Clinify Health’s Post

The recent explosion in the use of Remote Physiologic Monitoring (RPM) among Medicaid patients—over a 1,300% increase—highlights a transformative shift in healthcare delivery. This surge, primarily driven by a handful of providers and predominantly involving female patients and those with chronic conditions, demonstrates RPM's potential to significantly improve patient outcomes. Looking ahead, expanding RPM could lead to enhanced management of chronic diseases and reduce hospital visits, making healthcare more accessible to the Medicaid population. The ongoing development and support for RPM technologies could be a game-changer in how we provide care to some of the most vulnerable segments of society. #HealthcareInnovation #Medicaid #ChronicCareManagement https://lnkd.in/gTYKFfst

If you are about to embark on a making care primary initiative, check out our blog for how to get started here: https://bit.ly/49L2Ujf #makingcareprimary #primarycare #primarycaremodel #medicaid #caremanagement #healthcare

Attention healthcare providers: The Centers for Medicare & Medicaid Services have just released the Final Rule for the 2024 Medicare Physician Fee Schedule (PFS). Here's what you need to know: -Effective from January 1, 2024, the overall payment rates under the PFS will be reduced by 1.25%. -The final PFS conversion factor for 2024 will be $32.74, representing a decrease of 3.4% from the previous year. To learn more about the specifics of the Final Rule and its implications, visit the link below. Stay informed and be prepared for the upcoming changes in Medicare reimbursements. For any assistance, contact Tucker Arensberg, P.C. Shareholder Michael Cassidy. Link: https://hubs.ly/Q0287F8q0 #HealthcareProviders #Medicare #Medicaid

Value-based care (VBC) is revolutionizing the healthcare landscape, shifting the focus from volume to value. This approach rewards healthcare providers for delivering high-quality care and improving patient outcomes, rather than simply increasing the quantity of services provided. In this blog, we will explore what value-based care entails, key considerations for Medicaid providers, the benefits and challenges of VBC, and how organizations like us at Clinify Health can support providers in this transition. https://lnkd.in/gF5AVu5n #valuebasedcare #medicaid #medicaidproviders #digitalhealth #clinifyhealth #caretrax

Long-term and post-acute care (LTPAC) providers are crucial in our healthcare system, especially for complex patient populations like those needing LTPAC. Medicare spends a significant amount on post-acute care, nearly $57 billion, which is about 15% of its total spending. About 40% of hospital discharges are followed by LTPAC services, with nearly 2 million skilled nursing facility (SNF) stays yearly. Improving and coordinating post-acute care can lead to better quality and lower costs. LTPAC providers can lead the way in value-based care, but current models like accountable care organizations don't fully accommodate their unique challenges. Only a small percentage of SNFs participate in ACOs, and the Centers for Medicare & Medicaid Services (CMS) aims to have all Medicare beneficiaries in an accountable care relationship by 2030. Improving models to align with LTPAC providers can enhance care and lower costs. Abigail Barreto, Nisha Hammel, Aisha T Pittman, David Pittman, and Sarah Sugar, MPH, are the authors of this report published in Fierce Healthcare. #LTPAC #Medicare #ValueBasedCare https://lnkd.in/g2gzAi9w

Patient experience is increasingly impacting #Medicaid managed care contracts and reimbursement. Find out what steps one Medicaid MCO took to boost member satisfaction: 1️⃣ Modernized channel integration - A unified communications platform improved access to different care avenues like virtual care, chatbots, and call centers. 2️⃣ Expanded in-house support services - Increasing in-house care coordinators, health coaches, and member advisers established more trusted relationships between members and their health plan care team versus third-party delegated entities. 3️⃣ Targeted support programs - Hyper-personalized member support for high-risk conditions like pregnancy or behavioral health issues showed substantial gains in condition-specific experience scores as well as overall plan satisfaction. Focusing on streamlined access, internal expertise, and tailored services demonstrates how one Medicaid plan significantly moved the needle on patient experience. See details on the full patient experience improvement strategy: https://hubs.ly/Q02b41pC0

The largest payer, #CMS, advances #primarycare & #healthequity, addresses #SDoH & nudges #hospitals toward prospective all-payer global budgets (includes #hospital-based outpatient services). He/she who has the gold makes the rules!? A variation on the Golden Rule. #HealthcareReform #HealthcareTransformation #TripleAim #PublicPrivatePartnership #PublicPrivatePartnerships #Medicare #MedicareAdvantage #Medicaid #MedicaidManagedCare

As of 5 minutes ago the Centers for Medicare & Medicaid Services released the #PhysicianFeeSchedule Proposed Rule for CY2025. My colleagues and I have had the pleasure of working long and hard hours to bring these proposals forward in the hopes of expanding equitable care for Medicare beneficiaries. Some of my personal favorites from the proposed rule include: 🚀 Advanced Primary Care Management: CMS has proposed three new HCPCs G-codes, integrating care management and communication technology-based services. Alongside the APCM code bundle we have released an RFI to gather feedback on potential payment policies for advanced primary care services. ❤️ Cardiovascular Risk Assessments: Proposed payment for cardiovascular risk assessments based on the Million Hearts model to better manage heart health in patients with suspected risk of cardiovascular disease.  📋 RFI on #CommunityHealthIntegration and #PrincipalIllnessNavigation Codes and #SocialDeterminantsofHealth Risk Assessment: CMS is seeking feedback on factors to consider for future rulemaking, including auxiliary personnel, certification/training requirements, and improving utilization in rural areas. We also want to hear how these codes are being used in conjunction with community-based organizations. 💡 New Payments for High-Risk Interventions: CMS is proposing separate payments for practitioners assisting individuals at high risk of suicide or overdose. This includes dedicated payment for safety planning interventions and post-discharge follow-up contacts, ensuring continuous support for those in need. 🔓 Improving Medicare Access: Proposed policy changes to improve Medicare access for formerly incarcerated individuals and those not in physical custody of penal authorities. There's so much more to dive into! See here: -- Press Release: https://lnkd.in/gxSMEFMp -- Fact Sheet: https://lnkd.in/gAqJBETx -- Full Rule: https://lnkd.in/gZim4Euu As always, we encourage folks to provide their feedback during the public comment period which ends September 9, 2024. #Healthcare #PolicyUpdate #PrimaryCare #PatientCare #FeedbackRequested #ValueBasedCare #MedicarePFS

It’s inspiring to see healthcare systems like those in Florida embracing Medicaid reimbursements for hospital-at-home services. This trend highlights the crucial role of innovative care models in enhancing patient satisfaction and optimizing healthcare delivery. At Vironix Health, we are aligned with these innovative shifts through our advanced RPM and CCM solutions. By leveraging AI-driven analytics, we help healthcare providers monitor patient health remotely, ensuring timely interventions and reducing the need for hospital readmissions. This not only supports the hospital-at-home model but also extends its benefits by providing continuous, data-driven patient care. Excited to see how these developments will continue to shape the healthcare landscape, promoting both cost-efficiency and high-quality patient outcomes. If you're interested in discussing how digital health can transform patient care or if you have insights to share, please feel free to connect with me. Let’s explore collaborative opportunities and push the boundaries of what we can achieve in healthcare together. #HealthcareInnovation #RPM #CCM #HospitalAtHome

The role of care management emerges as a vital component in delivering effective and efficient healthcare services. This blog post explores the significance of care management within the realm of Medicaid, shedding light on its functions, benefits, and the evolving strategies employed to optimize patient outcomes. https://lnkd.in/dypth3QD #caremanagement #medicaid #medicaidservices #caremanagers #clinifyhealth #caretrax