The Case For Care Coordinators
Health care delivery is usually discussed in broad, dramatic strokes: open heart surgeries, organ transplants, cancer patient survival rates. But seemingly insignificant things can dramatically impact health care delivery. For example, a patient misses a crucial doctor’s appointment because they lack transportation, leading to another hospital stay. Or, a patient with diabetes lets their health […]
Comparing DSRIP in Texas and New York
Overview Delivery System Reform Incentive Payment (DSRIP) providers in Texas have been closely following the proposed extension to the Texas State Section 1115 Waiver as the Health and Human Services Commission (HHSC) prepares to submit an extension application to the Centers for Medicaid and Medicare Services (CMS). A main goal of the extension is to […]
Finger Lakes Care Collaborative Re-imagines Health Care Delivery
Healthcare providers in upstate New York are looking to transform care specifically for the Medicaid and uninsured population. Currently, the region is plagued by the same challenges facing many communities nationwide. Namely, a health care delivery system that operates in silos with poor care transitions and a disconnected information technology infrastructure that limits the ability […]
Care Coordination Valuable Then, Vital Now
Recognition of the need to better coordinate the fragmented pieces and parts of a patient’s health care services is not new. Coordination of care has, however, become an increasingly hot topic due to implementation of the Affordable Care Act (ACA) and health reforms that encourage decreased traditional hospital utilization and enhanced care management, particularly for […]
Call to Leadership: The California Delegated Model at Risk
Libertarians, and others frustrated with the costs and strictures of regulation, may express the view that regulation of the insurance industry is often burdensome and unnecessary. Without addressing the global topic, there is a solid argument that good regulation serves the public interest through supporting ongoing confidence in the insurance market in which the public […]
Population Health 360 Key Takeaways
On October 18, 2018, COPE Health Solutions and Montefiore Health System hosted the West Coast regional Population Health 360 Conference in Los Angeles, California. More than 50 health care leaders from provider and payor organizations gathered for this invite-only event to discuss current trends, challenges and the future vision of the value-based payment landscape. Attendees […]
Population Health 360 Conference Key Takeaways
Hospital Price Transparency: Unintended Consequences and Likely Impacts
The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule requiring hospitals to release pricing information before providing services. Under the rule, hospitals must list standard prices for 300 “shoppable services” as well as the lowest prices they will accept from cash-paying consumers. According to CMS Administrator Seema Verma, the new price […]
The Who, Where, Why and What You Should Do Next with the California DMHC’s Expanded Licensing and Exemption Requirements
Effective July 1, 2019, the California Department of Managed Health Care (“Department” or “DMHC”) is requiring organizations under certain conditions to file their risk contracts with DMHC. California managed care organizations, medical groups, risk bearing organizations (RBOs), clinically integrated networks (CINs) and any entities looking to enter into upside or downside financial risk agreements will […]