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Brian Norris, Managing Director of Strategic Consulting at MedeAnalytics There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb. Strategies for MA Plans to Address Social Needs 1.
New research from Harvard and Inovalon found MA beneficiaries had fewer hospital readmissions, fewer preventable hospitalizations and lower rates of high-risk medication use than those in traditional Medicare.
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.
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.
Social determinants of health – the food, shelter and security attributes of patients that exist outside of care settings – contribute disproportionate risks for disease, hospital readmissions and a lack of access to quality healthcare among vulnerable populations, including people on Medicare. Like what you hear?
The Reducing Unnecessary Senior Hospitalizations (RUSH) Act of 2020, bipartisan legislation introduced in both the House and Senate, aims to enable more widespread use of telehealth in skilled nursing facilities. This bipartisan bill will help transform rural health care and improve lives." WHY IT MATTERS. THE LARGER TREND.
The Connecticut Children's Care Network, with 37 independent pediatric practices and more than 200 pediatric primary care providers in Connecticut and Massachusetts, has a mission to improve the quality of care and healthoutcomes for infants, children and adolescents. 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.
Medicare Advantage (MA) beneficiaries have better quality of care and healthoutcomes than traditional fee-for-service counterparts, researchers from Harvard Medical School found.
"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.
Challenges in Employer-Provided Healthcare Employers face significant barriers in healthcare, including: – Cost: US employers spend over $800 billion annually, often paying hospitals nearly three times Medicare rates. – Cost Efficiency: Prices within the network are at or below Medicare levels.
How do care management interventions to mitigate SDOH as a risk for undesired healthoutcomes work? Recently, population health management strategies have begun to incorporate evaluations for patients' social needs connected to SDOH, as well as interventions addressing these needs.
"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.
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.
The impact of tech-enabled care on older adults Technology-driven healthcare solutions, such as in-home vitals monitoring, enable increased access to care for the Medicare population and support improved healthoutcomes by supplementing clinical care and helping to address acute and chronic conditions from the comfort of the patients home.
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.
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. THE LARGER TREND. ON THE RECORD.
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.
There are over 60 million enrollees in Medicare in 2019, and fully one-third are in Medicare Advantage plans. Medicare is adding 10,000 new beneficiaries every day in the U.S. Medicare Advantage enrollment is fast-growing, shown in the first chart where over 22 million people were in MA plans in January 2019.
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.
Hospitals and health systems, especially larger ones, are using AI in myriad new ways – including leveraging it for improved patient experience, and for better patient engagement with the goal of reducing health inequities. How did you originally see AI being a fit for improving the patient experience?
Heart failure hospitalizations are a leading cause of admissions for those 65 and older, totaling hundreds of billions in costs. Sean Brady, CEO and cofounder of Ventric Health, is doing his part to turn this problem around. Heart failure affects 6.5 million people in the U.S. with an additional 550,000 newly diagnosed each year.
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. Imagine a healthcare system caught up in fraudulent billing, submitting false claims to Medicare.
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”).
In the dynamic landscape of healthcare, where quality care and cost-effectiveness are paramount, initiatives like the Medicare Shared Savings Program (MSSP) play a pivotal role. MSSP ACOs are groups of doctors, hospitals, and other healthcare providers who voluntarily collaborate to deliver coordinated, high-quality care to Medicare patients.
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.
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.
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?
Chapter 7 of my book, HealthConsuming: From Health Consumer to Health Citizen , is titled, “ZIP Codes, Genetic Codes, Food and Health.” Here, I wonder, “What if… America reduced health disparities, increased health equity, and our ZIP codes didn’t determine our healthoutcomes and life expectancy?”
Medicare recognizes the importance of diabetes self-management training and offers coverage for eligible beneficiaries. However, there are specific guidelines and conditions that need to be met for Medicare billing. Diabetes Education Billing Guidelines for Medicare Who May Furnish the Training?
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.,
– Since its 2017 founding, Papa and its Papa Pals have served members in all 50 states, across Medicare Advantage, Medicaid, and employer health plans.
A lesser-known component of ARRA was Title XIII, the HITECH Act, which funded hospitals’ and physicians’ adoption of electronic health records systems (EHRs). The policy’s acronym fully spelled-out was the Health Information Technology for Economic and Clinical Health Act of 2009. out of the Great Recession.
What You Should Know: – The 32BJ Health Fund, a self-insured fund that provides care for 32BJ SEIU members and their dependents, today released a report that lays bare the stark price disparities between Medicare and private hospitals, and outlines solutions to both reins in prices and holds hospital systems accountable for these practices.
Consistently, according to the Robert Wood Johnson Foundation's County Health Rankings, Southeast Kansas and Northeast Oklahoma have some of the worst healthoutcomes and health factors in their respective states. One anecdotal example is a patient story from nurse Heather Mooneyham. Twitter: @SiwickiHealthIT.
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.
“Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. The authors suggest that investing more in prevention and health promotion for these groups could improve healthoutcomes and get to more equitable spending levels.
health care financing regime of volume-based payment didn’t fare well as millions of patients postponed or cancelled procedures and visits for fear of contracting the virus in the halls, offices and clinics of hospitals and doctor’s offices. hospitals were losing $1.4 hospitals were losing $1.4 In other words, the U.S.
The proposed decision, which is subject to public comments that are due to CMS by February 10, 2022, does not endorse nationwide Medicare coverage for these drugs. The FDA’s determination does not mandate Medicare coverage for Aduhelm. All CED trials would have to be conducted through hospital outpatient departments.
Reduced hospital admissions: Fewer unnecessary hospitalizations due to proactive management. Improved healthoutcomes: Early intervention and preventive care enhance long-term health. This report showcases the transformative impact of VBC models on specialty medical practices and population healthoutcomes.
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%
billion through Arcadia’s Medicare Shared Savings Program (MSSP) service. The past year included several important milestones for Arcadia, including: Inclusion on Inc. Growing total active unique users of the Arcadia Analytics platform by 50% in nine months; and Saving customers more than $1.3
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