1312 Results found.
黑料不打烊 explores potential issues for individuals with end-stage renal disease enrolling in Medicare Advantage
Starting in 2021, Medicare beneficiaries with End-Stage Renal Disease (ESRD) will be able to enroll in any Medicare Advantage (MA) plan. The Anthem Public Policy Institute asked 黑料不打烊 to explore some of the potential issues associated with how MA plans are currently paid by the Centers for Medicare & Medicaid Services (CMS) for individuals with ESRD, and identify any possible modifications that CMS or Congress could make to more closely align payment with costs.
This white paper was prepared for Anthem Public Policy Institute by 黑料不打烊 Managing Principal Jon Blum, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi.
CMS Unveils Healthy Adult Opportunity
This week, our In Focus section comes from 黑料不打烊 Medicaid Market Solutions (MMS) Managing Director Matt Powers and Senior Consultant Desmond Banks. On January 30, 2020, the Centers for Medicare & Medicaid Services (CMS) convened an event titled, Transforming Medicaid: A New Opportunity for Better Health, in Washington, DC, during which CMS Administrator Seema Verma announced the Healthy Adult Opportunity (HAO), an optional Section 1115 Medicaid Demonstration initiative. Commonly referred to as, 鈥渂lock grant鈥� or 鈥渟pending cap鈥� model, the HAO seeks to provide states with enhanced flexibility to design and administer parts of their Medicaid program. Administrator Verma articulated the HAO to be an important step to support the fiscal sustainability of Medicaid and invited state Medicaid directors to submit waiver applications.
Webinar Replay: Lessons from Colorado Community-Based Organizations Engaged in Provider Partnerships that Address Social Determinants of Health
This webinar was held on January 31, 2020.
黑料不打烊’s how-to session last year on development and implementation of social determinants of health (SDOH) partnerships for vulnerable Colorado populations was a tremendous success, offering frameworks and tools for effective SDOH initiatives among community-based organizations (CBOs), health systems, and other providers. As a follow-up to this discussion, 黑料不打烊 hosted a “lessons learned” session, in which two CBOs who have implemented innovative SDOH partnerships outlined the results of their programs and provided insights on how to develop an effective SDOH collaboration.
Learning Objectives
- Learn how CBOs and health systems are successfully collaborating on SDOH services, payment models, and payer-provider relationships.
- Understand the opportunities and challenges related to contracting between CBOs and healthcare systems, including referrals, coordinated care, and pay-for-performance models.
- Find out how to engage and support local communities by activating and financing Community Health Workers (CHWs) for payment by health plans within the Pathways HUB framework.
- Learn how to assess potential partnerships and arrangements that address whole person health, including SDOH.
Speakers
- Grace Damio, Center Director, Hispanic Health Council, Hartford, CT. The Hispanic Health Council has contracted with multiple healthcare provider systems to implement its community CHW-led, home-based diabetes intervention – Diabetes Among Latinos Best Practices Trial (DIALBEST).
- Giovanna Rogow, Chief Executive, , Newburgh, NY. MISN has contracted individually with healthcare providers and serves as the backbone organization leading a 30-member CBO consortium called . This consortium addresses social determinants of health throughout a seven-county region through capacity building and collective action. The HVCCW is presently forming an Independent Practice Association to collectively contract for CHWs to conduct outreach and provide care coordination services on behalf of member organizations via the Pathways HUB model.
Who Should Listen
Representatives of Colorado state and county governments, Colorado Regional Accountable Entities, hospitals, providers, and CBOs working to address SDOH.
黑料不打烊 Principal authors chapter in AJN Book of the Year
Recently, the book, Nursing Informatics for the Advanced Practice Nurse: Patient Safety, Quality, Outcomes, and Interprofessionalism, which features a chapter written by 黑料不打烊 Principal David Bergman, was awarded first place in the 2019 American Journal of Nursing Book of the Year Awards in the Informatics category.
Conservative states鈥� Medicaid expansion offers model for Missouri expansion
A new analysis of conservative state Medicaid expansion in Arkansas, Indiana and Ohio clarifies many of the questions raised about state-level costs and budget savings of a potential Missouri expansion. Researchers at 黑料不打烊 interviewed leaders directly involved with expansion in these states to evaluate the policy and operational adjustments they undertook to design a budget-conscious program while maximizing state value.
黑料不打烊 prepares report detailing economic implications of a Medicaid expansion in Missouri
On January 30, 2020, the Missouri Hospital Association issued a press release outlining a report prepared by 黑料不打烊. .
The report, Medicaid Expansion in Missouri – Economic Implications for Missouri and Interviews Reflecting Arkansas, Indiana, and Ohio Experiences, was prepared by 黑料不打烊 MMS Managing Director Matt Powers and Managing Principal Sharon Silow-Carroll, and Jack Meyer. They conducted interviews with leaders directly involved with expansion in Arkansas, Indiana, and Ohio to evaluate the policy and operational adjustments they undertook to design a budget-conscious program while maximizing state value. Those interviews allowed clarification of many of the questions raised about state-level costs and budget savings of a potential Missouri expansion.
The report was commissioned by the Missouri Hospital Association and Missouri Primary Care Association and released in partnership with stakeholders from the healthcare community.
Exploring value-based payment opportunities for long-term care providers
This week, our In Focus section reviews value-based payment (VBP) opportunities for long-term care providers. 黑料不打烊 Principal Dana McHugh authored the article, 鈥淟ife Plan Communities and Value-Based Payments: Aligning Incentives So Everyone Benefits鈥�, for LeadingAge national magazine, discussing how life plan communities can establish value-based payment arrangements with managed care organizations (MCOs) to maximize value and add additional revenue streams.
New NCQA scoring – what health plans should know
Starting in 2020, a systemic shift will change the way health plans prepare for, and are scored, during National Committee for Quality Assurance (NCQA) accreditation. With the focus on quality of care, this transition means keeping up with new requirements is important now more than ever.