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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.
By harnessing the latest research and training to enhance patient care and education, the network will focus on three priorities: Developing frameworks to assess FIM interventions and measuring healthoutcomes and costs. Sharing insights and identifying opportunities to optimize program design and delivery. economy $1.1
The Medicaid and CHIP Access to Prescription Digital Therapeutics Act seeks to expand care options that can help improve healthoutcomes and quality of life for those facing barriers to healthcare. The act would also define "prescription digital therapeutic" in Medicaid and allow U.S. WHY IT MATTERS.
When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. Continuity of Coverage.
"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?
The virtual care services will be delivered without copays, out-of-pocket costs or deductibles for families with active insurance or Medicaid coverage. WHY IT MATTERS.
According to a press statement from Thompson's office, it would: Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site. This is a common-sense step to make sure our policies keep pace with our technology," he added.
Expanding those successful screening practices across departments and practices, like family medicine, maternal and infant health, pediatrics and cardiology, etc. Gathering reliable data for research that can explore associations between positive screens and healthoutcomes, healthcare utilization and cost.
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.
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.
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.
House of Representatives on Thursday aims to ensure telehealth is able to continue to build on its potential in the years ahead, by making permanent some policies enacted during the pandemic and protecting Medicare beneficiaries' ability to engage in virtual care. WHY IT MATTERS. THE LARGER TREND.
The Fundraise Will Enable Soda Health to Broaden its Offering of Data Products and Services, and Expand its Support to New Benefit Categories Soda Health , a health tech company enhancing the use of benefit dollars to improve healthoutcomes and reduce inequities, today announced a $50M Series B financing.
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.
The acquisition brings Humbi AI’s deep actuarial expertise and robust Medicare and Medicaid data, covering over 200 million lives, to Innovaccer’s Healthcare Intelligence Cloud. Improve patient outcomes: Leverage data-driven insights to enhance care delivery and achieve better healthoutcomes.
Medicare Advantage (MA) will likely see expanded backing, further solidifying its role as a cornerstone of value-based care. They will adopt workflows and technologies that recognize the profound influence of culture, values, and lived experiences on healthoutcomes.
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.
"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.
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. Where is this data going to come from and what must hospital and health system IT executives do here?
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.
Address Cardiometabolic Conditions and Maternal Health The three-year deal will leverage Walmart’s position as a retailer and provider of health and wellness services, and CareSource’s role in the administration and delivery of Medicaid, Medicare and other health plan benefits and services.
Advocacy efforts could include sharing patient stories, presenting evidence-based recommendations, and emphasizing how certain policy decisionsor the lack thereofaffect patient care and healthoutcomes. Health equity, beyond being an ethical imperative, should be viewed as a long-term investment.
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.
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.
What You Should Know: – Wider Circle , which builds peer-driven communities nationwide to help people improve their health and quality of life through trusted connections, announced a partnership with CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst CHPMD).
million members through contracts with leading regional and national Medicaid Managed Care Organizations, Medicare Advantage plans, commercial insurers, and over one thousand employers. Notably, members continue to improve their healthoutcomes even three years later. Currently, Foodsmart serves over 2.2
In 2025, we’ll begin to see a renewed focus on reimagining primary care through more effective policies implemented to remove barriers to care and address the physician shortage the industry currently faces, as well as tax incentives to encourage employers to drive down health costs by prioritizing primary care.
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. The Role of ACOs ACOs participating in the Medicare Shared Savings Program (MSSP) saved Medicare more than $1.8
What You Should Know: – Wider Circle , which builds peer-driven communities nationwide to help people improve their health and quality of life through trusted connections, announced a partnership with CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst CHPMD).
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.
More than 85% of patients report improved health after receiving care from Galileo. Galileo first launched with in-home care for Medicare and Medicaid patients, creating a framework to include social determinants of health in clinical analysis and to bridge gaps in healthcare education. Census Bureau.
– Papa and Uber are working together to mitigate social isolation and negative healthoutcomes among Medicare and Medicaid recipients as well as those with employer health plans.
RPM was initially recognized in 2019 by the Centers for Medicare and Medicaid Services through a small set of codes for remote physiologic monitoring services, enabling clinicians to seek reimbursement for gathering data from patients through certain medical devices outside the hospital setting.
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.
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. Meanwhile, as the number of seniors aging into Medicare increases, the U.S.
" The group plans to lobby policymakers to broaden coverage for care services in the home – including extension and expansion of the Centers for Medicare and Medicaid Services' Hospital Without Walls provisions – advocate for bundled-payment models, home-based care and more. " But it's not enough.
The company’s core AI-enabled platform matches at-risk members with personalized, Registered Dietitian–vetted high-quality meal and grocery offerings that leverage behavioral science to support lasting dietary change and, ultimately, improved healthoutcomes.
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”). This option is available for five years and ends on March 31, 2027.
What You Should Know: mPulse Mobile , a leader in conversational AI and digital engagement solutions for the healthcare industry, released 2 major announcements: – acquired HealthCrowd , a leading communications platform-as-a-service innovator focused primarily on the Medicaid market. Acquisition Impact for mPulse.
– Since its 2017 founding, Papa and its Papa Pals have served members in all 50 states, across Medicare Advantage, Medicaid, and employer health plans.
Moreover, by creating individualized care plans, case managers play a key role in improving patient outcomes. The CMS Interim Final Rule The Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment period (IFC) to implement section 6052 of the Deficit Reduction Act of 2005 (DRA).
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.
These new tools, the company said, deliver stronger relationships across healthcare and life sciences organizations from anywhere, and by tapping into these innovations, organizations can streamline operations and, ultimately, drive better healthoutcomes.
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