Healthcare It News

FEBRUARY 28, 2023

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 health outcomes by increasing access, he reported.

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Electronic Medical Records Telemedicine Health Insurance Health Outcomes 250

HIT Consultant

JULY 13, 2022

has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Recently, CMMI stated that by 2030 every Medicare beneficiary should be in a value-based relationship – either an ACO or ACO-like model or Medicare Advantage – with a significant emphasis on health equity.

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Health Populi

DECEMBER 9, 2019

That program has the potential to change our Medicare members manage meds at home to ensure better adherence, supporting better health outcomes and personal feelings of efficacy and control. [As Last week, the Giant Eagle grocery chain was the first pharmacy retailer to offer a new medication management skill via Alexa.

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Medicare Medicare Health Outcomes Health Insurance 62

Bill of Health

APRIL 13, 2022

This policy improves coverage and helps reduce churn , which is associated with poor health outcomes. Two weeks after CMS issued its March 2022 guidance, the Kaiser Family Foundation released its annual survey of state Medicaid and Children’s Health Insurance Program (CHIP). What States Are Doing Now.

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Medicaid Medicaid COVID-19 Public Health 147

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.

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Health Populi

JUNE 2, 2021

and how much care would be postponed or never realized in the health care system. A big uncertainty in this year’s forecast, pondering the 2022 picture, is what extent eliminate care will have on future adverse health outcomes… something that keeps my scenario planning humming across various modeling.

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COVID-19 Health Insurance Health Outcomes Public Health 174

HIT Consultant

FEBRUARY 20, 2024

What You Should Know: – Strive Health , the national leader in value-based kidney care, and Medical Mutual , one of the largest Ohio-based health insurance companies, announced a new value-based kidney care partnership. Addressing a Hidden Health Crisis: Over 1.3

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Health Insurance Health Outcomes Medicare Medicare 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.

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Fraud Health Insurance Medicaid Medicaid 52

Healthcare IT Today

APRIL 10, 2023

Uncle Roy’s story is not unique; the individual behaviors that people with chronic conditions perform on a daily basis are the most important determinant of future health outcomes. But, it’s estimated that 40% of health outcomes are actually attributed to our individual behavior. In the U.S.,

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Health Outcomes Hospitals ACA Doctors 107

Health Care Law Brief

FEBRUARY 2, 2024

The Waiver Amendment was approved on January 9, 2024, by the Centers for Medicare & Medicaid Services (“CMS”) under Section 1115(a) of the Social Security Act and will expire on March 31, 2027. The rates must be at least 80% of Medicare rates. billion in Medicaid investments over the next three years. CMS has authorized up to $2.2

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Medicaid Medicaid Medicare Medicare 52

Compliancy Group

MARCH 19, 2024

Also, all insurance and Medicare or Medicaid claims must only include charges for services and treatments ordered and deemed necessary. Department of Health and Human Services (HHS) enforces laws relevant to patient care, healthcare delivery and billing, and workplace safety in the U.S. name, phone number).

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Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

Healthcare IT Today

APRIL 13, 2023

Although this focus started with attention to the population covered by Medicaid, the healthcare field has recognized that health equity is a relevant issue to populations covered by Medicare, Commercial, and other health insurance coverage. Let me provide some examples of what this could look like.

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Medicaid Medicaid Medicare Medicare 73

HIT Consultant

JULY 16, 2024

In January 2024, the Centers for Medicare and Medicaid Services (CMS) ruled that Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) can now bill for RPM under new global coding.

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Medicaid Medicaid Health Insurance Health Outcomes 105

Health Populi

AUGUST 24, 2021

In that introductory editorial, Ending Structural Racism in the US Health Care System to Eliminate Health Care Inequities, Ortega and Roby write that, “3 studies in this issue of JAMA show that access to and utilization of services is not merely predicated on health insurance or the availability of health care.

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COVID-19 Health Care Inequity COVID-19 Vaccine Medicare 139

HIT Consultant

NOVEMBER 9, 2023

With many being unable to pay emergency care bills, there will be an even greater debt put on health systems that are already financially constrained as they battle inflation, post-pandemic patient surges, and increased staffing shortages. As the surge of redetermination efforts winds down, there is an opportunity to forge a new path forward.

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Medicaid Medicaid Health Insurance COVID-19 64

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.

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MedTrainer

DECEMBER 4, 2023

Regulations in the district encompass diverse healthcare areas, including patient privacy and data security, Medicaid and Medicare compliance, health insurance marketplaces, and scope of practice for healthcare professionals. Healthcare in D.C.

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Compliance Health Insurance Medicaid Medicaid 52

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.

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Medicare Medicare Medicaid Medicaid 52

Health Populi

FEBRUARY 17, 2021

Those patients trying to stay medication-adherent tried various strategies such as stretching out their prescriptions, skipping doses, or reducing those doses — not sticking to the prescribed regimen, which can result in an adverse event or compromise the intended health outcome.

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COVID-19 Health Insurance Medicaid Medicaid 147

HIT Consultant

NOVEMBER 24, 2022

The regulations may provide an opportunity for health insurers to attract new members – and retain existing ones – with hearing loss. Health plans could, for example, consider covering OTC hearing devices as part of the hearing benefits package provided to their Medicare Advantage plan members. Expanding membership.

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FDA Public Health Fraud Medicare 98

HIT Consultant

JUNE 28, 2022

The results are one example of the gains that can be made in addressing health inequities—differences in health status or distribution of health resources by race, population, gender, income and more—by exploring the nuances that perpetuate disparities in health outcomes. Digging Deeper into Disparities in Care.

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Health Outcomes COVID-19 Medicaid Medicaid 52

Health Populi

JULY 13, 2020

The Consumer Technology Association (CTA) collaborated with The Economist Intelligence Unit (EIU) on the research report, Reinvigorating Value-Based Health Care: Exploring the Role of Technology Innovation. The Medicare Trust Fund is financed by payroll taxes, general tax revenue, and the premiums enrollees pay. of the U.S. of the U.S.

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COVID-19 Medicare Medicare Hospitals 110

Healthcare IT Today

JANUARY 5, 2024

A population health-based approach that incorporates social determinants of health and sexual orientation and gender identity will significantly improve community health outcomes. It showcases a growing patient preference for healthcare providers that prioritize value and outcomes. Improving the cancer journey.

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Nurses Medicare Medicare Medicaid 136

Health Populi

FEBRUARY 11, 2019

Patients most-trust their clinicians, physicians and nurses, as safe places in which to have an honest SDoH discussion, compared with a health insurance representative. To mitigate SDoH risks for older Americans, Medicare has begun to pay for services that promote coordinated care.

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Medicare Medicare Doctors Health Insurance 95

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”). 2] Black women have a maternal mortality rate 3.3

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Medicaid Medicaid ACA Public Health 52

Health Populi

NOVEMBER 19, 2019

In the past decade, I’ve been spending a lot of time considering SDoH through a variety of lenses across the health/care ecosystem, including care providers like hospitals, health insurance companies, pharma and life science, retail health care front doors, and non-profits and foundations.

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Medicare Medicare Health Care Access Health Insurance 59

HIT Consultant

FEBRUARY 7, 2022

Research says that those Americans who live in rural communities have less access to care and subsequently worse health outcomes than those who live in non-rural communities. African American adults are more likely to report they cannot afford to see a doctor, leading to worse health outcomes.

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Doctors Health Outcomes COVID-19 Health Insurance 98

MedTrainer

DECEMBER 7, 2023

The resources provided by these Idaho state agencies are essential for promoting public health, ensuring access to healthcare, supporting healthcare professionals, and enhancing overall health outcomes for the residents of Idaho. It also allows licensure exceptions for out-of-state providers under specific circumstances.

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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.

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Medicaid Medicaid Federal Policy Health Outcomes 52

Health Populi

OCTOBER 8, 2018

With “Economy” embodied in the law’s name, a rationale for including HITECH in ARRA was, in part, to help stimulate the nation’s economy beyond the revenues of health IT companies many of whom, in the short-term, directly benefited from the law. Some historical perspective is useful for context.

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Hospitals Health Insurance Health Outcomes Telemedicine 61

Healthcare Law Blog

DECEMBER 15, 2022

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

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Medicaid Medicaid Medicare Medicare 52

HIT Consultant

OCTOBER 7, 2021

Value-based care, a model that rewards better patient health outcomes, has experienced a surge in interest amid heightened consumer awareness and among payers seeking to lower costs and stabilize reimbursement. WEDI has close working relationships with both CMS and CAQH.

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Healthcare IT Today

JANUARY 18, 2024

By balancing compliance, innovation, and budget constraints, healthcare organizations will drive better health outcomes, ushering in a more efficient era in healthcare. Gabriel Mecklenburg, Co-Founder & Executive Chairman at Hinge Health Gabriel Mecklenburg shares his predictions on how technology will shape healthcare in 2024.

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Hospitals Compliance Health Outcomes Medicare 81

AIHC

AUGUST 13, 2024

It applies to health programs and activities that receive federal financial assistance, known as covered entities. Those covered by the rule may include hospitals, health clinics, health insurance issuers, state Medicaid agencies, community health centers, physicians’ practices, and home health care agencies.

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Compliance ACA Health Insurance Medicaid 52

Hall Render

JANUARY 5, 2024

region has health officials worried Half of Black D.C. helped shape Galen College of Nursing’s culture Kentucky Association of Health Plans names 2024 officers, expands reach to improve health of all Kentucky’s registered nurse median salary ranks 38th in U.S.

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COVID-19 Nursing Homes Nurses Hospitals 40

Health Populi

MAY 15, 2018

Health citizens living in states in New England, and then those west of Michigan and north of Missouri and Kansas, demonstrate better-than-average health outcomes. The social determinants of health — income and good jobs, using tobacco, and having health insurance — bolster good health.

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Health Insurance Health Outcomes ACA Public Health 74

Jane Sarashon

DECEMBER 22, 2022

Brian Klepper of Worksite Health Advisors , longtime consigliere to self-insured employers, unions, and value-oriented providers of medical services, explained the growth in value-based care he expects to see in the coming months: “Today’s descendants of the disruptor Managed Care companies of the 1980’s are value-focused and high performing….that

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COVID-19 Health Insurance Public Health Hospitals 52