#CMS recently made a first set of announcements about states set to join the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. The goals of the model are to improve overall population health of a state or sub-state region, reduce health disparities, and curb health care cost growth, using hospital global budgets as a key lever. CMS is setting the default for how Medicare reimbursement will work under a global budget, but states have choices to make with how Medicaid will implement a similar strategy. Manatt's Lora Kim, Edith Coakley Stowe and Anne Karl provide an overview of the model and top considerations related to Medicaid here: https://lnkd.in/emf8GzxE
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A recent study with EPI member Dr. Burton Singer, in collaboration with researchers from @YaleSPH, explores the #PublicHealth risks that changes in #healthcare coverage can pose. Read the paper to learn more about their findings: https://lnkd.in/gdcTuzpu.
Proposed changes to the U.S. Medicare and Medicaid programs could lead to thousands of additional deaths each year, according to new research by Prof. Alison Galvani & colleagues. "Working in the field of public health, it can be frustrating to see policymakers propose strategies that ignore evidence-based solutions capable of saving lives, boosting prosperity, and reducing health care costs," says Galvani. Read more: https://lnkd.in/eX8zWm62
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Very excited to partner with Oliver Wyman on this important SDoH/Health Equity initiative. I invite you to read further for interesting insights into the strong coorelations between HealthWise Data's predictions of health and wellness and patient outcomes. #healthequity #sdoh
Our health and quality of life are not solely determined by genetics or individual choices. Social Determinants of Health (SDoH) play a crucial role in shaping our overall well-being. Recognizing the significant influence of healthcare providers in improving access, quality of care, and community health, the Centers for Medicare and Medicaid Services (CMS) have proposed enhancements and incentives in the CY 2024 Medicare Physician Fee Schedule. These changes aim to address SDoH and promote better health outcomes. In our latest article, working with HealthWise Data, we shed light on the importance of SDoH in relation to health outcomes. We advocate for the inclusion of SDoH in provider/payer contracts to appropriately compensate healthcare providers for managing patients with social risk factors. By doing so, we can drive better health outcomes, reduce healthcare costs, and create healthier communities. Read more> https://owy.mn/3GGGdR5 #OWActuarial #Medicaid #ManagedMedicaid
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Health Equity has evolved from an admirable goal for hospitals to a MUST HAVE imperative. Beyond Health Equity compliance MANDATES by the IRS, new policies from Medicaid and Medicare (CMS) will impact the hundreds of $ millions of reimbursements, and hospital systems need rich socioeconomic data in order to meet these needs. The NEW CMS requirements for hospital systems to take effect this year, include: Health Equity Assessments: Published plans for overcoming health disparities and improving outcomes. Data Collection: Expanded patient demographics to better understand Social Determinants of Health (SDOH). Revenue Cycle Management: Reimbursement changes that provide premiums for treating patients from underserved populations combined with penalties for patients readmitted to the hospital within 72 hours. If you are a healthcare leader charged with measuring health equity, we’re here to help. #HealthEquity
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As we enter the new year, leaders predict the biggest challenges and opportunities facing the healthcare industry in 2024. Stakeholders question the outsized role of the EHR in patient care - is it here for the long term? The US continues to grapple with the reality of racial disparities in maternal healthcare and its effect on outcomes. Plus, as the maternal health crisis becomes more acute, the industry considers how to respond, with some states expanding Medicaid services. Read more ⤵️
1/12/2024: The State of Maternity Care and Digital Health
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North Carolina Medicaid’s Health Opportunities Pilot Program is “among the nation’s most expansive Medicaid programs to address health-related social needs, including housing.” In the Housing And Health issue, Katie Huber of Duke University and coauthors offer a mixed methods analysis of the pilot. Among the findings, the researchers identify four critical themes: the housing landscape varies within and across Health Opportunities Pilots regions; defining and pricing housing services in Medicaid is complex; successful implementation of housing services involves engaging diverse stakeholders; and housing is the most expensive Health Opportunities Pilots service domain. The authors conclude that findings from this program could inform other state and federal initiatives. Ready the full study: https://hubs.la/Q02k305_0
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Social Scientist | Evaluation Specialist | Project Manager | Health Policy Planner | Workforce Development Professional
The Centers for Medicare & Medicaid Services' Innovation Center (CMMI) has awarded #Connecticut $12 million over five years to participate in a new, healthcare transformation model: the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model). The AHEAD Model focuses on improving population health, advancing health equity by reducing disparities in health outcomes and curbing healthcare cost growth. Hospitals will be offered opportunities to participate in global budget payment models and participating community health centers and primary care practices will receive incentives to promote person-centered care. https://buff.ly/3W802sN
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Just whole healthcare executive scaling health equity through field-defining business, policy and service integration strategy
While Humana posted major financial and mega-merger losses, Elevance’s Carelon division seemed to be crushing it. The difference is fundamentally Medicare vs Medicaid innovation. This graphic from the new Health Management Associates report on VBP enablers and providers shows there’s much more room for growth in Medicaid. Hmm…why are these two companies experiencing such different outcomes? Could it be that a company focused on behavioral health is actually better for cost-saving than one focused just on the care of seniors…? While population health management is important to outcomes and costs, betting the farm on a specific population instead of structural needs across populations might just be the wrong answer. #mentalhealthishealth
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Regulatory roundup: CMS offers new state care model to increase health equity, access to care; Humana sues CMS over final RADV rule; and more
Regulatory roundup: CMS offers new state care model to increase health equity, access to care; Humana sues CMS over final RADV rule; and more
risehealth.org
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In their latest article, Oliver Wyman Actuarial shares how they leveraged HealthWise Data's insights to fuel their study into how #SDOH drives health outcomes and disparities:
Our health and quality of life are not solely determined by genetics or individual choices. Social Determinants of Health (SDoH) play a crucial role in shaping our overall well-being. Recognizing the significant influence of healthcare providers in improving access, quality of care, and community health, the Centers for Medicare and Medicaid Services (CMS) have proposed enhancements and incentives in the CY 2024 Medicare Physician Fee Schedule. These changes aim to address SDoH and promote better health outcomes. In our latest article, working with HealthWise Data, we shed light on the importance of SDoH in relation to health outcomes. We advocate for the inclusion of SDoH in provider/payer contracts to appropriately compensate healthcare providers for managing patients with social risk factors. By doing so, we can drive better health outcomes, reduce healthcare costs, and create healthier communities. Read more> https://owy.mn/3GGGdR5 #OWActuarial #Medicaid #ManagedMedicaid
Key Strategies To Transform Patient Care Via Health Equity
oliverwyman.com
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Health is not just about individual choices or medical interventions. It's influenced by the social and environmental conditions we live in. Social Determinants of Health (SDoH) encompass various domains that impact our overall well-being. Education Access & Quality, Economic Stability, Social and Community Context, Health Care Access & Quality, and Neighborhood/Built Environment are the key domains within SDoH. Each plays a vital role in shaping community health. To address the significance of SDoH, the Centers for Medicare and Medicaid Services (CMS) have proposed the CY 2024 Medicare Physician Fee Schedule. This rule aims to enhance healthcare providers' ability to manage patients with social risk factors and improve health outcomes. In our latest article, we shed light on the importance of SDoH and advocate for the integration of SDoH considerations in provider/payer contracts. By appropriately compensating providers for managing patients with social risk factors, we can drive better health outcomes and reduce the total cost of care. Read it here> https://lnkd.in/gy4m4vdH #OWActuarial #SocialDeterminantsOfHealth #ManagedMedicaid
Our health and quality of life are not solely determined by genetics or individual choices. Social Determinants of Health (SDoH) play a crucial role in shaping our overall well-being. Recognizing the significant influence of healthcare providers in improving access, quality of care, and community health, the Centers for Medicare and Medicaid Services (CMS) have proposed enhancements and incentives in the CY 2024 Medicare Physician Fee Schedule. These changes aim to address SDoH and promote better health outcomes. In our latest article, working with HealthWise Data, we shed light on the importance of SDoH in relation to health outcomes. We advocate for the inclusion of SDoH in provider/payer contracts to appropriately compensate healthcare providers for managing patients with social risk factors. By doing so, we can drive better health outcomes, reduce healthcare costs, and create healthier communities. Read more> https://owy.mn/3GGGdR5 #OWActuarial #Medicaid #ManagedMedicaid
Key Strategies To Transform Patient Care Via Health Equity
oliverwyman.com
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