NCQA

OCTOBER 31, 2023

The GUIDE model is the first of its kind to address health care costs and target reductions in federal spending on long-term nursing home placement. And then we’re also developing an approach for certification based on quality improvement and patient experience.”

Primary Care 52

Primary Care Quality Improvement Medicaid Accountable Care 52

NCQA

JANUARY 25, 2024

Community health workers. Psychiatric nurse practitioners. For example, primary care providers are playing a larger role in mental health care. We’re also seeing what we call “ workforce extenders” provide behavioral health care. Costs Costs of behavioral health care continue to rise.

Primary Care 52

Primary Care Quality Improvement Integration Population Health 52

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. ii] Rural areas are highly likely to suffer from shortages of primary care and other providers.

Primary Care 65

Primary Care Medicaid Accountability Quality Improvement 65

NASHP

DECEMBER 10, 2021

MHP Medicaid Health Plans. NCQA National Committee for Quality Assurance. NIH National Institutes of Health. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. PHW Pandemic Health Worker. PCMH Patient Centered Medical Home . 98961 – 2 to 4 patients.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

NASHP

NOVEMBER 29, 2021

Idaho reimburses for CHW services through its Medicaid managed care (Primary Care Case Management) program. The PCCM program incentivizes primary care providers to incorporate CHWs into their care coordination model by offering a higher per-member per-month (PMPM) case management payment.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

NASHP

OCTOBER 20, 2022

As a result, services were better aligned and the MCOs referred CYSHCN to the Title V CYSHCN program for care coordination given the program staff’s expertise in serving this population. Data are central to both direct care coordination service provision, as well as care coordination system monitoring and quality improvement efforts.

Medicaid 98

Medicaid Integration Quality Improvement Accountability 98