Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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Medicaid Medicaid Medicare Medicare 52

HIT Consultant

AUGUST 15, 2023

The partnership brings yet another level of important care services into the home for health plans using MedArrive, especially those that serve Medicaid beneficiaries. spends more than $320 billion – or 15 percent of the total health expenditure – treating or managing cardiovascular disease (CVD).

Medicaid 52

Medicaid Medicaid Health Outcomes 52

Healthcare It News

DECEMBER 16, 2022

The Medicaid and CHIP Access to Prescription Digital Therapeutics Act seeks to expand care options that can help improve health outcomes and quality of life for those facing barriers to healthcare. The act would also define "prescription digital therapeutic" in Medicaid and allow U.S. WHY IT MATTERS.

Medicaid 187

Medicaid Medicaid COVID-19 Health Outcomes 187

Healthcare IT Today

APRIL 26, 2023

The following is a guest article by Ashley Perry, MPH, Chief Strategy and Solutions Officer at Socially Determined When Congress passed the Consolidated Appropriations Act of 2023 , it decoupled the Public Health Emergency (PHE) from the Medicaid program’s continuous enrollment provision, which was implemented as part of the PHE in March 2020.

Medicaid 66

Medicaid Medicaid Public Health Health Outcomes 66

Healthcare IT Today

OCTOBER 21, 2022

Brave Health , the largest virtual mental health provider and engagement platform focused on serving Medicaid populations, today announced a $40M Series C funding round led by Town Hall Ventures, with existing investors Union Square Ventures, City Light Capital and others joining as well.

Medicaid 80

Medicaid Medicaid Health Outcomes Public Health 80

HIT Consultant

SEPTEMBER 22, 2022

What You Should Know: – MDwise and Cityblock Health , the first tech-driven healthcare provider for communities with complex health and social needs announced that they will be collaborating to provide high-quality, comprehensive care to 10,000 Medicaid members at launch in select Indiana communities, including Indianapolis.

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Medicaid Medicaid Health Outcomes Doctors 52

Healthcare It News

DECEMBER 29, 2023

This past week, New York Governor Kathy Hochul signed Senate Bill 1196a/Assembly Bill 1673a into law directing all state-regulated health plans, including Medicaid, to cover comprehensive biomarker testing, clearing the path for more patients to access precision medicine treatments.

Medicaid 257

Medicaid Medicaid Health Outcomes 257

Bill of Health

AUGUST 22, 2022

The additional steps needed for accessing lifesaving therapies by requiring prescribers to create and submit PAs are deterrents that can result in treatment delays, relapse, and worse health outcomes for patients who are already in a vulnerable state.

Medicaid 246

Medicaid Medicaid COVID-19 Health Services Administration 246

C&M Health Law

JANUARY 18, 2023

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

Medicaid 52

Medicaid Medicaid Health Outcomes Federal Policy 52

Fierce Healthcare

AUGUST 3, 2023

Such programs have been shown to provide significant cost savings and be a cost-effective way to improve health outcomes and reduce disparities in underserved populations—particularly as Medicaid redeterminations threaten many individuals' access to care.

Health Outcomes 98

Health Outcomes Medicaid Medicaid 98

HIT Consultant

FEBRUARY 28, 2023

Address Cardiometabolic Conditions and Maternal Health The three-year deal will leverage Walmart’s position as a retailer and provider of health and wellness services, and CareSource’s role in the administration and delivery of Medicaid, Medicare and other health plan benefits and services.

Medicaid 98

Medicaid Medicaid Health Outcomes Medicare 98

Health Populi

JUNE 23, 2023

adults rate of uninsurance are highest in the states where Governors did not expand Medicaid, which are states indicated by the orange bars. This 2023 Scorecard of health system performance added a new metric to the analysis — Reproductive Care and Women’s Health. This domain encompasses health outcomes and access.

COVID-19 129

COVID-19 Health Outcomes Medicaid Medicaid 129

NY Health Law

FEBRUARY 13, 2024

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. Workforce: Workforce investments with a goal of equitable and sustainable access to care in Medicaid.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

Healthcare IT News - Telehealth

MARCH 25, 2024

The Centers for Medicare and Medicaid Services just released data on its Acute Hospital Care at Home initiative , which thus far has admitted 11,159 patients suffering from respiratory infections, heart failure and severe sepsis. Where is this data going to come from and what must hospital and health system IT executives do here?

Hospitals 167

Hospitals Health Outcomes Medicaid Medicaid 167

Healthcare It News

OCTOBER 27, 2023

Expanding those successful screening practices across departments and practices, like family medicine, maternal and infant health, pediatrics and cardiology, etc. Gathering reliable data for research that can explore associations between positive screens and health outcomes, healthcare utilization and cost.

Medicaid 241

Medicaid Medicaid World Health Health Outcomes 241

HIT Consultant

MARCH 21, 2024

While these tools promise better health outcomes and cost savings, the research paints a different picture: Small, Unsustained Improvements: HbA1c reductions, a key diabetes measure, were minimal (0.23 Payers: Health plans and employers should require evidence of tool benefits and tie financial coverage to clinical outcomes.

Health Outcomes 104

Health Outcomes Medicaid Medicaid Doctors 104

HIT Consultant

MARCH 6, 2024

What You Should Know: – Ochsner Digital Medicine , a leader in remote patient management, has partnered with Humana Healthy Horizons, Louisiana’s Medicaid plan, to offer digital health programs for members diagnosed with hypertension and type 2 diabetes.

Medicaid 52

Medicaid Medicaid Licensing Health Outcomes 52

NEJM

APRIL 7, 2023

People who are dually enrolled in Medicare and Medicaid face issues related to fragmented care and poor health outcomes associated with inadequate coordination of benefits and services.

Health Outcomes 53

Health Outcomes Medicaid Medicaid Medicare 53

Healthcare IT Today

MARCH 1, 2024

Joining Forces to Deliver Demonstrably Improved Health Outcomes and Meaningful Cost Savings to Patients, U.S. million eligible patients through more than 680 health centers across 41 U.S. Employer, and Union-Sponsored Clients Extends Reach to Serve 2.5 Million Eligible Patients and Over 630 U.S.

Health Outcomes 100

Health Outcomes Medicaid Medicaid 100

HIT Consultant

SEPTEMBER 12, 2022

– Using Gainwell’s advanced research platform and de-identified Medicaid claims data from select clients, Stanford concluded that 30 percent of patients prescribed opioids for the first time developed a dependency. Stanford used 180,000 de-identified Medicaid claims from six states.

Medicaid 97

Medicaid Medicaid Health Outcomes Governance 97

HIT Consultant

FEBRUARY 13, 2023

Tom Wriggins, Principal Industry Advisor at SAS John Maynard, CPA, CFE, AHFI Principal Solutions Architect at SAS In 2022, the Center for Medicare and Medicaid Services (CMS) established health equity as a pillar of its future work. Health outcomes and Medicaid program integrity Health outcomes are a function of the quality of care.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Jane Sarashon

JANUARY 19, 2024

Elevance Health, the health plan organization comprising XXX plans serving 117 million members, launched a program to channel mobile phones and data plans into the hands of some Medicaid plan enrollees, explained in the organization’s press release on the program.

Medicaid 70

Medicaid Medicaid COVID-19 Health Outcomes 70

Healthcare It News

JANUARY 18, 2022

Social determinants of health are major contributors to health inequity and rising healthcare costs in vulnerable populations such as Medicaid beneficiaries. How do care management interventions to mitigate SDOH as a risk for undesired health outcomes work?

Health Outcomes 352

Health Outcomes Patient Satisfaction Medicaid Medicaid 352

Healthcare It News

OCTOBER 31, 2022

"The ability to use and build from established standards in real-time and as part of screening practices that help identify specific needs related to insecurity is an important step in enabling more coordinated care and timely assistance or interventions needed to improve health outcomes," according to Argentieri, Meklir and Henry.

Licensing 270

Licensing Health Outcomes Medicaid Medicaid 270

Bill of Health

NOVEMBER 9, 2023

America is the only wealthy nation to lack universal health coverage. Under-investment in social determinants of health are major drivers of inequitable health outcomes in the United States. health system continue to exacerbate poor health and disparities. Uninsured people in the U.S. COVID-19 and the U.S.

COVID-19 157

COVID-19 Public Health ACA Health Insurance 157

MedTrainer

MARCH 8, 2024

FQHCs can receive financial rewards for deploying an individualized, patient-centered care model that builds trust between patients and providers, which has shown to improve health outcomes. FQHCs can participate in APMs through Medicare and Medicaid Managed Care Organizations (MCOs).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

SEPTEMBER 18, 2023

The newest value-based payment program purposely designed to address SDOH is the ACO Realizing Equity, Access, and Community Health (ACO REACH) model, launched by the Centers for Medicare & Medicaid Services (CMS).

Health Outcomes 114

Health Outcomes Electronic Medical Records Medicaid Medicaid 114

HIT Consultant

FEBRUARY 7, 2024

Cityblock’s unique care model connects members to a dedicated team of healthcare professionals, including primary care providers, behavioral health specialists, community health partners, nurse care managers, and more. This multidisciplinary approach ensures holistic care that addresses both physical and mental health needs.

Health Outcomes 52

Health Outcomes Medicaid Medicaid Nurses 52

Healthcare It News

JANUARY 10, 2023

The virtual care services will be delivered without copays, out-of-pocket costs or deductibles for families with active insurance or Medicaid coverage. WHY IT MATTERS. "As pediatric primary care providers, we know the short- and long-term medical and neurodevelopmental advantages of breastfeeding," said Dr.

COVID-19 251

COVID-19 Hospitals Telemedicine Health Outcomes 251

HIT Consultant

MARCH 9, 2023

Rajesh Sharma, Vice President and General Manager of Systems Integration, Data Analytics and Interoperability Product Offerings, Gainwell Technologies The Centers for Medicare and Medicaid Services (CMS) has laid the critical groundwork to create a connected healthcare system in which patients, providers, and payers can easily exchange information.

Health Outcomes 94

Health Outcomes Governance Compliance Medicaid 94

HIT Consultant

FEBRUARY 4, 2024

Nate Favini, Chief Medical Officer at Pair Team What You Should Know: – Pair Team , a leader in virtual and community-based care for high-risk Medicaid patients, announced today the appointment of its first-ever Chief Medical Officer, Dr. Nate Favini , alongside two other strategic leadership additions.

Medicaid 52

Medicaid Medicaid Health Outcomes 52

HIT Consultant

OCTOBER 18, 2021

– Papa and Uber are working together to mitigate social isolation and negative health outcomes among Medicare and Medicaid recipients as well as those with employer health plans.

Health Outcomes 95

Health Outcomes Medicaid Medicaid HIPAA 95

CMS.gov

OCTOBER 2, 2018

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

Medicaid 40

Medicaid Medicaid Fraud Health Outcomes 40

HIT Consultant

JULY 20, 2022

For most patients, it has always been extremely difficult to their personal health and medical data electronically. However, with the CMS Interoperability and Patient Access Final Rule , consumers, specifically Medicaid members, there is a greater push to give access to, and ownership of, this data. About Kristin Ballantine.

Governance 97

Governance Medicaid Medicaid Public Health 97

HIT Consultant

APRIL 16, 2024

REACH Program: Reducing Barriers and Improving Outcomes The REACH program from the Center for Medicare & Medicaid Innovation (CMMI) aims to address healthcare disparities. This data-driven approach allows for proactive care and improved health outcomes for the entire patient population.

Medicare 52

Medicare Medicare Health Outcomes Medicaid 52

HIT Consultant

JANUARY 10, 2022

What You Should Know: mPulse Mobile , a leader in conversational AI and digital engagement solutions for the healthcare industry, released 2 major announcements: – acquired HealthCrowd , a leading communications platform-as-a-service innovator focused primarily on the Medicaid market. Acquisition Impact for mPulse.

Medicaid 98

Medicaid Medicaid Health Outcomes Medicare 98

HIT Consultant

NOVEMBER 2, 2023

Lumeris stands out as the only value-based care enablement company with experience working across various patient populations, including those covered by Medicare Advantage, CMMI programs, commercial insurance, and Medicaid.

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Medicare Medicare Medicaid Medicaid 52