 104

Home Health Care

OCTOBER 4, 2022

With the annual enrollment period just around the corner, Medicare Advantage (MA) organizations are starting to tout what benefits they’re offering seniors for the upcoming year. MA is a form of Medicare that is administered by private insurers. Medicare open enrollment runs from October 15 to December 7, 2022. Humana Inc.

Medicare 105

Medicare Primary Care Urgent Care Home Care 105

HIT Consultant

AUGUST 24, 2022

has integrated Bamboo Health’s Pings™ solution. – The Pings rollout delivers real-time admission, discharge, and transfer (ADT) e-notifications for HTA’s 15,000 North Carolina PPO and HMO Medicare Advantage plan members. For example, Pings will be integrated into HTA’s UM tool to automatically enable prior authorizations.

Integration 52

Integration Medicare Care Transition Patient Experience 52

Health Populi

AUGUST 3, 2021

“You can trust us to help you find the right Medicare coverage for you and your lifestyle,” the tagline reads. It is, specifically, Midwest Heritage, Hy-Vee’s banking, insurance and investments subsidiary, that will implement the Medicare Aisle program.

Medicare 124

Medicare Primary Care Accountability Integration 124

Home Health Care

APRIL 23, 2022

Compared to fee-for-service Medicare, seniors save close to $2,000 on average in total annual health care spending with Medicare Advantage (MA). That’s according to a new study — based on 2019 Medicare Current Beneficiary Survey data — from Better Medicare Alliance, which features an analysis conducted by the Washington, D.C.-based

Medicare 98

Medicare Home Care Medicaid Integration 98

Home Health Care

JANUARY 17, 2022

The end of 2021 brought a handful of key home health policy issues to a temporary conclusion, including the congressionally secured delay to Medicare sequestration. One of the most recent ones is Medicare sequestration. Because it’s again, delaying that 2% Medicare sequestration cut, but also PAYGO requirements as well. [00:01:27]

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Integration Home Care Medicare Medicaid 105

HIT Consultant

MARCH 23, 2023

What You Should Know: – Aledade is continuing its strong momentum today, announcing that Cigna Healthcare Medicare Advantage customers can now receive value-based care from Aledade’s network of independent primary care practices.

Medicare 52

Medicare Primary Care Integration Healthcare 52

Briggs Healthcare

APRIL 21, 2022

CMS has provided MLN4761491 – Medicare Modernization of Payment Software Fact Sheet (5-pages in length) for providers submitting institutional claims to Medicare Administrative Contractors (MACs). Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare. CMS is modernizing its grouping and code editor software.

Medicare 52

Medicare Rehabilitation Nursing Integration 52

Sheppard Health Law

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

Medicare 52

Medicare Accountable Care Primary Care Accountability 52

GoMoHealth

SEPTEMBER 30, 2022

GoMo Health + Diet ID Bring Innovation in Personalized Meals for Medicare Advantage Members. Integrating Food and Nutrition with Chronic Condition Management for Improved Overall Wellbeing. We engage with Medicare seniors with the health activity they most enjoy – eating a healthy meal.

Medicare 72

Medicare Life Sciences Integration Prevention 72

Healthcare It News

APRIL 5, 2024

Dell and Northwestern drive AI further into hospital workflows Dell Technologies and Northwestern Northwestern University Feinberg School of Medicine aim to develop and integrate generative multimodal large language models into hospital workflows to improve patient care and reduce physician burnout, according to an announcement Friday from Dell.

Integration 224

Integration Medicaid Hospitals Prevention 224

Briggs Healthcare

AUGUST 23, 2023

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. As of mid-August, CMS has visited over 7,000 hospices.

Hospice Care 40

Hospice Care Integration Medicare Medicaid 40

Healthcare It News

NOVEMBER 29, 2023

million in savings across multiple Medicare and Medicare Advantage plans, according to an announcement Wednesday. That saved Franciscan $481,000 for its MSSP population and $388,000 for its Medicare Advantage population and avoided a total of 75 inpatient visits across both populations during the measuring period.

Medicare 205

Medicare Population Health Patient Experience Nursing 205

Cloud Blogs

FEBRUARY 28, 2022

In 2020, the Centers for Medicaid and Medicare Services (CMS) issued additional rules requiring that payors and providers who receive CMS funds make health information more accessible. It empowers users to take a giant leap towards continuous, integrated care. These goals require increasingly data-driven approaches to care.

Integration 88

Integration Healthcare Quality of Care Regulations 88

Home Health Care

OCTOBER 12, 2021

With enrollment up and more plans launching each year, Medicare Advantage (MA) organizations have had to figure out how to differentiate themselves in an increasingly competitive field. Every aspect of Medicare Advantage is becoming more competitive,” Traynor said. As a bonus for UCare, it further differentiates itself in the MA field.

Medicare 111

Medicare Nursing Home Care Primary Care 111

HIT Consultant

FEBRUARY 1, 2022

Further encouraging this long-term growth, the 2022 physician fee schedule from the Centers for Medicare and Medicaid Services extended parity reimbursement for telehealth services through December 31, 2023 – but indicates that changes may be made permanent. Shift to the Cloud Eases Integration.

Integration 52

Integration Healthcare Patient Experience Accountability 52

Home Health Care

DECEMBER 6, 2021

Now that the Louisville-based company is integrating Kindred at Home, it’s putting on a balancing act between what makes it money and where health care is going. Original Medicare is the largest customer,” Humana CFO Susan Diamond said at the BofA Securities Home Care Conference Monday. “The

Medicare 59

Medicare Home Care Integration Hospitals 59

HIT Consultant

AUGUST 24, 2022

The suite of tools in the EHR-integrated eGMS platform guides pharmacists and other healthcare providers to achieve best practice care by providing personalized treatment recommendations, identifying and alerting of patients in glycemic disarray, and providing guardrails that enhance patient safety.

Integration 52

Integration Patient Safety Medicaid Hospitals 52

Home Health Care

MARCH 14, 2024

Individuals who are dually eligible for both Medicare and Medicaid make up a sizable portion of the overall home-based care population. In Medicare, duals make up about 19% of all enrollment, but they account for 34% of total spending. Centers for Medicare & Medicaid Services (CMS). Legislation introduced in the U.S.

Medicaid 113

Medicaid Medicare Accountability Integration 113

Briggs Healthcare

APRIL 19, 2022

On April 18, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1771-P) that provides updates to the fiscal year (FY) 2023 Long-Term Care Hospital Quality Reporting Program (LTCH QRP). Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare. The unpublished public PDF is found here.

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Medicare Hospitals Healthcare Quality Medicaid 75