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How We Help Medicaid & Long-Term Services and Supports

NCQA

In July, NCQA will update these programs to further align with best practices and federal regulations. Here’s how states are harnessing these programs to improve oversight. Service Coordination and Monitoring: “MCOs did not adequately coordinate or monitor beneficiaries’ quality of care.”

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Dental Medical Loss Ratios: Understanding the Landscape in Massachusetts and Beyond

NASHP

The Affordable Care Act (ACA) requires health insurance plans to spend at least 80 to 85 percent (for large group plans) of an enrollee’s premium dollars on medical care and quality improvement rather than on administrative costs and profits. This is known as the Medical Loss Ratio (MLR).

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Patient generated data can be a key factor in reducing health inequity

Healthcare It News

The same is true in care delivery, where the ability to pair patient-generated and/or reported data with secondary data from care delivery has the potential to revolutionize decision support, quality improvement, and digital guideline development.

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What are CY 2024 Policy Updates For MIPS Reporting? (Part II)

p3care

Overall, the new MIPS inventory has 106 improvement activities that have not been finalized yet. The title for this new IA is ‘“Practice-Wide Quality Improvement in MVPs’. Meanwhile, CMS has permanently removed 3 improvement activities, whereas 1 got a modification.

Medicare 130
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Unlocking Value-Based Care: How AI Can Overcome Key Challenges

HIT Consultant

As more plans, providers and members enter VBC arrangements, substantial volumes of clinical data will need to be managed effectively to oversee patient risk and care quality. Arming providers with a longitudinal patient summary for conducting comprehensive risk assessments improves patient outcomes while lowering the cost of care.

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UnityPoint Health pins hopes on interoperable digital health platform for patients

Healthcare It News

Digital transformation also is essential in making an impact on quality improvement and cost containment goals associated with value-based care initiatives." "As interoperability regulations continue to change, the back-end requires constant attention and development. " PROPOSAL.

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What HHVBP Means for Managed Care, SNF Utilization

Home Health Care

But payer partners want to be “wowed” by data, and evidence suggests that HHVBP mostly leads to relatively modest quality improvements. New data supports that idea, meaning changes to HHVBP’s design are likely, given regulators’ current prioritization on health equity and access. Individual Membership. 400 per year. 2–5 members.