Healthcare It News

DECEMBER 16, 2022

The Medicaid and CHIP Access to Prescription Digital Therapeutics Act seeks to expand care options that can help improve health outcomes 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.

Medicaid 192

Medicaid Medicaid COVID-19 Health Outcomes 192

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”).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

HIT Consultant

APRIL 16, 2024

What You Should Know: – inVio Health Network and CVS Accountable Care Organization, a division of CVS Health , have announced a collaboration to participate in the new Medicare Accountable Care Organization (ACO) REACH program.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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”). This option is available for five years and ends on March 31, 2027.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

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. Meanwhile, as the number of seniors aging into Medicare increases, the U.S.

Medicare 98

Medicare Medicare Health Outcomes Medicaid 98

Medisys Compliance

JULY 13, 2023

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?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 52

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. Sections 120 and 402 of the CAA made two key changes to Medicare enrollment rules.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

HIT Consultant

JUNE 26, 2024

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 health outcomes even three years later. Currently, Foodsmart serves over 2.2

Health Outcomes 105

Health Outcomes Medicaid Medicaid Medicare 105

HIT Consultant

FEBRUARY 28, 2023

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.

Medicaid 98

Medicaid Medicaid Health Outcomes Medicare 98

Healthcare IT Today

SEPTEMBER 26, 2024

This shift places health plans at the core of the healthcare experience, requiring them to adapt to the evolving member expectations. They illustrate that a person’s ability to use digital tools can significantly impact their health outcomes.

Health Outcomes 73

Health Outcomes Medicare Medicare Medicaid 73

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. The Role of ACOs ACOs participating in the Medicare Shared Savings Program (MSSP) saved Medicare more than $1.8

Patient Satisfaction 147

Patient Satisfaction Medicare Medicare Medicaid 147

Health Law Advisor

JANUARY 13, 2022

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. The Medicare Part B program would not cover the drugs in any other setting.

Medicare 52

Medicare Medicare FDA Medicaid 52

Healthcare IT News - Telehealth

JANUARY 25, 2021

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.

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COVID-19 Medicare Medicare Telemedicine 211

NEJM

APRIL 7, 2023

People who are dually enrolled in Medicare and Medicaid face issues related to fragmented care and poor health outcomes associated with inadequate coordination of benefits and services.

Medicaid 53

Medicaid Medicaid Health Outcomes Medicare 53

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.

Medicaid 52

Medicaid Medicaid Federal Policy Health Outcomes 52

NY Health Law

FEBRUARY 13, 2024

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. Workforce: Workforce investments with a goal of equitable and sustainable access to care in Medicaid.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

Healthcare It News

OCTOBER 31, 2022

"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 health outcomes," according to Argentieri, Meklir and Henry.

Licensing 280

Licensing Medicaid Medicaid Health Outcomes 280

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. Understandably, Medicaid and Medicare agencies attempt to reduce that abrasion.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Healthcare It News

OCTOBER 27, 2023

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 health outcomes, healthcare utilization and cost.

Medicaid 256

Medicaid Medicaid World Health Health Outcomes 256

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”).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Healthcare It News

JANUARY 10, 2023

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.

COVID-19 265

COVID-19 Hospitals Telemedicine Medicaid 265

HIT Consultant

OCTOBER 18, 2021

– Papa and Uber are working together to mitigate social isolation and negative health outcomes among Medicare and Medicaid recipients as well as those with employer health plans.

Medicaid 94

Medicaid Medicaid Health Outcomes HIPAA 94

HIT Consultant

NOVEMBER 2, 2023

Lumeris stands out as the only value-based care enablement company with experience working across various patient populations, including those covered by Medicare Advantage, CMMI programs, commercial insurance, and Medicaid.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare It News

JANUARY 18, 2022

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 health outcomes work?

Medicaid 347

Medicaid Medicaid Patient Satisfaction Health Outcomes 347

Healthcare IT News - Telehealth

MARCH 25, 2024

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?

Hospitals 175

Hospitals Health Outcomes Medicaid Medicaid 175

Healthcare IT Today

JULY 1, 2024

Improving Health Outcomes and Driving Down Costs Established in 2019, Better Health provides support and medical supplies for people with chronic conditions, such as ostomy, chronic wounds, diabetes, chronic retention, and incontinence. For health plans, Better Health’s unparalleled engagement of 10.5

Health Outcomes 73

Health Outcomes Medicare Medicare Medicaid 73

HIT Consultant

MARCH 21, 2024

While these tools promise better health outcomes and cost savings, the research paints a different picture: Small, Unsustained Improvements: HbA1c reductions, a key diabetes measure, were minimal (0.23 Payers: Health plans and employers should require evidence of tool benefits and tie financial coverage to clinical outcomes.

Health Outcomes 104

Health Outcomes Medicaid Medicaid Doctors 104

Hall Render

FEBRUARY 22, 2024

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 66

Hospitals Medicare Medicare Medicaid 66

HIT Consultant

FEBRUARY 21, 2023

The company continues to be the largest network of independent primary care in the country, with more than two million patients covered by more than 150 value-based contracts across Medicare, Medicare Advantage, Medicaid and commercial payers.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

MedTrainer

MARCH 8, 2024

FQHCs can receive financial rewards for deploying an individualized, patient-centered care model that builds trust between patients and providers, which has shown to improve health outcomes. FQHCs can participate in APMs through Medicare and Medicaid Managed Care Organizations (MCOs).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

SEPTEMBER 18, 2023

The newest value-based payment program purposely designed to address SDOH is the ACO Realizing Equity, Access, and Community Health (ACO REACH) model, launched by the Centers for Medicare & Medicaid Services (CMS). million people enrolled in Medicare that year, less than 2% had claims that incorporated Z codes.

Health Outcomes 114

Health Outcomes Electronic Medical Records Medicaid Medicaid 114

HIT Consultant

FEBRUARY 16, 2022

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 health outcomes.

Medicaid 98

Medicaid Medicaid Public Health Medicare 98

HIT Consultant

NOVEMBER 16, 2022

What You Should Know: – Cipher Skin and Parker Health launches a new pilot program to help bring tech-enabled physical therapy to Medicare and Medicaid patients. And many patients—especially those on Medicare and Medicaid—do not have the luxury of extending their recovery time.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Law Advisor

MAY 2, 2023

The Centers for Medicare & Medicaid Services (“CMS”) is using its annual rulemaking process to update the CMS payment system rules for fiscal year (“FY”) 2024 as a mechanism to advance health equity systematically across various CMS payment programs. health system.” [9] health system.” [9]

Payment Systems 52

Payment Systems Medicare Medicare Nurses 52

Healthcare IT Today

APRIL 13, 2023

The following is a guest article by Paul Barnes, Partner at CWH Advisors Today, there is widespread consensus that Social Determinants of Health (SDoH) have an impact on health inequities among various populations; resource scarcity in food, housing and other areas result in different health utilization and outcomes.

Medicaid 73

Medicaid Medicaid Medicare Medicare 73

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 93

Health Outcomes Governance Compliance Medicaid 93