HIT Consultant

OCTOBER 13, 2022

Medicare Advantage Plan for LGBTQ+ Older Adults. There is a growing number of LGBTQ+ adults over age 50, with the number expected to reach 7 million by 2030. – SCAN Health Plan will offer the SCAN Affirm plan to members in California’s Los Angeles and Riverside Counties.

Medicare 98

Medicare Medicare 98

Health Populi

APRIL 16, 2024

The stories: 4 future health care worlds for 2030 My goal for this post and for the AHIP panel is to brainstorm what the person’s health care experience would be in each of these four worlds. looking far enough in the future from now to 2030, recognizing that we will have had two U.S. For 2030, consider….

Public Health 77

Public Health Governance Medicare Medicare 77

MRO Compliance

JULY 12, 2023

Accurate, properly documented, interoperable patient data is required to achieve CMS’s goal for 100 percent of Medicare (and the majority of Medicaid) beneficiaries to be enrolled in some type of accountable, or value-based, care arrangement by 2030.

Medicaid 130

Medicaid Medicaid Medicare Medicare 130

HIT Consultant

JANUARY 18, 2023

– Reimbursable through Medicare and many commercial plans, Ornish Lifestyle Medicine by Sharecare is the first and only ICR program scientifically proven in randomized controlled trials to often reverse the progression of coronary heart disease and many other chronic conditions, without drugs or surgery.

Medicare 98

Medicare Medicare Nurses 98

HIT Consultant

JANUARY 25, 2024

What You Should Know: The Ohio State University Wexner Medical Center a nd CVS Accountable Care, part of CVS Health® (NYSE: CVS), today announced the creation of an accountable care organization (ACO) to improve the quality of care for Medicare beneficiaries by Ohio State providers in central Ohio.

Medicare 90

Medicare Medicare Hospitals 90

Healthcare IT News - Telehealth

DECEMBER 14, 2021

Caravan Health President and CEO Tim Gronniger previously was chief of staff and director of delivery system reform at the Centers for Medicare and Medicaid Services. In 2019 and 2020, its partners earned $300 million in Medicare savings, more than $120 million in shared savings, and quality scores exceeding 97%, the company reported.

COVID-19 200

COVID-19 Medicare Medicare Telemedicine 200

Healthcare IT Today

OCTOBER 3, 2024

As CMS targets having all Traditional Medicare beneficiaries and most Medicaid beneficiaries in accountable care relationships by 2030, there is an urgent need for healthcare providers, particularly those serving the 65+ demographic, to adopt value-based approaches. .

Medicare 120

Medicare Medicare Medicaid Medicaid 120

Jane Sarashon

JUNE 17, 2024

You would assume that most people over 50 would be worried about the financial future of Medicare to cover health care as those middle-aged Americans age. The most cost-secure are people over 65 (read: Medicare-secure, among two-thirds) and younger people 18 to 29 (6 of whom lack confidence to pay for health care as they age).

Medicare 59

Medicare Medicare Health Insurance 59

HIT Consultant

JANUARY 2, 2025

Heath Sampson, President and Chief Executive Officer of Modivcare By 2030, one in six people will be 60 years old or over, increasing the demand for care and intensifying the burden on an already strained healthcare system.

Health Outcomes 64

Health Outcomes Medicare Medicare Hospitals 64

Healthcare IT Today

DECEMBER 30, 2024

healthcare affordability crisis can be solved by 2030 if we can improve access to primary care. Allison Combs, Head of Product, Payer, Clinical Effectiveness at Wolters Kluwer Health In 2024, Medicare Advantage faced decreasing reimbursement rates alongside surging enrollment, and both trends are likely to continue into and beyond 2025.

US Department of Health and Human Services 91

US Department of Health and Human Services Nurses Medicare Medicare 91

MedTrainer

APRIL 18, 2024

Behavioral health credentialing exploded in 2023 and 2024 as providers could enroll in Medicare for the first time. Download Now Common Challenges in Behavioral Health Credentialing Where behavioral health credentialing diverges from typical provider credentialing is Medicare enrollment.

Medicare 52

Medicare Medicare Licensing Compliance 52

Hall Render

MAY 23, 2023

The Centers for Medicare & Medicaid Services (“CMS”) is now accepting applications from ACOs to participate in the Medicare Shared Savings Program (“MSSP” or “Program”) for the agreement period beginning January 1, 2024. The application process is split into two phases.

Medicare 64

Medicare Medicare Medicaid Medicaid 64

HealthIT Answers

SEPTEMBER 25, 2023

By Aisha Pittman MPH & Clif Gaus ScD - NAACOS has been advocating for several changes to the Medicare Shared Savings Program. The post NAACOS Largely Supports Proposed Changes to Medicare’s Largest ACO Program appeared first on Health IT Answers.

Medicare 64

Medicare Medicare 64

Healthcare IT News - Telehealth

JANUARY 23, 2024

Because of the lag in diagnosis, clinical research has shown that 65% of Medicare patients are first diagnosed with heart failure in the ER or inpatient setting, and this the number increases to 75% for patients with lower socioeconomic status. healthcare expenditures by 2030. Heart failure will account for $70 billion of U.S.

FDA 194

FDA Medicare Medicare Hospitals 194

Health Populi

JULY 13, 2020

economic outlook for 2020 to 2030 on July 1, 2020. For health care, the data portrayed in the next chart will be concerning: the Medicare and Social Security Trust Funds are expected to hit “zero” (the X-access) by 2025 and just after 2030, respectively. The Congressional Budget Office published an update to the U.S.

COVID-19 110

COVID-19 Medicare Medicare Hospitals 110

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

Medicare 52

Medicare Medicare Licensing Health Insurance 52

Health Populi

JUNE 3, 2020

McKinsey’s report models outpatient and office visits that can be virtually enabled for patients covered by both commercial and public sector health plans (Medicare and Medicaid). The Deloitte report boldly looks forward to 2030 and 2040, imagining that several forms of healthcare will migrate to virtual formats.

COVID-19 153

COVID-19 Hospitals Medicaid Medicaid 153

Healthcare IT Today

MAY 21, 2024

They’re goal is to have 100% of Medicare beneficiaries in a value-based care arrangement by 2030. We see a number of ACO approaches that make up these efforts, along with Medicare Advantage plans. The following is a guest article by Phyllis Wojtusik, Executive Vice President of Value-Based Care at Real Time Medical Systems.

Medicare 136

Medicare Medicare Hospitals Doctors 136

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. Standards for benchmarking and data completeness for the Medicare CQM collection type will mirror the MIPS benchmarking and scoring policies.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

HealthIT Answers

NOVEMBER 28, 2022

By Liz Fowler JD PhD, Purva Rawal PhD, Sarah Fogler PhD, Brian Waldersen MD MPH, Meghan O’Connell MPH, & Jacob Quinton MD MSHS - In 2021, CMS established a goal to have 100 percent of Original Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care relationships by 2030,,, The post The CMS Innovation Center’s (..)

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

MARCH 27, 2023

billion by 2030, according to Research and Markets Reports. New Payer Coverage and Revenue Cycle Management With 250 million patient lives covered under 600+ of the nation’s top payers, including Medicare, Medicaid and every major private insurer, OpenLoop is also announcing today a new Payer Coverage & RCM service.

Licensing 115

Licensing Health Outcomes Medicaid Medicaid 115

Jane Sarashon

MAY 30, 2024

But to keep building on models for staying at home as we age will require policy changes for public sector programs, such as Medicare and Medicaid, as well as commercial/private sector programs that can support people in aging in novel ways not yet served up in the private sector.

Medicare 75

Medicare Medicare Licensing Hospitals 75

HIT Consultant

APRIL 3, 2023

These risk-based care models are designed to encourage proactive care, better population health and reduced spending across the healthcare spectrum.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Healthcare IT News - Telehealth

FEBRUARY 19, 2024

By 2030, all Baby Boomers will be over 65 – all as alternative care models emerge. McKinsey estimates $265 billion worth of care services for Medicare patients could shift from traditional facilities to the home by 2025.

Hospitals 183

Hospitals Nurses Medicare Medicare 183

Healthcare IT News - Telehealth

MARCH 28, 2023

"An individual with heart disease costs Medicare twice as much as the typical beneficiary," he concluded. By 2030, we can expect it to affect 40% of the population. " The U.S. healthcare system cannot afford to lose the progress it has made in the last three years, he added. and cases are only rising.

COVID-19 187

COVID-19 Patient Satisfaction Hospitals Telemedicine 187

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

Healthcare IT Today

JANUARY 23, 2023

Medicare saved $1.6 In addition, Medicare has a goal for 2030 whereby all beneficiaries are to be treated by a VBC provider. billion in 2021 through its Shared Savings Program, which works with accountable care organizations.

Medicare 111

Medicare Medicare 111

Hall Render

MARCH 21, 2024

The Centers for Medicare & Medicaid Services (“CMS”) recently announced the ACO Primary Care Flex Model (“Flex Model”), a new voluntary model within MSSP for low-revenue ACOs, that begins January 1, 2025.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Healthcare IT News - Telehealth

AUGUST 28, 2023

The Acute Hospital Care at Home waiver program from the Centers for Medicare & Medicaid Services has grown to 125 health systems and 289 hospitals in 37 states in less than three years. For those who don't know, please describe the Acute Hospital Care at Home waiver program from the Centers for Medicare & Medicaid Services.

Hospitals 142

Hospitals Medicaid Medicaid COVID-19 142

Healthcare IT Today

OCTOBER 2, 2023

healthcare workers retiring by 2030. The “silver tsunami” is also to blame, with 10K baby boomers aging into Medicare coverage daily, placing even further strain on the situation.

Nurses 128

Nurses Hospitals COVID-19 Licensing 128

HIT Consultant

FEBRUARY 8, 2024

The Centers for Medicare and Medicaid Services (CMS) intends to shift traditional Medicare and many Medicaid beneficiaries into VBC arrangements by 2030. Value-based contracting rapidly evolves, with federal and state regulatory bodies imposing new mandates.

Medicaid 105

Medicaid Medicaid Medicare Medicare 105

HIT Consultant

FEBRUARY 6, 2024

These FQHCs will participate in two key CMS value-based care programs: ACO REACH and MSSP (Medicare Shared Savings Program). The participating ACOs will collectively cover nearly 50,000 Medicare lives, significantly expanding access to value-based care for underserved communities.

Medicare 52

Medicare Medicare 52

HIT Consultant

AUGUST 23, 2022

The Center for Medicare and Medicaid Services (CMS) is leading the charge in value-based-care, with recent updates, including the CY 2023 Medicare Advantage Rate Notice to its CY 2023 Physician Fee Schedule (PFS) Proposed Rule.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Medisys Compliance

JULY 27, 2022

CMS is planning to gradually reduce this coinsurance until it’s completely free for dates of service on or after January 1, 2030. For dates of service on or after calendar year 2030, Medicare waives the coinsurance. For dates of service calendar years 2027-2029, the reduced coinsurance is 10%.

Medical Billing 52

Medical Billing Medical Billing Outsourcing ACA Medicare 52

Healthcare IT Today

JULY 18, 2024

CareJourney derives market-leading analytics from Medicare, Medicaid, Medicare Advantage, and Commercial claims data across more than 300 million beneficiaries and over 2 million providers nationwide. Payers, providers, and employers can use these actionable insights to accelerate growth and improve performance. .”

Medicare 81

Medicare Medicare Governance Medicaid 81

HIT Consultant

NOVEMBER 16, 2022

People over 85 are the most rapidly expanding demographic and the elderly segment of the American population is expected to double in 2030 from 2010. By 2030, we are projected to have less than 7,300 geriatricians nationwide. The total number of Board Certified Geriatricians in the U.S.

Nurses 52

Nurses Telemedicine Patient Satisfaction Medicare 52