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Cityblock, Sunshine Health Partner to Deliver Primary Care to Florida Medicaid Members - HIT Consultant Summary: #Cityblock #SunshineHealth #PrimaryCare #Florida #Medicaid Cityblock and Sunshine Health have joined forces to provide primary care services to Medicaid members in Florida. This partnership aims to improve access to quality healthcare for underserved populations in the state. Cityblock's innovative approach to healthcare delivery, combined with Sunshine Health's extensive network, will ensure that Medicaid members receive comprehensive and personalized care. By leveraging technology and data analytics, Cityblock and Sunshine Health will be able to address the unique needs of each patient and improve health outcomes. This collaboration highlights the importance of partnerships in delivering effective and patient-centered care to vulnerable communities. #HealthcareIT #Partnership #HealthcareDelivery #DataAnalytics ai.mediformatica.com #health #medicaid #partnership #model #this #acceibility #centene #healthcare #carecoordination #centenecorporation #collaboration #complexneeds #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3WJwkeC)

News from First Report Managed Care Volume 21, Issue 2: The Centers for Medicare & Medicaid Services (CMS)'s AHEAD model aims to improve population health management by awarding funding to states and promoting primary care investment and enhanced equity measures, but implementation challenges and cultural shifts may hinder its success. “States have relationships with many of the stakeholders whose perspectives and support will be vital to the success of this model,” Maureen Hennessey, PhD, SVP, director of value transformation at Precision AQ, told First Report Managed Care. Access the full issue here: https://lnkd.in/eKAWrpWp #FirstReportManagedCare #FRMC #CMS #AHEADModel #PopulationHealth

How can #Medicaid policymakers advance the adoption of value-based arrangements by Federally Qualified Health Centers? 1.     Through the Return of Shared Savings to #FQHCS. – Participating FQHC networks should be eligible to share in a substantial portion (50% or more) of the savings realized when the actual total costs incurred for their attributed population are below the benchmark or goal set for average Total Cost Of Care (TCOC). 2.     Adjust the Payment Model for the FQHC Patient Population. – The benchmark costs used to set rates should be based on the average #TCOC in the market, or the average amount the Managed Care Organization gets paid per enrollee, rather than using the FQHC networks’ own historical low reimbursement as a starting point. Learn more in this report authored by our Kim Prendergast, Aditya Mahalingam-Dhingra, and Vikki Wachino for the Milbank Memorial Fund - https://lnkd.in/eCGMECd2 #Valuebasedcare ##FQHC #ACO #TCOC #Medicare #ProspectivePaymentSystem #ManagedCare #Managedcareorganizations #VBP #Healthcarequality #CMS #healthequity #Communityhealthcenters #Communityhealth Massachusetts League of Community Health Centers National Association of Community Health Centers (NACHC)

Community health worker (CHW) programs have faced significant funding challenges across the U.S. — despite numerous studies showing the positive impact they can have on health outcomes and costs for patients receiving Medicaid. In a new article published in the Journal of Community Health, we compared Medicaid payment rates for CHW programs to costs for implementing them across all 50 U.S states, Washington D.C. and Puerto Rico. Our study found that current payment rates are insufficient to achieve benefits of CHW programs on patient outcomes and costs identified in previous randomized trials. The results demonstrate the need for considerably higher payment for CHW services. This is our third peer-reviewed journal article of 2024 (❗). As a public benefit company, we’re committed to advancing the evidence base for models and approaches that work in Medicaid care delivery and we’ll continue publishing original research, data and commentary in the months ahead. Read the study here 👉 https://wymrk.co/3w85YaT Sanjay Basu Sadiq Y. P. Kiiera Robinson, Ed.D, MPH, MA Aaron Baum #medicaid #communityhealthworkers #communityhealth

Fascinating read on community health work economics for Medicaid from the team at Waymark. They've identified a significant difference between median Medicaid reimbursement rates and cost of care delivery. Interestingly, if you remove overhead costs, the rate necessary to cover costs drops: for a 30-minute CHW visit, it decreases from $53 to $32. Could you use latent capacity in existing workforces with deep local roots, like community organizers or EMS, to create a viable model?

What role can randomized evaluations play in evaluating the impact of Medicaid? A new op-ed in Health Affairs from J-PAL North America Co-Scientific Director Amy Finkelstein and former Connecticut Medicaid Director Gui Woolston shows how Medicaid offices can rigorously evaluate their programs using randomized evaluations to improve program effectiveness and impact. The authors propose two approaches and five actionable steps that Medicaid offices can take to begin the evaluation process. https://lnkd.in/dGizuhqX Want to evaluate your program? J-PAL North America is ready to support any Medicaid offices interested in conducting randomized evaluations of their programs.

The Health Care Transformation Task Force recently released a resource brief that provides a succinct overview of the Centers for Medicare & Medicaid Services AHEAD Model. Check out the resource here: https://lnkd.in/eYv6XaDm This is the newest resource in a collection of briefs on policies and CMMI models that amplify how value-based payment is changing our health care system for the better. View the collection here: https://lnkd.in/edTbnqr4 

For primary care advocates, there’s a lot to like in the direction laid out in Centers for Medicare & Medicaid Services leaders’ latest Health Affairs blog: Expanding Permanent Pathways for Accountable Care. We know primary care-centric ACOs in the Medicare Shared Savings Program are outpacing others. Today CMS signaled interest not just in continued model tests at the CMS Innovation Center but in permanent improvements aimed at strengthening primary care. This direction has promise… and it’s good to see the agency double down on their commitment to primary care. To get the details right on this new direction, we urge the agency to continue engaging deeply with the #PrimaryCare community. https://bit.ly/4dEuKj7

Designing an equity-focused value-based payment (VBP) model involves a number of decisions — decisions that should be informed by payers, providers, and the communities they serve. This CHCS brief outlines seven key considerations for states and other payers seeking to design VBP models that reduce health disparities, reflect community needs, and positively impact health outcomes and costs in Medicaid. https://bit.ly/44HI3MM

Interesting read on Medicaid VBC model design and implementation.