5 Things to Know About California’s Medicaid Waiver Renewal
Understand what California’s CalAIM waiver renewal means for plans and providers, and the strategic moves to protect performance and funding.
A 5-Step Framework to Improve Your Health Plan’s Star Rating
Get a practical roadmap to diagnose performance gaps, prioritize HEDIS and Star measures, and focus investments where they will move scores the most.
$50B Rural Health Transformation Opportunity: What FQHCs and Rural Providers Need to Know
Learn how the Rural Health Transformation program can fund long-term stability, workforce, and innovation for FQHCs and rural providers.
CMS Announces Key Updates to AHEAD: What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) recently announced updates to the Achieving Healthcare Efficiency through Accountable Design (AHEAD) model, a state total cost of care model that Maryland, Connecticut, Hawaii, Vermont, Rhode Island and Downstate New York will participate in. While certain changes affect state requirements, key changes affecting hospitals and providers include: […]
Measuring Your MSO: The Key to Growth and Premium Retention
As healthcare organizations navigate a rapidly evolving landscape shaped by value-based care, population health, and payer-provider realignment, many providers are turning to Management Services Organizations (MSOs) to enhance operational efficiency and fuel growth. Whether you’re an independent practice, a medical group, or an emerging provider network, evaluating the size and scope of your MSO is […]
Actions to Take Now for Awarded MCP Practice Participants
1. Evaluate your practice’s capacity to meet the three domains of MCP’s care delivery approach*: care management, care integration, and community connection * Practices must meet the care delivery requirements in their starting Track by the end of PY2 (12/31/25) 2. Evaluate financial implications to your practice by modeling the six new MCP payment types; […]
5 Things to Know About CMS First AHEAD Awards
On July 2, CMS announced the first states to be accepted to participate into the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. The states that were announced as participants are Vermont, Maryland, and Connecticut. In addition, Hawaii has also been conditionally accepted pending satisfaction of certain requirements. If you are located in a state that […]
Key Considerations for AHEAD Version 2.0
As we write to you in June 2024, the first cohort application dates have passed and the third in August remains. Our team highlights key considerations for hospitals below: 1. Hospitals Should Monitor Whether Their State Applied for Cohorts 1 & 2 or Intend to Apply for Cohort 3Applications for the first two cohorts were […]
4 Ways Community Health Workers Impact Primary Care Clinic Performance
Community Health Workers (CHWs), also referred to as Promotores, are community-based frontline health workers experienced in providing linguistic and culturally sensitive, individualized whole person care in both clinical and non-clinical environments. CHWs can enhance access to and quality of primary care and are often underutilized due to a lack of understanding of their capabilities and […]
Investing in NPs/PAs to Improve Primary Care Provider Shortages
At the end of February, the Millbank Memorial Fund released their 2024 primary care scorecard entitled ‘No One Can See You Now’. A bleak assessment of primary care in the United States, the scorecard identifies five key contributors to the ever-worsening patient access crisis, the top two of which cite the need for workforce expansion1: […]