Physician groups all over the country are looking for assistance as they search for ways to best manage their Medicare Advantage population. The fact of the matter is:
Health care costs are having real impacts on patients’ and consumers’ budgets across the country. Families have seen their health insurance premiums increased by almost 130 percent in the past decade while their out-of-pocket spending has risen by almost 80 percent.
In the post reform era, the amount of change facing behavioral health organizations is unprecedented. From service delivery to reimbursements and outcomes reporting, behavioral health organizations need to re-visit their operational strategies in order to stay competitive in the new value-based health care environment which combines physical and behavioral health.
Measures and ResultsAs part of a five-year project with the California Geriatric Education Center at UCLA, and funded by the Health Resources and Services Administration (HRSA), Western University of Health Sciences developed the Ambulatory Team Observed Structured Clinical Evaluation (ATOSCE).
The MetroHealth System is harnessing the power of Electronic Medical Records (EMRs) to enhance care, decrease costs, and improve health outcomes for their patients. MetroHealth is a health system with 17 locations based in Cleveland, Ohio and is affiliated with Case Western Reserve University. Using EMR data, MetroHealth carefully selected 28,000 patients for their Care Plus program, giving them Medicaid coverage, coordinating their care, providing personalized follow-up from nurses, and tracking the outcomes.
Care Coordination under the Medicaid Benefit for Children and AdolesCare coordination is critical for meeting the needs of vulnerable children, as it can ease the process of receiving services by helping to manage the care of the child, reducing duplication of effort, improving transitions and limiting gaps between service providers. It provides a bridge across multiple systems that serve children and families, helping to ensure that a child receives additional screening, diagnosis and/or treatment as recommended by a health care practitioner.
Washington, DC – A new, independent research study, conducted by RTI International and published in the Health Services Research journal, adds to the evidence that NCQA patient-centered medical homes (PCMHs) deliver lower cost and drive more appropriate health care utilization.
The study focused on participants in the Medicare Fee-for-Service (FFS) program, comparing 308 PCMHs recognized by the National Committee for Quality Assurance (NCQA) with a sample of nearly 2,000 non-accredited PCMHs across three years, beginning in July of 2008.
Palliative care is one of the fastest growing areas in health care, with three times as many hospitals providing palliative services today as did just 15 years ago. Offering personalized, coordinated treatment to address the pain, symptoms and stress associated with serious illness, palliative care has been shown to reduce emergency department use and hospital re-admissions while improving quality of life and extending survival times. However, access to these services remains inconsistent across hospitals and even more limited in other care settings.
This webinar will explore the leap from health system transformation planning to practice by showcasing four leading states that are designing and implementing multi-payer payment reforms. Through a facilitated discussion, state officials will discuss policy levers to shift payment systems away from fee-for-service, offer strategies for sustaining stakeholder momentum and commitment, and share perspectives on promising practices for and operational challenges of turning a plan for multi-payer payment reform into reality.
