NASHP

MAY 10, 2024

Primary Care AHEAD is designed to be tailored to states’ primary care goals within their Medicaid programs, while aligning these goals with Medicare’s primary care strategy that incorporates investments from Medicare. A core aspect is a focus on alignment between payers.

Primary Care 52

Primary Care Medicaid Medicare Integration 52

Healthcare ECONOMIST

APRIL 3, 2024

Pharmacy plan quality is vital since approximately 85% of the US population has prescription drug coverage through public (e.g., Medicare , Medicaid) or commercial (e.g., aligns with key plan/population health priorities, usability (i.e., aligns with key plan/population health priorities, usability (i.e.,

Medicaid 69

Medicaid Population Health Prevention Medicare 69

Sheppard Health Law

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration.

Medicaid 59

Medicaid Accountability Nursing Population Health 59

Healthcare It News

OCTOBER 31, 2022

Through the secure collection, documentation, reporting, access and use of data across provider types, ONC aims to address health inequities that have their root causes in poverty and racism. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org. Healthcare IT News is a HIMSS publication.

Private Healthcare 272

Private Healthcare Population Health Medicaid Medicare 272

HIT Consultant

NOVEMBER 30, 2022

Significant Growth Anticipated for Medicaid and Capitation Contracts: Most respondents report strategic plans to expand their VBC contracts over the next three years. VP of population health. Key Themes and Ideas Regarding Value-Based Care Reimbursement 2022. The product would be a replacement.

Population Health 98

Population Health Medicaid Medicare Integration 98

Healthcare It News

AUGUST 29, 2022

Regional and national health plans, employers, and Fortune 500 organizations use Galileo to help improve population health. More than 85% of patients report improved health after receiving care from Galileo. His goal is to help remove language as a barrier for access to healthcare for the 53 million U.S. Spanish speakers.

Telemedicine 253

Telemedicine Primary Care Medicaid Urgent Care 253

NASHP

NOVEMBER 27, 2023

In early September, the Center for Medicare and Medicaid Innovation (CMMI), also known as the CMS Innovation Center, announced a new total cost of care (TCOC) model for states, the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.

Primary Care 69

Primary Care Medicaid Medicare Hospitals 69

HIT Consultant

NOVEMBER 2, 2023

Collaboration aims to drive coordinated care and improve quality while reducing costs NS-EEH will strengthen its clinically integrated network (CIN) by incorporating Lumeris’ population health data platform into its value-based care strategy.

Accountable Care 52

Accountable Care Population Health Accountability Medicaid 52

HIT Consultant

OCTOBER 18, 2021

– Papa and Uber are working together to mitigate social isolation and negative health outcomes among Medicare and Medicaid recipients as well as those with employer health plans. The partnership advances Papa’s and Uber Health’s shared missions to support population health among vulnerable communities.

Population Health 95

Population Health Medicaid Medicare 95

HIT Consultant

APRIL 3, 2023

These risk-based care models are designed to encourage proactive care, better population health and reduced spending across the healthcare spectrum.

Accountable Care 98

Accountable Care Accountability Integration Private Practices 98

HIT Consultant

JANUARY 31, 2023

Their clinically integrated network, inVio , is one of the largest in the Southeast with more than 5,000 employed and independent network providers delivering high quality, value-based care (VBC) to more than 377,000 patients spanning Medicare, Medicaid, and commercial agreements.

Population Health 52

Population Health Medicaid Integration Patient Experience 52

p3care

OCTOBER 30, 2020

CMS (The Centers for Medicare and Medicaid Services) released the proposed rule for QPP MIPS 2021 via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). How to report MIPS data is what add to your revenue year after year, especially for clinicians associated with Medicare.

Medicare 243

Medicare Measurable Quality Medicaid Accountable Care 243

NASHP

DECEMBER 8, 2023

The Centers for Medicare & Medicaid Services (CMS) recently released its latest total cost of care model, the Advancing All-Payer Health Equity Approaches and Development (AHEAD) model with the goals of slowing growth in health care costs, improving population health, and advancing health equity.

Primary Care 52

Primary Care Population Health Medicaid Medicare 52

HIT Consultant

MAY 2, 2023

For decades, the industry lacked a patient-centric approach focused on efficiency, reliability, and accessibility for all populations, especially those enrolled in Medicare Advantage and Medicaid plans. In a recent study , 21% of U.S.

Medicaid 96

Medicaid Regulations Medicare Integration 96

p3care

JANUARY 19, 2023

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has shared an authorized program for providers in the US. Each year the Centre for Medicare and Medicaid Services gives a final rule with little modifications for implementation. This program is not other than the Merit-based Incentive Payment System.

Medicare 130

Medicare Population Health Medicaid Healthcare 130

Healthcare It News

JANUARY 18, 2022

Social determinants of health are major contributors to health inequity and rising healthcare costs in vulnerable populations such as Medicaid beneficiaries. How do care management interventions to mitigate SDOH as a risk for undesired health outcomes work?

Pharmaceuticals 348

Pharmaceuticals Accountable Care Accountability Medicaid 348

NASHP

MARCH 1, 2024

Many states are looking to move away from the health system’s current reliance on fee-for-service, utilization-driven payment and are pursuing reforms that incentivize improving population health and provide predictable funding to providers in ways that also contain costs.

Primary Care 59

Primary Care Population Health Hospitals Medicaid 59

NASHP

JANUARY 19, 2024

Applicant states must identify a lead agency, which may be the Medicaid, public health, state insurance, or other agency with rate setting or budget authority. The Medicaid agency does not have to be the lead agency, but if it is not, it must be identified as a sub-recipient as part of the application.

Primary Care 59

Primary Care Medicaid Population Health Hospitals 59

HIT Consultant

OCTOBER 27, 2022

What You Should Know: – Color Health acquires Mood Lifters , a leading group-based mental health company and launches a new behavioral health product. The new solution will expand access to mental healthcare for organizations tackling public and population health.

Medicaid 52

Medicaid Population Health Medicare Integration 52

HIT Consultant

SEPTEMBER 7, 2022

Artificial intelligence (AI) has emerged as a powerful tool for making population health analytics more accurate and interventions more effective. Sensitivity to a wider range of factors that can impact population health, including SDOH, cultural and community issues, is key to minimizing both coding and data-driven bias.

Population Health 98

Population Health Health Analytics Quality Assurance Medicaid 98

HIT Consultant

SEPTEMBER 18, 2023

The newest value-based payment program purposely designed to address SDOH is the ACO Realizing Equity, Access, and Community Health (ACO REACH) model, launched by the Centers for Medicare & Medicaid Services (CMS). million people enrolled in Medicare that year, less than 2% had claims that incorporated Z codes.

Accountability 114

Accountability Population Health Medicaid Accountable Care 114

HIT Consultant

AUGUST 2, 2022

– Brave Health , a virtual-first behavioral health provider focused on serving Medicaid and Medicare populations, today announced an innovative referral partnership with MedArrive. Today, access to basic behavioral health services for the nation’s most vulnerable populations is a public health crisis.

Medicaid 97

Medicaid Telemedicine Integration Medicare 97

HIT Consultant

MAY 15, 2024

Caregivers will then be able to view benefit details, coordinate services, and pay for covered expenses using the care-receiver’s health benefits. In the coming months, the organization will begin working with Medicare Advantage, Medicaid, and commercial plans to provide enhanced support to caregivers in the United States.

Doctors 81

Doctors Medicaid Medicare Healthcare 81

HIT Consultant

FEBRUARY 28, 2023

Address Cardiometabolic Conditions and Maternal Health The three-year deal will leverage Walmart’s position as a retailer and provider of health and wellness services, and CareSource’s role in the administration and delivery of Medicaid, Medicare and other health plan benefits and services.

Medicaid 98

Medicaid Medicare Population Health 98

Health Populi

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

Hospitals 136

Hospitals Population Health Medicaid Prevention 136

NCQA

OCTOBER 31, 2023

“ It’s a marathon, not a sprint ,” said Liz Fowler, Director at the Center of Medicare and Medicaid Innovation (CMMI), during a recent Fireside Chat with NCQA Executive Vice President Eric Schneider.

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

HIT Consultant

MARCH 22, 2022

Toyin Ajayi, CEO at Cityblock Health. What You Should Know: – Cityblock Health, a value-based healthcare provider for Medicaid, dually-eligible and lower-income Medicare beneficiaries appoints co-founder Dr. Toyin Ajayi to CEO.

Medicaid 98

Medicaid Medicare Integration Healthcare Providers 98

NASHP

MAY 3, 2024

State Spotlight: Payment and Financing Levers Strategy Example Medicaid 1115 Demonstration Waivers Oregon has started to implement its approved 1115 Medicaid Waiver to provide air conditioners, air filtration systems, and other devices for Medicaid beneficiaries during climate events declared by the governor or federal government.

Medicaid 59

Medicaid Hospitals Prevention Population Health 59

GoMoHealth

OCTOBER 20, 2022

This led me to GoMo Health, where we create, activate and scale these improvements daily. While most managed care organizations go to great lengths to comply with Medicaid and Medicare mandates, many are still struggling to meet their goals. Ability to Foster Trust within Community-Based Organizations and Providers.

Quality Improvement 79

Quality Improvement Medicaid Population Health Medicare 79

Home Health Care

JULY 11, 2022

As far as Caravan Health, Signify’s leaders believe its acquisition of the company, which took place in February, will allow them to provide total-cost-of-care management services. The Kansas City, Missouri-based Caravan Health works to help ACOs succeed in population health management and value-based payment programs.

Medicaid 81

Medicaid Medicare Population Health Prevention 81

HIT Consultant

SEPTEMBER 14, 2023

Achieving health equity presents an urgent challenge that demands attention from all stakeholders. However, actual medical care accounts for 20% or less of what affects population health. Additionally, sharing information between payers and providers is inefficient, leading to physician and patient fatigue.

Health Data 115

Health Data Telemedicine Accountability Population Health 115

HIT Consultant

AUGUST 15, 2022

Approximately 42% of Medicare beneficiaries are enrolled in Medicare Advantage plans—a segment projected to reach 46% by 2025. Due to rapid growth of the 65-and-older portion of the population, Medicare expenditures are forecast to reach $1,559.4 – Continued increase in overall Medicare costs.

Medicare 52

Medicare Population Health Medicaid Healthcare 52

HIT Consultant

FEBRUARY 13, 2023

Tom Wriggins, Principal Industry Advisor at SAS John Maynard, CPA, CFE, AHFI Principal Solutions Architect at SAS In 2022, the Center for Medicare and Medicaid Services (CMS) established health equity as a pillar of its future work. Understandably, Medicaid and Medicare agencies attempt to reduce that abrasion.

Patient Safety 52

Patient Safety Medicaid Integration Medicare 52

HIT Consultant

APRIL 13, 2022

More than a decade ago when Meaningful Use was introduced through the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the industry focused on implementing e lectronic health records (EHRs) and putting healthcare data online. This spurred an entire ecosystem of population health companies.

Population Health 98

Population Health Medicaid Medicare Healthcare 98

Home Health Care

OCTOBER 18, 2022

Before joining Inbound Health, Kerwar was the chief product officer at Mount Sinai Health System, where he built a digital-first capability to help power the company’s population health programs. For now, Inbound plans to expand to three or four sizable markets in the next year.

Hospitals 95

Hospitals Nursing Medicare Population Health 95

Home Health Care

DECEMBER 20, 2023

Patient care is provided through a partnership with Castell, Intermountain’s population health entity. “We Looking ahead, Intermountain plans to extend its hospital-at-home services to traditional Medicare and Medicaid patients in Utah next year. The program’s readmission rate is roughly 7%.

Hospitals 76

Hospitals Nursing Primary Care Population Health 76

NASHP

FEBRUARY 27, 2024

This report is one section of State Strategies to Leverage Medicaid Managed Care Contracting for Investments in Health and Housing Alignment. For more information on financing housing-related services, please visit our Medicaid and Housing toolkit. See the full resource guide.

Medicaid 40

Medicaid Population Health Hospitals Medicare 40