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 62

Primary Care Medicaid Accountability Quality Improvement 62

NASHP

DECEMBER 10, 2021

ACO Accountable Care Organizations. CBCM Community Based Care Management Program. CDC Centers for Disease Control and Prevention. PCCM Primary Care Case Management. PH-MCO Physical Health Managed Care Organization. USPSTF United States Preventative Services Task Force. SPA State Plan Amendment.

Medicaid 120

Medicaid Primary Care Prevention Nursing 120

NASHP

MARCH 22, 2024

Invest in prevention and early intervention. Enhance and streamline system of care for children with complex needs and their families. In addition, through its new 1115 demonstration extension and “Roadmap for Behavioral Health Reform,” the state is phasing in a new integrated primary care payment and reimbursement structure.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

Cloud Blogs

FEBRUARY 28, 2022

Shortage of primary care professionals, unequal access to care. Inaccessible and incomplete patient data creates insurmountable challenges to coordination, financial-risk arrangements, and effective preventative care. It empowers users to take a giant leap towards continuous, integrated care.

Integration 140

Integration Healthcare Quality of Care Regulations 140

Briggs Healthcare

MAY 4, 2023

CMS also requires plans to notify beneficiaries if a behavioral health or primary care provider is no longer in network via written and telephonic communications with more stringent notification requirements and establish care coordination programs to ensure behavioral health a key component of individual beneficiary care planning.

Medicare 40

Medicare Regulations Nursing Primary Care 40

Cloud Blogs

FEBRUARY 28, 2022

Shortage of primary care professionals, unequal access to care. Inaccessible and incomplete patient data creates insurmountable challenges to coordination, financial-risk arrangements, and effective preventative care. It empowers users to take a giant leap towards continuous, integrated care.

Integration 88

Integration Healthcare Quality of Care Regulations 88

NASHP

APRIL 17, 2023

Performance measurement is a pillar of state quality improvement and oversight. Other states, such as Colorado, establish advisory committees that provide input on all aspects of a state’s quality improvement program , including measure selection. It is often factored into plan payment, and it supports public reporting.

Medicaid 52

Medicaid Quality Assurance Quality Improvement Quality Review 52

Patient Safety Movement

APRIL 1, 2023

Save the Date: June 1-2, 2023 10th Annual World Patient Safety, Science & Technology Summit The 10-year anniversary marks professionals like you making a significant difference in eliminating preventable medical errors. These figures are also consistent with diagnostic errors and harm rates in primary care and inpatient settings.

Patient Safety 52

Patient Safety Doctors Prevention Hospitals 52

Sheppard Health Law

OCTOBER 27, 2021

In addition, only four models met the requirements to be expanded in duration and scope: Home Health Value-Based Purchasing Model; Pioneer ACO Model; Repetitive, Prior Authorization of Repetitive, Schedule Non-Emergent Ambulance Transport Model; and Medicare Diabetes Prevention Program Expanded Model. FOOTNOTES. [1]

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

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

NASHP

MARCH 22, 2024

Integrated Primary and Behavioral Health Care A modern behavioral health system of care is fully integrated into the continuum of health care services, including primary and specialty care settings, and extends into homes and communities to ensure holistic and coordinated support.

Medicaid 52

Medicaid Integration Primary Care Nursing 52

NASHP

AUGUST 31, 2023

Interviewees shared a range of perspectives, including those of local health departments, the state’s sheriff’s association, the state medical society, community health centers, hospital and primary care associations, funders, a CBO, aging and assisted living partners, consumer advocacy groups, and legislators.

Medicaid 52

Medicaid Accountability Public Health services Population Health 52

Accountable Care Doctors

OCTOBER 21, 2020

Recognize that primary care and prevention are the tools that will keep Americans healthy and build a health care system to support it. The patient experience also significantly improves when care is coordinated versus delivered piecemeal. Today, health care is a team sport.

Primary Care 59

Primary Care Integration Remote Care Population Health 59

NASHP

MARCH 11, 2022

State experience indicating that payment is an effective lever for improving service delivery. State officials viewed their efforts as part of broader efforts to improve behavioral health and better integrate it with primary care. " > Why Use Payment to Improve Delivery of SUD Services. Integrated Primary Care.

Medicaid 57

Medicaid Integration Quality Improvement Primary Care 57

NCQA

MARCH 22, 2023

Four Roadmap Landmarks The Roadmap is organized around four “landmarks”—key steps on the path to better CKD care. Slowing or preventing disease progression is possible if the disease is treated early. Center care on patients. As part of our drive to improve health equity , most toolkit resources are available in Spanish.

Primary Care 52

Primary Care Population Health Pharmaceuticals Accountable Care 52

NASHP

OCTOBER 8, 2021

The Black Maternal Health Momnibus Act of 2021 , recently introduced in the House, builds on existing federal legislation to comprehensively address social and health systems that impact the care of pregnant people throughout the country.

Medicaid 62

Medicaid Clinical Practice Primary Care Quality Improvement 62

NASHP

DECEMBER 20, 2022

States are taking steps to provide additional prevention, treatment, and recovery services to higher-risk individuals with opioid use disorder (OUD), including those in contact with the criminal legal system. Community Services and Prevention (Intercept 0). Across states, drug violations have led to most arrests in recent years.

Medicaid 52

Medicaid Prevention Integration Hospitals 52

Healthcare It News

MARCH 26, 2024

Besides workforce solutions, enabling the real-time exchange of information between and among patients and care teams is also imperative to "prevent siloed care and support transitions of care which are so crucial in care continuity and health outcomes."

Rehabilitation 230

Rehabilitation Integration Remote Care Prevention 230

NASHP

JUNE 22, 2022

On the other hand, a health plan may use the guide to implement a high-quality screening and assessment process through primary care providers. Recruit providers to support system improvements. Conduct research on best practices for care coordination. Support quality improvement efforts.

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

Sheppard Health Law

JANUARY 5, 2023

Requiring MAOs to incorporate one or more activities into their overall Quality Improvement program that reduce disparities in health and health care among their enrollees. Codifying appointment wait time standards for primary care and behavioral health services that correspond with the Medicare Managed Care Manual.

Medicare 52

Medicare Primary Care Medicaid Integration 52