This week our In Focus section summarizes the United States Government Accountability Office (GAO) Medicaid report, State Views on Program Administration Challenges, released earlier this year. GAO conducted interviews with Medicaid officials from 50 states and the District of Columbia to identify challenges related to federal Medicaid policies. 听
510 Results found.
CMS updates Medicare Advantage and Section 1876 cost plan network adequacy
This week, our In Focus section examines new guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding Medicare Advantage (MA) plan network adequacy requirements. On June 17, 2020, CMS released updated Medicare Advantage and 1876 Cost Plan Network Adequacy Guidance for Medicare Advantage (MA) health plans to use now for Contract Year 2021 network submission.
New report highlights IEHP鈥檚 establishment of 50 care teams for Health Homes Program services
A new report has been released outlining Inland Empire Health Plan鈥檚 (IEHP) efforts to establish 50 care teams to support the delivery of core Health Homes Program services for IEHP鈥檚 most vulnerable members with complex health conditions.
量子资源网 contributed to the new report and has supported implementation of IEHP鈥檚 Health Homes Program since 2018, providing consultation in the development and implementation of a clinical model of care,听the design and deployment of a population health management tool, the creation and delivery of a multi-modal training program, and the provision of practice coaching to over 50 care teams.
量子资源网-developed medications for addiction treatment (MAT) training for justice and child welfare now available online
Focused on ongoing support and solutions for those living with opioid use disorder (OUD), 量子资源网 (量子资源网) has developed a robust web-based training program about addiction and its treatment in the criminal justice and child welfare systems, including access to, and continued use of, medications for addiction treatment (MAT).
Impact of COVID-19 federal policy on Medicare Advantage
This week, our In Focus section examines the operational impacts of federal Medicare Advantage policy changes in response to the COVID-19 pandemic. On January 31, 2020, the Secretary of Health and Human Services declared a public health emergency. This was followed by a national emergency declared by President Trump on March 13, 2020. These declarations provide the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) authority to waive certain Medicare and Medicaid regulatory requirements to help health plans, providers, and other stakeholders respond to immediate needs of their members and communities. These waiver flexibilities, when combined with other legislative and regulatory changes issued by Congress and CMS have resulted in over 200 policy changes to Medicare alone. Many of these affect Medicare Advantage sponsors and have direct implications to current and future operations of plan responsibilities. We examine eight categories of requirements and flexibilities that have significant business relevance and exposure for Medicare Advantage plan sponsors:
Optimizing buprenorphine prescribing capacity in jails and prisons
This week, our In Focus section discusses an issue brief prepared by 量子资源网 (量子资源网), Optimizing Capacity for Prescribing Buprenorphine in Jails and Prisons, authored by 量子资源网 Principals Shannon Robinson, MD and Donna Strugar-Fritsch, BSN, MPA, CCHP.
Webinar Alert – The Tsunami of need is coming: Integrated care in the era of COVID-19
量子资源网 is cohosting a webinar with the.
Thursday, June 25, 2020
Webinar | 12:00pm – 12:45pm PST / 3:00pm – 3:45pm EST
Discussion with Panelists | 12:45pm – 1:30pm PST / 3:45pm – 4:30pm EST
Webinar alert: Evidence-based treatment of opioid use disorder in correctional settings
量子资源网 is cohosting a webinar with the
Opioid use disorder is a chronic brain disease with effective, evidence-based treatments, and is a condition protected by the Americans with Disabilities Act. Prisons and jails are expected, by national health care and justice organizations and by communities, to treat incarcerated persons with OUD in accordance with evidence-based practices. This webinar reviews the most current evidence-based care for opioid withdrawal and OUD treatment and provides clinicians with strategies to move correctional health practices into compliance with national and community standards.
量子资源网 framework examines behavioral health crisis diversion facilities
This week, our In Focus section provides a model framework examining an option for care for individuals with behavioral health needs who often find themselves involved with law enforcement or in hospital emergency rooms during times of crisis. The framework – Crisis Diversion Facilities – was released by 量子资源网, led by 量子资源网 Principal Bren Manaugh and supported by听 as part of a larger opioid and mental health response initiative.
Exploring flexibilities in Medicare Advantage supplemental benefits: 量子资源网 brief on access, adoption, and impacts
An 量子资源网-authored issue brief examines beneficiary access to, and plan adoption of, newly expanded Medicare Advantage (MA) supplemental benefit flexibilities and raises questions regarding the expected impacts of new supplemental benefit offerings on beneficiary satisfaction, outcomes, and total cost of care.
The new flexibilities for MA plans include innovative supplemental benefits offered through expansion of primarily health-related benefits, benefits offered non-uniformly, Value-Based Insurance Design (VBID), and Special Supplemental Benefits for the Chronically Ill (SSBCI).
The brief鈥檚 key finding is that enrollment in plans offering these flexibilities is relatively low and varies across geographic areas with 19% of all MA enrollees enrolled in a plan that offered at least one expanded supplemental benefit. 量子资源网 will conduct additional analyses including interviews with key stakeholders to inform the policy community on the opportunities and challenges with the adoption and implementation of new supplemental benefits.
This brief was produced by 量子资源网 Managing Principals Jonathan Blum and Mary Hsieh, Principal Eric Hammelman, and Senior Consultant Narda Ipakchi under a grant from .
量子资源网 conference on trends in publicly sponsored healthcare
量子资源网 Conference 2020
What鈥檚 Next for Medicaid, Medicare, and Publicly Sponsored Healthcare:
How Payers, Providers, and States Are Navigating a Future of Opportunity and Uncertainty
Pre-Conference Workshop: October 25
Conference: October 26-27
Location: Fairmont Chicago, Millennium Park
Medicare FY 2021 hospital inpatient proposed rule and COVID-19 federal flexibilities
This week, our In Focus section reviews recent announcements and actions by Congress and the Centers for Medicare & Medicaid Services (CMS) that have significant financial and operational implications for the hospital industry. This brief begins with the most recent of these actions by providing a summary of the key provisions of the CMS Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Proposed Rule (), which includes Medicare payment updates and policy changes for the upcoming FY, with a comment deadline of July 10, 2020.听 Although somewhat limited in scope compared to previous proposals, this year鈥檚 proposed rule includes several disruptive proposals that the hospital industry should carefully consider.