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

NASHP

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. Executive Summary.

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State Approaches to Behavioral Health Measures in Medicaid Managed Care

NASHP

Performance measurement is a pillar of state quality improvement and oversight. In addition, starting in 2024, federal rules will require states to report performance on some measures, including some behavioral health measures, to the Centers for Medicare & Medicaid Services (CMS).

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CMMI Prioritizes Multi-Payer Alignment in New Models

NCQA

“ 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.”

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

HIT Consultant

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.

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How PACE Could Cover More Older Adults

Home Health Care

Beyond geographic PACE expansion, the National PACE Association also sees a future where the model evolves to reach a larger demographic of seniors, including those that fall outside of the category of Medicaid-eligible. Traditionally, PACE cares for dual-eligible seniors in a given community. “We We refer to them as Medicare-only.

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Centers for Medicare and Medicaid Innovation Center: Equity and Vision

Sheppard Health Law

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.

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Homebound Seniors Remain Disproportionately Costly For Medicare

Home Health Care

In light of these findings, the homebound represent a critically important population to target for quality improvement and reductions in Medicare spending.”. Homebound patients heavily utilize hospital-based care. The researchers also noted that homebound seniors are not utilizing outpatient care.