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

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

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 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 161

Hospitals Health Outcomes Medicaid Medicaid 161

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

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

Health Law Advisor

JANUARY 13, 2022

The proposed decision, which is subject to public comments that are due to CMS by February 10, 2022, does not endorse nationwide Medicare coverage for these drugs. The FDA’s determination does not mandate Medicare coverage for Aduhelm. The Medicare Part B program would not cover the drugs in any other setting.

Medicare 52

Medicare Medicare FDA Medicaid 52

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. Understandably, Medicaid and Medicare agencies attempt to reduce that abrasion.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Healthcare IT News - Telehealth

JANUARY 25, 2021

According to a press statement from Thompson's office, it would: Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site. This is a common-sense step to make sure our policies keep pace with our technology," he added.

COVID-19 206

COVID-19 Medicare Medicare Telemedicine 206

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 227

Medicaid Medicaid World Health Health Outcomes 227

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

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 255

Licensing Health Outcomes Medicaid Medicaid 255

Hall Render

FEBRUARY 22, 2024

In the FY 2024 IPPS Final Rule (the “Final Rule”), the Centers for Medicare & Medicaid Services (“CMS”) incorporated certain social risk factors into the Hospital Value-Based Purchasing (“VBP”) Program (“the Program”).

Hospitals 66

Hospitals Medicare Medicare Medicaid 66

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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.

Medicare 52

Medicare Medicare Medicaid Medicaid 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.

COVID-19 236

COVID-19 Hospitals Telemedicine Health Outcomes 236

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

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). million people enrolled in Medicare that year, less than 2% had claims that incorporated Z codes.

Health Outcomes 114

Health Outcomes Electronic Medical Records Medicaid Medicaid 114

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 339

Health Outcomes Patient Satisfaction Medicaid Medicaid 339

HIT Consultant

FEBRUARY 21, 2023

The company continues to be the largest network of independent primary care in the country, with more than two million patients covered by more than 150 value-based contracts across Medicare, Medicare Advantage, Medicaid and commercial payers.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIT Consultant

NOVEMBER 30, 2023

. – The expanded strategic partnership will impact more than 80 practices, 15 health centers, and 25 rural health clinics across Virginia and covers Medicare Advantage, commercially insured, or Medicaid members.

Medicare 52

Medicare Medicare Health Outcomes Medicaid 52

HIT Consultant

NOVEMBER 16, 2022

What You Should Know: – Cipher Skin and Parker Health launches a new pilot program to help bring tech-enabled physical therapy to Medicare and Medicaid patients. And many patients—especially those on Medicare and Medicaid—do not have the luxury of extending their recovery time.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Law Advisor

MAY 2, 2023

The Centers for Medicare & Medicaid Services (“CMS”) is using its annual rulemaking process to update the CMS payment system rules for fiscal year (“FY”) 2024 as a mechanism to advance health equity systematically across various CMS payment programs. health system.” [9] health system.” [9]

Payment Systems 52

Payment Systems Medicare Medicare Nurses 52

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 16, 2022

The company’s core AI-enabled platform matches at-risk members with personalized, Registered Dietitian–vetted high-quality meal and grocery offerings that leverage behavioral science to support lasting dietary change and, ultimately, improved health outcomes.

Medicaid 98

Medicaid Medicaid Public Health Medicare 98

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

Healthcare IT Today

APRIL 13, 2023

The following is a guest article by Paul Barnes, Partner at CWH Advisors Today, there is widespread consensus that Social Determinants of Health (SDoH) have an impact on health inequities among various populations; resource scarcity in food, housing and other areas result in different health utilization and outcomes.

Medicaid 66

Medicaid Medicaid Medicare Medicare 66

Healthcare IT Today

JUNE 21, 2023

The following is a guest article by Mike Pattwell, Principal Business Advisor, Value Based Care at Edifecs Consumers are at the heart of healthcare — their fears are forcing healthcare innovators to shift priorities to deliver consumer-centric digital health offerings. In the same time period we have seen a large surge in Medicaid enrollment.

Medicare 62

Medicare Medicare COVID-19 Medicaid 62

HIT Consultant

NOVEMBER 4, 2021

– Since its 2017 founding, Papa and its Papa Pals have served members in all 50 states, across Medicare Advantage, Medicaid, and employer health plans.

Health Outcomes 97

Health Outcomes Medicaid Medicaid Medicare 97

Medisys Compliance

APRIL 18, 2022

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. In order to do so, a clinician must be in a Medicare Advanced APM.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

Healthcare IT Today

APRIL 21, 2023

Funding Will Grow Medication Adherence Services for Medicaid and Other Under-Resourced Populations Scene Health , the leading medication engagement company, has closed an oversubscribed $17.7 Scene reaching a milestone of impacting more than 200,000 lives with over 40M engagements through its 360° model of care.

Medicaid 57

Medicaid Medicaid Medicare Medicare 57

CMS.gov

NOVEMBER 16, 2018

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Director, Medicare-Medicaid Coordination Office, Topic. Medicare Parts A & B. Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Jeremy.Booth@c…. Tim Engelhardt.

Medicare 35

Medicare Medicare Medicaid Medicaid 35

Innovaare Compliance

MARCH 24, 2024

According to the National Health Care Anti-Fraud Association, the financial losses due to healthcare fraud are estimated to be in the billions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1 The Challenge of Health Care Fraud.

Fraud 52

Fraud Health Insurance Compliance Medicaid 52

Healthcare It News

DECEMBER 20, 2022

"While I am really hopeful about the momentum we are seeing across healthcare to address health disparities and their underlying causes, there is much work left to do," Sherry told Healthcare IT News in a look ahead at health equity in 2023.

Hospitals 173

Hospitals Health Outcomes Medicaid Medicaid 173

Healthcare IT News - Telehealth

AUGUST 29, 2022

More than 85% of patients report improved health after receiving care from Galileo. Galileo first launched with in-home care for Medicare and Medicaid patients, creating a framework to include social determinants of health in clinical analysis and to bridge gaps in healthcare education. Census Bureau.

Telemedicine 150

Telemedicine ACA Medicaid Medicaid 150

Healthcare IT News - Telehealth

JULY 16, 2020

House of Representatives on Thursday aims to ensure telehealth is able to continue to build on its potential in the years ahead, by making permanent some policies enacted during the pandemic and protecting Medicare beneficiaries' ability to engage in virtual care. WHY IT MATTERS. THE LARGER TREND.

COVID-19 160

COVID-19 Medicare Medicare Public Health 160

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. percent of the gross domestic product (GDP) on healthcare, which was almost two times the average of other high-income countries, while the health outcomes in the U.S. healthcare system were exorbitant.

Medicare 59

Medicare Medicare Medicaid Medicaid 59