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Enhancing Quality Improvement Adoption in US Nursing Homes 

Briggs Healthcare

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The COVID-19 pandemic exacerbated and illuminated quality failings in nursing homes, persistent equity issues, and the system- and policy-level factors that contribute to their endurance. Can nursing homes improve quality by focusing on culture, trust, and will?

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The National Imperative to Improve Nursing Home Quality

Briggs Healthcare

Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. The 1986 Institute of Medicine report Improving the Quality of Care in Nursing Homes identified a range of challenges to the quality of care in nursing homes.

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How to Improve Your VBP Scores and Boost Medicare Payments

Home Health Care

Since CMS standardized it in 2018, Quality Assurance and Performance Improvement program, or QAPI, has served as a guiding light for home-based care providers. The program is the process by which a home-based care provider measures its quality metrics. Nurses, home health aides, therapists — even schedulers.

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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, CMS and the National Committee for Quality Assurance (NCQA) both produce national performance metrics that states can use as performance benchmarks. It is often factored into plan payment, and it supports public reporting.

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State Policy Considerations to Support Equitable Systems of Care for Children and Youth with Special Health Care Needs 

NASHP

Paid Family Caregiving Colorado Colorado allows family members of Medicaid-enrolled CYSHCN to be paid for providing care to their children by becoming licensed as certified nursing aides. skilled nursing, home health care, behavioral health, etc.) are another key challenge related to access to services for CYSHCN.

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State Community Health Worker Models

NASHP

NCQA National Committee for Quality Assurance. CHW services could be used for many health conditions as long as there is a care plan in place written by a physician, physician assistant, nurse practitioner, or a certified nurse midwife. MCO Managed Care Organizations. MCE Managed Care Entities. 98961 – 2 to 4 patients.

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

NASHP

For example, to move from tier 3 to tier 4, the provider must meet all the requirements of tier 3 and several new requirements, such as having a well-established quality improvement process. Oklahoma’s care management and quality departments support the PCCM providers. Idaho also offered flexibility to providers. v] Per §438.2