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So today we are diving into this topic to see just how social determinants of health impact population healthoutcomes and what initiatives are being implemented to address these factors and reduce health disparities within communities.
"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 healthoutcomes," according to Argentieri, Meklir and Henry.
The federal government and several states have implemented strategies to improve and promote OUD treatment access, especially for the relatively inexpensive and effective medication buprenorphine.
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 healthoutcomes work?
My name is Vatsala Kapur, and I’m the Vice President of External Affairs at Bamboo Health. My career spans over three decades in health information technology, health policy and public health, including roles at the Centers for Medicare and Medicaid Innovation and in state government.
Anish Sebastian, CEO and Co-founder, Babyscripts A discussion of technology and the Medicaid population inevitably raises the topic of the digital divide — that is, the gap between people who have access to modern information and communications technology (ICTs) and those who don’t. “We But there’s a lot of reasons to be optimistic.
Kristen Ballantine, VP of Government Relations at Gainwell. For most patients, it has always been extremely difficult to their personal health and medical data electronically. About Kristin Ballantine.
We reached out to our brilliant Healthcare IT Today Community with the question – how is the integration of digital health tools, telemedicine, and mobile health applications contributing to the enhancement of population health management, and what challenges exist in ensuring equitable access to these technologies across diverse communities?
The payer mix of health insurance is typical, with 35% of patients representing government insurance such as Medicare or Medicaid, 60% commercial insurance, and 6% self-pay patients. Virtual-first primary care has been shown to improve healthoutcomes by increasing access, he reported.
These improvements span internal and customer-facing operations at payers, care delivery organizations, and government entities such as the Centers for Medicare & Medicaid Services and public hospitals. According to McKinsey , advancements in AI, GenAI, could transform the healthcare industry by boosting operational efficiencies.
All parties must adhere to both federal and state laws, including those set by governing bodies, and follow ethical standards that safeguard the well-being of patients. The primary governing bodies that set healthcare compliance standards include: The U.S.
Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.
The acquisition combines Humbi AIs expertise in Medicare and Medicaid data, spanning over 200 million lives, with Innovaccers Intelligence Cloud. This integration will enhance Innovaccers ability to help healthcare organizations improve healthoutcomes and manage risk and performance more effectively.
Meanwhile, the American Telemedicine Association is pleading with the Centers for Medicare and Medicaid Services for expanded flexibilities and further guidance on payment and coverage. The government must take the lead. One recent study reported on telehealth trends in U.S. Industry experts also see the need for clarity.
– 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.
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.
On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). In states that have not expanded Medicaid, however, many postpartum women lose coverage.
These networks ensure employees can receive top-tier care regardless of location, enhancing satisfaction and improving healthoutcomes. This API-first approach will be driven by health plans needing to perform with Medicare Advantage and managed Medicaid. Government-funded capitation has to ensure care is adequate.
The acquisition advances Healthy Together’s mission to improve collective health and make government and enterprises more efficient. This acquisition reinforces Healthy Together’s commitment to driving positive change in public healthoutcomes.
However, it gained significant traction in the early 2000s and continues to evolve with ongoing efforts to refine payment models, improve care coordination, enhance patient outcomes, and manage cost efficiency. In addition to cost-savings, payers are increasingly adopting population-specific health plans to better address health equity.
In healthcare, that means understanding the unique challenges for each patient based on their social determinants of health and using technology to fill gaps that traditional healthcare models might have overlooked. We believe the critical avenue to mental health equity is ensuring access to timely and high quality care through Medicaid.
Neena Patel, MHA, CSM, VP of Client Success at Chordline As population health initiatives for Medicare and Medicaid members pick up steam, one of the biggest obstacles to care transformation remains a lack of trust among healthcare’s key stakeholders. That’s a risk that organizations can’t afford to take.
Prioritizing data that has been purpose-built and clinically validated ensures that we’re tracking data that truly predicts and impacts healthoutcomes, not just correlation. Cancer researchers are investigating the impacts of cancer on long-term healthoutcomes, financial strain, and household impact.
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. Healthoutcomes and Medicaid program integrity Healthoutcomes are a function of the quality of care.
Advances in telehealth have allowed both populations to receive more convenient, high-quality care, thus leading to better healthoutcomes. It's imperative that policymakers, CMS, state Medicaid programs and commercial insurers use the ever-increasing set of data to estimate the effect of telehealth on access, costs and quality.
According to Karl Ulfers, co-founder and vice president of growth at DUOS , governments offer excellent listings of resources with which care managers and clinicians can address housing, food, transportation, and other SDoH. Machine learning creates predictions for people who were not in the original sample.
In 2016, the Golden State began its Whole-Person Care (WPC) pilots at the county level integrating physical health, behavioral health, and social services for complex needs Medicaid enrollees. The reentry population faces complex barriers to healthcare and behavioral health help. And they were a great success!
Austin-based Cartmell has 25 yearsof experience in healthcare as a Chief Operating Officer, Chief Revenue Officer, board member and VC investor, as well as an advisor to Morgan Stanley, UnitedHealthcare, the University of Texas at Austin Dell Medical School and the British Government.
Caring for each other is a foundational part of our humanity – it can be both beautiful and incredibly intense, impacting our work, our relationships, and our health. Now is the time for employers, healthcare organizations, and governments to invest in supporting unpaid caregivers in a sustainable way.
Anne Davis, VP of Government Markets & Strategy at Wellth. Social drivers of health, which impact a disproportionate number of non-white Americans who live below the poverty line, account for as much as 90% of individuals’ healthoutcomes. These are just two examples of data that highlight the need for equity.
Sarah Carroll, Senior Vice President, Center for Care Transformation at AVIA HealthMedicaid and Medicare have become one of the biggest quiet crises in health systems today. As artificial intelligence becomes increasingly integral to healthcare, the urgency to integrate ethical governance cannot be overstated.
Wayne Johnson, Vice President of Special Operations at Sunwave Health. Outcomes and accountability will be more critical. Regulatory changes and continued private equity investment will likely drive increased interest in outcomes tracking for mental health and SUD providers in 2023.
Value in healthcare is the measured improvement in a person’s healthoutcomes for the cost of achieving that improvement1. The government is reforming healthcare into a new health ecosystem. When done “right,” value-based healthcare’s focus for better healthoutcomes aligns clinicians with their patients.
Like other regions in the United States, Wisconsin is characterized by its unique blend of rules and mandates that govern healthcare compliance within the state. Medicaid Telehealth Services For healthcare providers and compliance professionals in Wisconsin, the Medicaid Telehealth Expansion is an important policy to consider.
The ability to seek treatment from a doctor specializing in your specific medical need is beneficial and improves healthoutcomes. Yet, an intrinsic outcome of this personalization is data fragmentation — data points from different doctors, platforms and tools stored in multiple systems, completely disconnected from each other.
The Medical Assistance Division (MAD) within the New Mexico Human Services Department (HSD) administers the state’s Medicaid program, providing essential healthcare services and financial assistance to eligible low-income residents and families in New Mexico.
The Division of Health Benefits administers the state’s Medicaid program, which provides essential healthcare coverage to eligible individuals and families. Under this law, it is mandated that no individual or entity can start or offer a new institutional health service unless they have secured a certificate of need (CON).
Ohio Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Ohio Department of Health (ODH) is key to safeguarding and enhancing the health of Ohio residents. The license is valid for three years unless revoked.
An oft-cited statistic estimates that 80% of healthoutcomes can be attributed to SDoH. Dr. Geoff Rutledge, chief medical officer of HealthTap , says that variations in healthcare outcomes between adjacent counties can be huge. About 25% of the disparity can be attributed to difficulties getting access to healthcare.
As value-based care increasingly becomes a priority for people, community health workers will play a pivotal role in bridging the gap between healthcare delivery and building trust within communities. Digital health will be critical for advancing health equity. The 2020s are the years of Medicaid standardization.
On 22 nd April 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare enrollment and eligibility rules that would expand coverage for people with Medicare and advance health equity. Our team is well versed and updated on billing and coding updates for government and private payers.
Kentucky Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Kentucky Department for Public Health (DPH) plays a vital role in promoting and protecting the health and wellness of the citizens of Kentucky through various programs, initiatives, and health services.
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. 2021, April).
Georgia Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Georgia Department of Public Health (DPH) plays a crucial role in safeguarding the health and well-being of Georgians.
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