黑料不打烊

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黑料不打烊 Insights: Your source for healthcare news, ideas and analysis.

黑料不打烊 Insights鈥攊ncluding briefs, webinars, and our podcast鈥攇ives you easy access to 黑料不打烊鈥檚 deep expertise, helping you stay current on the latest healthcare trends and topics. Search for a topic of interest or browse the latest insights below.

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Webinar

Webinar Replay – Health Performance Accelerator Webinar Series: How States Are Rethinking Medicaid Managed Care Performance Management

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This webinar was held on September 8, 2020.

State Medicaid agencies (SMAs) are actively exploring improved approaches to managing the performance of Medicaid managed care organizations (MCOs) and accountable care organizations (ACOs), emphasizing tailored quality measures, new incentive models, more effective use of information technology, and revised contract requirements.

During this webinar, experts from 黑料不打烊 and HealthEC outlined potential improvements to MCO/ACO performance management and showcased ways in which information technology can be deployed to enable these improvements.

Learning Objectives:聽聽聽聽

  • Learn about ways in which the number and mix of measures, the design of business processes and use of information systems should change to achieve improvements in MCO/ACO performance management.
  • Learn how 黑料不打烊 can work with SMAs on performance management initiatives.
  • Find out how IT solutions such as HealthEC鈥檚 can dramatically improve SMA processes such as data aggregation, synthesis, transformation, validation, and comparative analysis in support of performance management system improvements.

Speakers

Steve Soto, Principal, 黑料不打烊
Sita Kapoor, HealthEC, Chief Information Officer

Webinar

Webinar Replay – Health Performance Accelerator Webinar Series: Optimizing Your Communicable Disease Outbreak Management

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This webinar was held on September 3, 2020.

The COVID-19 pandemic has demonstrated the challenges faced by state and local data management and analytics infrastructures in preventing and responding to infectious disease outbreaks. During this webinar, experts from 黑料不打烊 and HealthEC provided a framework for how states and local jurisdictions can leverage data to prevent major disease outbreaks and implement targeted strategies to address outbreaks when they occur.

Learning Objectives:

  • Understand how data and analytics infrastructures can be used to help prevent infectious disease outbreaks.
  • Learn about surveillance capabilities, including 鈥渆arly warning鈥� capabilities, made possible by more robust contact tracing functionality and Internet-enabled devices, such as thermometers and remote monitoring systems.
  • Explore response management capabilities, such as robust real-time adaptive modeling that can drive resource allocation and deployment.
  • Understand risk stratification and predictive modeling which supports smart pre-deployment of outreach to vulnerable populations.

Speakers

Liddy Garcia-Bunuel, Principal, 黑料不打烊
Jennifer Leaf Jaeger, MD, MPH, MS, HealthEC, Senior Medical Director

Webinar

Webinar Replay – Health Performance Accelerator Webinar Series: Achieving Health Equity for Disadvantaged Populations

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This webinar was held on September 1, 2020.

Across the nation, an unprecedented focus is being placed on achieving the goal of health equity. This goal requires acquiring, aggregating, and analyzing data on social determinants of health to help identify and address the root causes of health disparities. During this webinar, experts from 黑料不打烊 and HealthEC provided a roadmap for how states, health plans, and providers can leverage data to support the design, development, and implementation of successful health equity initiatives.

Learning Objectives:

  • Understand why achieving health equity is an increasingly important goal for state Medicaid agencies, health plans and providers.
  • Learn how racial inequality and social determinants of health contribute to inequities in health care access, outcomes, and status.
  • Assess the readiness of states, health plans, and providers to address concerns over the impact of health equity on the morbidity and mortality or disadvantaged populations.
  • Understand the role of analytics and population health management in identifying the causes of health disparities and building successful health equity initiatives.

Speakers

Desmond Banks, MPH, PhD, Senior Consultant, 黑料不打烊, Washington DC
Jennifer Leaf Jaeger, MD, MPH, MS, Health EC, Senior Medical Director

Blog

黑料不打烊 summary of Democratic nominee Joe Biden鈥檚 healthcare plan

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This week, our In Focus section reviews Democratic Nominee Joe Biden鈥檚 healthcare plan to protect and build on the Affordable Care Act (ACA). On August 18, 2020, Biden was officially nominated as the presidential candidate. Biden vowed at the 2020 Democratic National Convention (DNC) that if elected, he would strengthen the ACA and provide a Medicare-like public option. 黑料不打烊 summarizes Biden鈥檚 official plan below.

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Webinar

Webinar Replay: National and State Strategies for Long-Term Care at Home

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This webinar was held on August 31, 2020.

The COVID-19 pandemic has created greater impetus for the growth of home-based care alternatives to hospital and institutional care. In this webinar, 黑料不打烊 experts provided a national overview of the trend toward home-based care and highlighted innovations in state policies, payer programs, clinical models, and payment models. Speakers also took an in-depth look at California鈥檚 new LTC at Home benefit.

Learning Objectives:

  • Understand how the pandemic is spurring new interest and growth in home-based alternatives to institutional care.
  • Identify trends among home health and home care providers in the era of COVID-19.
  • Learn about promising state and payer initiatives for promoting home-based long-term care (LTC)
  • Explore the details and ramifications of California鈥檚 new LTC at Home benefit.

黑料不打烊 Speakers

Karen Brodsky, MHS, Principal, New York
Jody Gastfriend, LCSW, Principal, Boston
Barry Jacobs, Psy.D., Principal, Philadelphia
Jason Silva, JD, Senior Consultant, Sacramento

Materials Referenced in this Webinar

Continuum of Care Table

Blog

黑料不打烊 summary of Medicare Fee-for-Service (FFS) proposed rules

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This week, our In Focus section reviews two Medicare fee-for-service (FFS) proposed rules recently issued by the Centers for Medicare & Medicaid Services (CMS). On August 3, 2020, CMS released a proposed rule that includes updates to services furnished under the Medicare Physician Fee Schedule (PFS). On August 4, CMS released the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. These proposed regulations include payment rate and policy changes for the upcoming calendar year. Key features in this year鈥檚 PFS proposed rule include: policies to retain, extend, or end certain telehealth flexibilities implemented in response to the novel COVID-19 public health emergency (PHE), changes to enable certain health care professionals to practice at the top of their licenses, modifications to opioid treatment programs (OTPs), and updates to the Medicare Shared Savings Program (MSSP). View additional information on the PFS Proposed Rule. Among the most notable policy changes in the OPPS and ASC proposed rule are: 1) transitioning services to lower cost settings by eliminating the inpatient-only list to enable more services to be provided in the outpatient settings and increasing the scope of procedures that can be provided in ASCs, 2) further reducing payments for the 340B drug program, and 3) modifying the formula for calculating Hospital Star Ratings, and expand the use of prior authorization for outpatient services. Find additional information about these proposals.

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Brief & Report

黑料不打烊 examines current state of Medicare-Medicaid integration programs

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The experts at 黑料不打烊 (黑料不打烊) have released the Medicare-Medicaid Integration: Reflecting on Progress to Date and Charting the Path to Making Integrated Programs Available to all Dually Eligible Individuals issue brief and companion bibliography appendix, the second in a series of issue briefs examining Medicare-Medicaid integrated programs.

Based on 黑料不打烊’s review of the literature and available public information, this brief summarizes the elements for success and barriers encountered by integrated programs. It concludes with essential questions and next steps to move forward with federal and state public policies and care delivery options centered around, informed by, and available to, more dually eligible individuals.

黑料不打烊 colleagues Sarah Barth, Jon Blum, Elaine Henry, Narda Ipakchi and Sharon Silow-Carroll contributed to the research and final brief.

For the next phase of research, 黑料不打烊 will convene and interview individuals, their families and other caregivers, providers, payers, community-based organizations, state government, and other stakeholders in select regions across the country.

The project was funded by a grant from , a philanthropy dedicated to tackling some of the most pressing problems in the United States.聽聽

Blog

Regulatory changes to Medicare in response to COVID-19

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This week, our In Focus section examines how the federal government implemented changes to the Medicare program in response to COVID-19.聽 As the COVID-19 pandemic began in the United States, Congress and the Administration responded with a series of legislative, regulatory, and sub-regulatory changes to the Medicare program that were designed to provide relief from certain Medicare rules to assist health care providers, Medicare Advantage organizations, and Part D plans in responding to the pandemic. Some of these changes waived conditions of Medicare participation to enable patients to be treated in alternative care settings. Others permitted physicians and other providers to receive Medicare reimbursements for telemedicine services.

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