In her new Forefront article, Kate McEvoy from National Association of Medicaid Directors discusses how the Medicaid program continues to be both the bedrock means of providing comprehensive health services to low-income people as well as the central seat of innovation in our health care system around people’s co-occurring health-related social needs. But two issues, she argues, are getting in the way of this essential work. "The first of these is the serious and intractable bottleneck in federal capacity to timely review and approve the large and growing volume of 1115 research and demonstration waiver applications and renewals that are the central means of advancing reform and innovation in Medicaid. The tough reality is that the Center for Medicaid and CHIP Services (CMCS), which has taken many steps to streamline its administrative processes, simply does not have the staff resources to move forward all of the waivers in its pipeline, to say nothing of the many submissions that will likely yield this spring from legislative sessions all across the country." Read the full article here: https://bit.ly/3JkTKii
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R.J. Briscione nailed it: a social benefits package that includes housing is essential for better health outcomes. Housing stability sets the foundation for addressing other social determinants of health. We know affordable, stable housing isn’t just shelter—it’s the cornerstone of well-being. Our member-centric approach ensures affordability, safety, and sustainability.
We asked five healthcare industry veterans what changes they would make to Medicaid, if they had a magic wand. - Alice Hm Chen, Chief Health Officer at Centene Corporation, believes federal continuous eligibility for children would have a huge impact on long-term health outcomes. - Ali Khan, MD, MPP Khan, Chief Medial Officer, Medicare at Aetna, a CVS Health Company would define Medicaid eligibility at the federal level. - Jason Cunningham, Chief Executive Officer at West County Health Centers County Health Centers, wants to align the payment model better. - Molly Coye, senior advisor at AVIA and Redesign Health, would create an annual social wellness check. - R.J. Briscione, principal at Health Management Associates, would implement a social benefits package. https://lnkd.in/emrZTB_P #medicaid #healthcare
Here are five changes we would make to Medicaid tomorrow
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We asked five healthcare industry veterans what changes they would make to Medicaid, if they had a magic wand. - Alice Hm Chen, Chief Health Officer at Centene Corporation, believes federal continuous eligibility for children would have a huge impact on long-term health outcomes. - Ali Khan, MD, MPP Khan, Chief Medial Officer, Medicare at Aetna, a CVS Health Company would define Medicaid eligibility at the federal level. - Jason Cunningham, Chief Executive Officer at West County Health Centers County Health Centers, wants to align the payment model better. - Molly Coye, senior advisor at AVIA and Redesign Health, would create an annual social wellness check. - R.J. Briscione, principal at Health Management Associates, would implement a social benefits package. https://lnkd.in/emrZTB_P #medicaid #healthcare
Here are five changes we would make to Medicaid tomorrow
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Interesting article in Health Affairs today highlighting both the opportunities associated with #Medicaid Section 1115 waivers and the current bottlenecks including lack of dedicated funding and limited capacity at the Centers for Medicare & Medicaid Services #CMCS to review Section 1115 waiver requests in a timely manner. Initiatives such as expanding Medicaid eligibility, addressing health-related social needs such as food or housing security, and expanding benefits for behavioral health services can meaningfully improve #populationhealth, #publichealth, and #patientaccess to care. The article is certainly worth a read.
Congress Must Act To Advance Innovation In Medicaid | Health Affairs Forefront
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Enabling US healthcare providers and technology companies to grow through enhanced frontline customer experience and support | Vice President, Epiphany Management
Medicaid is changing🤷♀️ One thing that needs to improve with these changes is the CUSTOMER EXPERIENCE❗ This Article by KFF Health News tracking all the 1115 waivers really shows that there are real changes happening now https://lnkd.in/dkEW_Vjh There are many new programs in Medicaid that are either already started, approved or pending approval. These new programs range from helping solve issues with behavioral health, SDoH, housing, and better quality care for the elderly or those with disabilities. Whatever the goal of these new programs we need to really put the people first. These programs are designed to help, but we need to help people understand the program and help them use the program properly. Epiphany helps programs like these 1115 waivers. Reaching out to members, providers and CBO's to help identify how to make the program successful is a key to changes within Medicaid. Do you think some of these new waiver programs will have an effect on Medicaid or its members? What changes do you think are needed? DM me if you would like to talk or put a comment to discuss. #1115Waivers #medicaid #change #healthcare
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State | KFF
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Texas Children’s Health Plan Medicaid Contract Loss The loss of Texas Children’s Health Plan Medicaid contract could severely impact provider revenues and patient care. Learn how healthcare providers can navigate this challenge with proactive strategies. #MedicaidContractLoss #ProviderRevenue #HealthcareProviders #TexasMedicaid #TCHP #PatientCare #ClaimsMed #TexasChildren
Texas Children’s Health Plan Medicaid Contract Loss
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In their new Forefront article, Jeffrey Schiff, Clara Filice, and Christopher Chen from AcademyHealth, MassHealth, and Washington State Health Care Authority discuss how the time is ripe to reexamine what the past 15 years of investment in Medicaid quality measurements has yielded and to identify opportunities to better measure what matters to Medicaid members. "The innovative efforts to develop the National Quality Strategy—coupled with the implementation of mandatory reporting for the Medicaid Child Core Set, the behavioral health measures of the Adult Core Set, and the Health Home Core Set—have reignited longstanding interest in measure selection, standardization, and alignment across CMS programs.or this ambitious vision for quality to come to fruition for all citizens served by CMS, particular attention to measurement for the Medicaid (note 1) and CHIP programs must be front and center. These programs serve one in five Americans and 40 percent of all children. The time is ripe to reexamine what the past 15 years of investment in Medicaid quality measurements has yielded and to identify opportunities to better measure what matters to Medicaid members." Read the full article here: https://bit.ly/3TaAMj3
Building On 15 Years Of Medicaid And CHIP Quality Measurement | Health Affairs Forefront
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Simplifying renewals can help people keep health coverage in critical moments. We discussed three key tactics that state governments can use in a recent post (https://lnkd.in/diUBWu_S), so we’re excited by a new federal rule that will streamline enrollment in #Medicaid and #CHIP! “Today’s rule also builds on CMS’ work during Medicaid ‘unwinding,’ which has highlighted how simplifying and streamlining renewals can dramatically help eligible people stay covered,” notes the Centers for Medicare and Medicaid Services (https://lnkd.in/endXMwdF). “For example, while families in some states have faced barriers when transitioning a child’s coverage from Medicaid to CHIP during the unwinding process, today’s rule will require all states to make this transition more seamless in the future.”
How modern technology can enable a more human-centered Medicaid unwinding
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The Centers for Medicare & Medicaid Services (CMS) has approved an amendment to New York's Medicaid program, advancing health equity and enhancing access to primary and behavioral health care. This approval allows New York to make substantial investments in Medicaid initiatives, including sustainable base rates for safety net hospitals, housing and nutritional support services, coordinated treatment for substance use disorders and long-term investments in the healthcare workforce. This emphasizes the importance of collaborative state initiatives to address health disparities and promote a more integrated and person-centered health and social care system. Learn more at https://go.cms.gov/3Isbyb0. #CaseManagementSoftware #EHR #HealthEquity #CommunityCareLink #ElectronicHealthRecord #ConnectingCommunities
Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State | KFF
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Dually-eligible individuals - the 12.5 million beneficiaries who are simultaneously enrolled in #Medicaid and #Medicare because they qualify for both programs due to age or disability and income - are heterogenous in age and physical or mental health, but they have one thing in common: low income and very modest savings. Ensuring the care and services received from each program is integrated, and that appropriate protections limit predatory or misleading health plan promotion practices, must be a priority for the Centers for Medicare & Medicaid Services. Interesting new Health Affairs article explaining what some proposed #CMS policy changes would mean for dually eligible beneficiaries. Read the article here: https://lnkd.in/gm_fDtVZ
CMS Proposes Significant Policy Changes To Improve Care For Dually Eligible Individuals | Health Affairs Forefront
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Explore the impact of #Aetna's protest and #UCare's withdrawal on Kansas Medicaid services and healthcare landscape. #KansasMedicaid #HealthcareContracts #healthcare #DistilINFO. https://lnkd.in/g77Hax2s
Aetna's Challenge and UCare's Withdrawal
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Well-said and unfortunately true.