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Key Consideration for the Final Round of California CITED Funding

November 12, 2024

Capacity and Infrastructure Transition, Expansion and Development (CITED) is an incentive payment model available to Enhanced Care Management (ECM) and Community Supports (CS) providers which includes Federally Qualified Health Centers (FQHC), county and social services agencies, community clinics, and other community-based entities. CITED is one component of the Providing Access and Transforming Health (PATH) Initiative […]

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Key Considerations for Hospitals and Providers Amidst CMS Announcement of Cohort 3 AHEAD Awards

October 31, 2024

On October 28, CMS announced that Rhode Island and Downstate New York were accepted to participate into Cohort 3 of the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. Cohort 3’s first Performance Year is 2027. Downstate NY will consist of the following five counties: Bronx, Kings, Queens, Richmond, and Westchester. AHEAD is […]

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It’s Time For ACO Participants To Invest In Themselves

October 31, 2024

For the last 10+ years, most providers participating in Medicare Accountable Care Organizations (ACOs) have done so under the umbrella of an ACO aggregator. These aggregator organizations form risk-bearing entities, contract with CMS, and then recruit physician groups to participate in their ACO. While this “I’ll drive, you can ride in the back seat” type […]

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5 Things to Know About Medicare Advantage Changes in 2025

October 31, 2024

As Medicare open enrollment begins for 2025, major reductions in Medicare Advantage (MA) plan offerings are expected to lead to major shifts in patient enrollment in plans. Existing enrollees will need to decide whether to explore alternative plans or switch to traditional Medicare. It’s imperative that providers keep a close track on enrollment trends for […]

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Webinar: Forum on 1115 Waiver – Lessons Learned from California and What’s Ahead in New York

October 7, 2024

In this webinar, speakers from Bond Schoeneck & King and COPE Health Solutions to discuss New York State’s implementation of nearly $6 billion in federal funding intended to transform healthcare delivery. The forum will cover: The basics, including what the waiver is and why it’s important How similar waiver funds have been utilized in California What […]

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The Importance of Credentialing Processes in Healthcare Practices

September 25, 2024

The National Committee for Quality Assurance was founded in 1990. For almost four decades, practices have been required to maintain, and regularly submit to carriers, credentialing data for their clinicians. So how is it, nearly forty years later, practices still treat this process as an afterthought? The reality of “the re-cred firedrill” is not limited […]

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How Integrated Analytics and Care Management Tools Are Transforming Healthcare

September 25, 2024

In today’s rapidly evolving healthcare landscape, the integration of data analytics and care management tools is proving to be a game-changer. With healthcare systems moving toward value-based care models, the demand for efficient, data-driven decision-making has never been higher. Integrated analytics and care management tools are bridging the gap between patient outcomes and operational efficiency, […]

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Webinar: Improving Performance and Financial Sustainability Utilizing the CA PATH TA Marketplace

September 12, 2024

The PATH Technical Assistance (TA) Marketplace is part of California’s 1115 waiver “Medi-Cal Transformation” formerly CalAIM. PATH TA serves as a virtual marketplace for TA services, where potential and current Enhance Care Management and Community Support Providers can access TA resources from DHCS approved Vendors. The services offered through the Marketplace are fully covered by […]

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The Important Aspects When Considering Value-Based Contracting, Part 1

August 29, 2024

Value-based contracting between payers and healthcare organizations and/or providers has seen steady growth in recent years. The basic idea is to incentivize healthcare and provider organizations for better performance on the targets set up by these agreements, with the ultimate goal to achieve the Quintuple Aim. While they offer the potential to align financial incentives […]

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New York State Social Care Networks Announced: 5 Essential Steps for Success

August 7, 2024

New York State has revealed the nine organizations awarded with Social Care Network (SCN) status under the 1115 Medicaid Waiver Amendment. One of the state’s main goals under the 1115 Waiver is to invest in the screening and delivery of Health-Related Social Needs (HRSN) services to reduce health disparities and improve quality outcomes. SCNs will […]

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