Medicaid, Population Health 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. This led me to GoMo Health, where we create, activate and scale these improvements daily.

Quality Improvement

Quality Improvement Medicaid Population Health Medicare

CMMI Prioritizes Multi-Payer Alignment in New Models

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. And then we’re also developing an approach for certification based on quality improvement and patient experience.”

Primary Care

Primary Care Quality Improvement Medicaid Accountable Care

Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Sheppard Health Law

OCTOBER 27, 2021

On October 20, 2021, the Centers for Medicare and Medicaid (“ CMS ”) Innovation Center (“ Innovation Center ”) published a white paper detailing its vision for the next ten years: a health system that achieves equitable outcomes through high quality, affordable, person-centered care. Strategic Objective 2: Advance Health Equity.

Medicaid

Medicaid Medicare Accountable Care Accountability

NCQA Launches Race and Ethnicity Stratification Learning Network

HIT Consultant

APRIL 26, 2023

About the Race and Ethnicity Stratification Learning Network The Race and Ethnicity Stratification Learning Network was convened in late-2022 to develop a greater understanding and resources to support the stratification of quality performance data and use of stratified data to advance health equity.

Quality Assurance

Quality Assurance Quality Improvement Medicaid Medicare

State Community Health Worker Models

NASHP

DECEMBER 10, 2021

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs HRSA Health Resources and Services Agency. MHP Medicaid Health Plans. NCQA National Committee for Quality Assurance.

Medicaid

Medicaid Primary Care Prevention Nursing

Fact Sheet: Using New and Existing Federal Funds to Modernize Immunization Information Systems

NASHP

NOVEMBER 22, 2021

*(from the Centers for Disease Control and Prevention (CDC) and the Center for Medicare and Medicaid Services (CMS). What gaps can be filled to help facilitate public health activity? What tasks can support IIS interoperability, integration, and outreach with partner systems like Medicaid and Public health? Data Sharing.

Medicaid

Medicaid Quality Improvement Prevention Integration

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

This substandard access to quality care can lead to poor health outcomes.[6]. have a special health care need, and an estimated 44 percent of CYSHCN are enrolled in Medicaid.[7] In June 2022, NASHP convened a national forum with state health officials (e.g., Nearly 20 percent of children in the U.S.

Medicaid

Medicaid Integration Quality Improvement Accountability

The cornerstone of continuous, integrated, and value-based healthcare

Cloud Blogs

FEBRUARY 28, 2022

Passed in 2016, The Cures Act requires that electronic health record (EHR) systems provide patient-facing application programming interfaces (APIs) to maintain federal certifications. Microsoft Cloud for Healthcare was built with the understanding that interoperability is the cornerstone of VBC.

Integration

Integration Healthcare Quality of Care Regulations

Closing Gaps in Care with Advanced Interoperability Capabilities

Lexis Nexis

JULY 20, 2022

To remediate these care gaps, payers must improve their ability to access data by making significant changes to their health IT infrastructure. Closing gaps in care via interoperability mirrors the risk adjustment process currently challenging health plans engaged in population health programs.

Prevention

Prevention Medicare Medicaid Quality Improvement

Community Health Worker Models

NASHP

NOVEMBER 29, 2021

Development and ongoing updates of the State Community Health Worker Models Map would not be possible without the generous support of the Robert Wood Johnson Foundation and the National Center for Healthy Housing. Medicaid Reimbursement. Medicaid Reimbursement.

Medicaid

Medicaid Primary Care Prevention Nursing

The cornerstone of continuous, integrated, and value-based healthcare

Cloud Blogs

FEBRUARY 28, 2022

Passed in 2016, The Cures Act requires that electronic health record (EHR) systems provide patient-facing application programming interfaces (APIs) to maintain federal certifications. Microsoft Cloud for Healthcare was built with the understanding that interoperability is the cornerstone of VBC.

Integration

Integration Healthcare Quality of Care Regulations

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

NASHP

AUGUST 23, 2021

Primary care case management (PCCM) programs are one of the oldest types of Medicaid managed care, but over time most states have shifted to use managed care organizations (MCOs) to deliver services to Medicaid participants. million Medicaid participants. million Medicaid enrollees.

Primary Care

Primary Care Medicaid Accountability Quality Improvement

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

NASHP

AUGUST 31, 2023

Figure 1 displays a consolidated overview of the “Framework for Public Health-Health Care System Collaboration.” Specific examples taken from a variety of states will be examined in greater detail throughout the toolkit. One example is Live Well San Diego.

Medicaid

Medicaid Accountability Public Health services Population Health

Connecticut and Pennsylvania’s Approaches to Maternity-Focused Value-Based Payment Models

NASHP

JUNE 22, 2023

Medicaid covers more than 40 percent of births nationally. Given the critical role that Medicaid plays in maternal health, there is a longstanding interest in the role of Medicaid service delivery systems to improve perinatal health outcomes. All Medicaid beneficiaries served by the practice are included.

Medicaid

Medicaid Prevention Accountability Medicare

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

About This Resource Guide: Promising Practices to Address Health Disparities

NASHP

MAY 8, 2023

Source: Centers for Medicare & Medicaid Services Health Disparities : Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. Social Determinants of Health-Healthy People 2030.

Medicaid

Medicaid Regulations Prevention Medicare

Shifting the Health Disparities Paradigm

NASHP

MAY 8, 2023

Through the strike force, Ohio leveraged community feedback from virtual community forums, town hall meetings, and a community needs assessment performed by the Ohio State University College of Public Health, pairing equity goals (better health outcomes for communities of color) with equity-based processes aimed to transform the health system.

Medicaid

Medicaid Accountability Integration Accountable Care

Health Care Quality Digest

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

CMMI Prioritizes Multi-Payer Alignment in New Models

Trending Sources

Centers for Medicare and Medicaid Innovation Center: Equity and Vision

NCQA Launches Race and Ethnicity Stratification Learning Network

State Community Health Worker Models

Fact Sheet: Using New and Existing Federal Funds to Modernize Immunization Information Systems

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

The cornerstone of continuous, integrated, and value-based healthcare

Closing Gaps in Care with Advanced Interoperability Capabilities

Community Health Worker Models

The cornerstone of continuous, integrated, and value-based healthcare

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

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

Connecticut and Pennsylvania’s Approaches to Maternity-Focused Value-Based Payment Models

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

About This Resource Guide: Promising Practices to Address Health Disparities

Shifting the Health Disparities Paradigm

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