HIT Consultant

NOVEMBER 9, 2023

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.

Medicaid 64

Medicaid Medicaid Health Insurance COVID-19 64

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

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

Healthcare Law Blog

APRIL 6, 2022

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.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

Healthcare IT News - Telehealth

SEPTEMBER 9, 2024

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.

Telemedicine 160

Telemedicine Licensing Health Outcomes Governance 160

Healthcare IT Today

APRIL 5, 2024

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 health outcomes.

Public Health 94

Public Health Medicaid Medicaid Governance 94

Healthcare IT Today

MAY 10, 2023

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.

Health Outcomes 128

Health Outcomes Medicaid Medicaid Nurses 128

MRO Compliance

AUGUST 8, 2024

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.

Patient Satisfaction 147

Patient Satisfaction Medicare Medicare Medicaid 147

HIT Consultant

OCTOBER 11, 2024

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.

Medicare 98

Medicare Medicare Health Outcomes Medicaid 98

Healthcare IT Today

MARCH 24, 2023

Prioritizing data that has been purpose-built and clinically validated ensures that we’re tracking data that truly predicts and impacts health outcomes, not just correlation. Cancer researchers are investigating the impacts of cancer on long-term health outcomes, financial strain, and household impact.

Health Outcomes 115

Health Outcomes Public Health Medicaid Medicaid 115

Healthcare IT Today

NOVEMBER 8, 2024

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?

Telemedicine 138

Telemedicine Health Outcomes COVID-19 Governance 138

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

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Enrollee Participation in Plan Governance (§ 422.107).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Healthcare IT News - Telehealth

JANUARY 26, 2022

Advances in telehealth have allowed both populations to receive more convenient, high-quality care, thus leading to better health outcomes. 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.

Fraud 148

Fraud Telemedicine COVID-19 Licensing 148

Healthcare IT Today

OCTOBER 19, 2023

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.

Department of Veterans Affairs 128

Department of Veterans Affairs Nursing Homes Health Outcomes Hospitals 128

Healthcare IT Today

FEBRUARY 15, 2024

Sarah Carroll, Senior Vice President, Center for Care Transformation at AVIA Health Medicaid 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.

Medical Device Industry 130

Medical Device Industry Medicaid Medicaid Nurses 130

HIT Consultant

JUNE 7, 2023

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!

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

AUGUST 12, 2024

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.

Pharmaceutical Industry 52

Pharmaceutical Industry Medicaid Medicaid Health Outcomes 52

HIT Consultant

MARCH 28, 2023

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.

Medicaid 98

Medicaid Medicaid Medical Billing Medicare 98

HIT Consultant

MAY 3, 2022

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’ health outcomes. These are just two examples of data that highlight the need for equity.

Medicaid 52

Medicaid Medicaid Governance Health Outcomes 52

Healthcare IT Today

JANUARY 10, 2023

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.

Health Outcomes 88

Health Outcomes Health Care Access Medicaid Medicaid 88

HIT Consultant

NOVEMBER 7, 2024

Often, their health needs are complex, influenced by significant trauma, and exacerbated by the systemic barriers they encounter. Despite these challenges, there is an immense opportunity for the healthcare system, particularly Medicaid, to play a transformative role in addressing health equity for this population.

Medicaid 52

Medicaid Medicaid Health Outcomes State Policy 52

AIHC

OCTOBER 20, 2023

Value in healthcare is the measured improvement in a person’s health outcomes 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 health outcomes aligns clinicians with their patients.

Health Outcomes 59

Health Outcomes Medicare Medicare Governance 59

MedTrainer

NOVEMBER 30, 2023

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.

Compliance 52

Compliance Medicaid Medicaid Licensing 52

Healthcare IT Today

JANUARY 5, 2024

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.

Nurses 105

Nurses Medicare Medicare Medicaid 105

Healthcare IT Today

JANUARY 4, 2023

The ability to seek treatment from a doctor specializing in your specific medical need is beneficial and improves health outcomes. 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.

US Department of Health and Human Services 75

US Department of Health and Human Services Doctors COVID-19 Health Outcomes 75

MedTrainer

DECEMBER 7, 2023

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

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).

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

MedTrainer

NOVEMBER 27, 2023

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Healthcare IT Today

OCTOBER 16, 2023

An oft-cited statistic estimates that 80% of health outcomes 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.

US Department of Health and Human Services 130

US Department of Health and Human Services COVID-19 Hospitals Public Health 130

Medisys Compliance

MAY 5, 2022

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.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

MedTrainer

DECEMBER 4, 2023

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

HIT Consultant

DECEMBER 19, 2024

Our team found that Medicaid members who are misassigned due to bad provider data for a single health system in one state lead to around $55 million being unnecessarily spent over a month. Improve Data, Improve Outcomes Precise, up-to-date provider data is fundamental to achieving better clinical and financial outcomes in healthcare.

Patient Satisfaction 52

Patient Satisfaction Governance Medicaid Medicaid 52

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. 2021, April).

Fraud 52

Fraud Compliance Health Insurance Medicaid 52

MedTrainer

NOVEMBER 27, 2023

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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

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 billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Health Insurance Medicaid Medicaid 52

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”). Enrollee Participation in Dual Eligible Special Needs Plan (“D-SNP”) Governance (§ 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52