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This means there is a pretty good overlap of SDOH with population health. 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.
When a new member joins, MA plans usually lack insights into beneficiaries claim history, morbidity risk, and health behaviors. Without that data, understanding social risk becomes difficult for identifying beneficiary needs, guiding interventions, and ultimately improving healthoutcomes.
Joining the effort are several other major healthcare organizations including Geisinger, Highmark Health, CVS Health, Elevance Health, Devoted Health and Blue Cross Blue Shield of North Carolina. Sharing insights and identifying opportunities to optimize program design and delivery. economy $1.1
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. You contend CMS's Acute Hospital Care at Home program needs scalability to survive.
The virtual care services will be delivered without copays, out-of-pocket costs or deductibles for families with active insurance or Medicaid coverage. Before the pandemic, patients had to be in a rural area in a hospital or clinical setting to receive reimbursement for telehealth. WHY IT MATTERS. THE LARGER TREND.
Now more hospitals and health systems are looking to expand their efforts beyond video visit-based virtual care, and push for expanded remote patient monitoring programs – up to and including the provision of acute care at home. They cleared the path for parity reimbursement during the public health emergency.
"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.
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?
What You Should Know: – Brave Health , a Miami-based virtual behavioral health provider for Medicaid, today announced it has closed a $10M Series B round ($20.75M in total) led by City Light Capital, Union Square Ventures and Able Partners, bringing its total funding to $20.75M. Recent Traction/Milestones.
Brave Health , the largest virtual mental health provider and engagement platform focused on serving Medicaid populations, today announced a $40M Series C funding round led by Town Hall Ventures, with existing investors Union Square Ventures, City Light Capital and others joining as well.
What You Should Know: – PointClickCare , a healthcare technology platform, and MassHealth, the Massachusetts Medicaid program launches a new Behavioral Health Treatment and Referral Platform. Boarding can lead to delays in treatment, increased stress for patients and families, and strain on hospital resources.
"Timely availability of clinical information during health care transitions, in a setting with robust telemedicine access, can shift the method of care delivery without adversely affecting patient healthoutcomes," wrote the researchers. WHY IT MATTERS. ON THE RECORD.
Together, these tools can significantly enhance population healthoutcomes. However, challenges remain, including the digital divide, which can limit access in communities with high social determinants of health. However, the challenge lies in ensuring these advancements reach all communities equitably.
UPMC Central Pennsylvania, a hospital that in 2021 achieved Stage 7, the top of the HIMSS Electronic Medical Record Adoption Model, has been a leader in telemedicine, with more than two dozen robust virtual care programs. Virtual-first primary care has been shown to improve healthoutcomes by increasing access, he reported.
Making health data more accessible to patients – not to mention doctors and health plans – is a priority for all hospitals and health systems today, as the final Centers for Medicare and Medicaid Services Interoperability Rule mandates patient access.
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.
Capacity Planning: AI tools help hospitals predict admission surges, ensuring adequate staffing and resources during peak demand periods. 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.
Jordan Messler, MD, SFHM, FACP, Chief Medical Officer at Glytec The modern-day hospital is grappling with an alarming trend. This is generating a national conversation among health system leaders on inpatient glycemic management strategies, and whether their facilities are doing enough. The time for change is now.
American seniors are already comfortable with video call technology, the survey found, revealing 45% have used FaceTime, Skype or Google Hangout, and a quarter are already using a mobile phone health app. ON THE RECORD.
Gary Rothenberg, Director of Medical Affairs at Podimetrics According to a recent survey of more than 1,000 Medicaid patients, 86% stated they want their plan to cover more tools and approaches to keeping them connected with their healthcare team. They are often readmitted to the hospital, leading to worse healthoutcomes.
What You Should Know: – Alliance Health , a managed care organization serving over 137,000 Medicaid beneficiaries in North Carolina, announced a new partnership with Cityblock , a value-based healthcare provider for Medicaid and dually eligible individuals. ”
The following is a guest article by Ashley Perry, MPH, Chief Strategy and Solutions Officer at Socially Determined When Congress passed the Consolidated Appropriations Act of 2023 , it decoupled the Public Health Emergency (PHE) from the Medicaid program’s continuous enrollment provision, which was implemented as part of the PHE in March 2020.
What You Should Know: – Cityblock , a value-based healthcare provider specializing in Medicaid, announced a new partnership with Sunshine Health , a Florida managed care plan. – The partnership expands Centene Corporation’s , Sunshine Health’s parent company, existing relationship with Cityblock. .
A push to improve reimbursement for remote patient monitoring programs has stalled, and that could prompt health systems and hospitals to think twice about launching or expanding their platforms. Oren Nissim is CEO and cofounder of Brook Health, a remote patient monitoring company, and is an expert in the realm of RPM reimbursement.
Telemedicine, though, cannot directly provide services to address social determinants of health, services that still remain scattered and disparate. A Medicaid member may not have a smartphone, high-speed wireless internet or unlimited data plans. We have to take into consideration the economic barriers that the underserved experience.
America is the only wealthy nation to lack universal health coverage. Under-investment in social determinants of health are major drivers of inequitable healthoutcomes in the United States. health system continue to exacerbate poor health and disparities. Uninsured people in the U.S. COVID-19 and the U.S.
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 – and explored opportunities and barriers to growth. 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. What can hospitals and health systems do to make this happen?
The Medicaid population, who typically benefits from progress last, still grapples with harmful biases within the healthcare system that pose extreme barriers to care. For the Medicaid population, receiving this type of care is more challenging and increasingly necessary. Adequate representation is also a crucial piece of the puzzle.
hospitals lose millions annually due to unpaid medical bills. Additionally, utilizing data analytics to customize financial education and payment plans can assist in enhancing patient satisfaction and trust, ultimately improving healthoutcomes. This puts America’s healthcare system into a detrimental, transient state.
"For example, a member who had recently been discharged from the hospital who does not follow up with their primary care physician within a week has a higher likelihood of being hospitalized soon after," Carrazco noted. "By preventing hospitalizations, we can save the industry the burden of this high healthcare cost.
Department of Health and Human Services (HHS) Enforces regulations like the Health Insurance Portability and Accountability Act (HIPAA) to ensure patient data privacy and security. For example, patients may hold back critical health information in fear that it will be shared or leaked, which can negatively affect healthoutcomes.
– Since its 2017 founding, Papa and its Papa Pals have served members in all 50 states, across Medicare Advantage, Medicaid, and employer health plans.
While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.
(Side Note: Be sure to check out Data’s Role in Health Equity and Technology and Health Equity as well) Kimberly Hartsfield, Executive Vice President of Growth Enablement at VisiQuate Shockingly, 58% of hospital bad debt comes from insured patients. This highlights the dire need to address patient access to care.
Jeff Geier, Cyber Security Leader at Pivotalogic California’s bold new CalAIM Medicaid transformation program is restructuring what partnership for health looks like across the state. This support not only improves overall healthoutcomes but also contributes to the stability and well-being of the community.
Most patients with OUD diagnosis had Medicaid, were uninsured or homeless – with associated visit costs largely borne by health systems. during 2017-2022, creating a substantial economic burden for affected hospitals. during 2017-2022, creating a substantial economic burden for affected hospitals. hospitals are $95.43
In 2025 I think we will see a more focused back-to-basics approach to applying technology to the modernization of care, with health systems being more laser-focused on addressing one or two specific pain points as opposed to a shotgun approach of throwing technology at problems to see what sticks.
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 healthoutcomes. Across these 23,452 members last year, our clients measured an average of 42% reduction in hospitalizations. In the U.S.,
of the total market share due to increased adoption to manage chronic conditions and monitor healthoutcomes. OpenLoop White-Label Telehealth Solutions OpenLoop was founded with the mission to expand access to care and improve community healthoutcomes. Additionally, telehealth services hold 45.7%
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.
In this article, I’ll show how many hospitals, payers, and other institutions are acting on that data. Of course, the staff of a clinic or hospital don’t go around looking for apartments the way they actively look for a long-term care facility. ” Some of this data involves SDoH, such as indications of isolation.
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.
In addition, the complexities associated with finding the appropriate follow-up care for patients’ behavioral health needs create “a cycle of ED help-seeking behaviors and mental states that worsen with early discharge,” researchers say. and studies have shown that the timing of a crisis can play a critical role in patient outcomes.
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