National MLTSS Health Plan Association’s Post

Accessible care is huge! More focus is needed on meeting the member where they are. Holistic approaches to treating as a whole is critical in today’s world. Value based care, telehealth, rural health focus, SDOH, NHS Frameworks, HEDIS measures, etc. The list goes on and on and it’s imperative that members are being identified and receiving appropriate care and services. Many states have waiver waitlists years long. Changes are coming and need to happen.

Following extensive advocacy from NAACOS and others, the Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule to address anomalous billing in #Medicare ACOs. If finalized, the rule would remove claims from two problematic catheter codes from the Medicare Shared Savings Program's (MSSP) performance year 2023 expenditures. The CMS Innovation Center is expected to take similar steps to address this issue in the ACO REACH Model. We appreciate CMS’s recognition of this critical issue and corrective actions. Read NAACOS' statement on the rule: https://lnkd.in/eVtjDvHQ Proposed rule: https://lnkd.in/ej3w6Krf CMS fact sheet: https://lnkd.in/e4C4PkMg Stakeholder letter to CMS: https://lnkd.in/eQaDA3SA

HealthWorksAI's exclusive bi-monthly CMS RoundUp Summaries deliver clear summaries of updates from the Centers for Medicare & Medicaid Services (CMS). Check out the full CMS Roundup here: https://lnkd.in/gCwCEFE7 Follow HealthWorksAI for these insightful summaries & #MedicareAdvantage market insights! Don't miss out. #StayInformed #Medicare #MedicareInsurance

Learn how leaders from the Department of Health and Human Services, the Centers for Medicare and Medicaid Services, and the Health Resources and Services Administration are addressing primary care challenges in Central Texas https://lnkd.in/g94E79XX

Exciting news for healthcare providers and patients! The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare will now cover Wegovy when prescribed to reduce the risk of heart attack and stroke. This is a significant development in the fight against obesity-related health issues. Healthcare professionals can now confidently recommend Wegovy to eligible patients knowing that Medicare will cover the cost. Let's continue to prioritize preventive care and make strides toward better health outcomes for all. #Wegovy #MedicareCoverage #PreventiveCare #HealthcareAdvancements https://hubs.ly/Q02qplQl0

Today, the Health Care Transformation Task Force and the National Association of ACOs released a resource outlining policy recommendations for the Centers for Medicare & Medicaid Services aimed at strengthening patient engagement in ACO governance, care delivery redesign, and individual care planning, with a particular focus on Medicare Accountable Care Organizations (ACOs).   The recommendations are categorized by:  ▶ Beneficiary communications and education  ▶ Beneficiary engagement in care delivery redesign  ▶ Beneficiary participation and input in ACO governance Read the resource here: https://lnkd.in/eMjwq3Ue

Are you ready to meet the Centers for Medicare & Medicaid Services’ goal of having all Medicare beneficiaries in an accountable care arrangement by 2030? Join us TODAY at noon (EDT) for a webinar with Accountable Care Organization (ACO) Aledade that will delve into the principles and mechanics of value-based care, including ACOs: https://buff.ly/44vbCRA

CMS-2442-F is a new final rule from the Centers for Medicare & Medicaid Services (CMS). It aims to improve Medicaid and CHIP managed care programs. Here’s what it does: • Better Protection for Patients: It gives patients more access to information and resources • More Transparency and Accountability: Managed care plans must report details on their services. • Improved Care Coordination: It helps the health of those with complicated health issues • Higher Quality of Care: Improves the care patients receive • Simplified Administration: It makes programs easier to manage by reducing paperwork and administrative tasks Read the fact sheet here: https://ow.ly/IzUz50S8rbt #DisabilityRights #InclusiveLaws #CenterOnDisability

Are you prepared for the coming additions to The Centers for Medicare and Medicaid Services (CMS) Medicare Advantage (MA) Star Ratings Measures? Beginning January 1, 2025, CMS is implementing additions and changes that will impact 2027 Star Ratings. MA Plans and providers must ensure they are fully prepared to identify beneficiaries for which these new measures apply and develop strategies to address their care needs — and time is ticking. Learn more: https://lnkd.in/e-4R75TR #FTIHealthcare Key Contacts: Mark Van Ert and Krunal Patel

5 things to know about the new Centers for Medicare & Medicaid Services ACO Primary Care Flex Model 👇 https://lnkd.in/eFRnBKbk