Join us on February 26 for a panel at the ViVE Conference
 
Join us on March 7 in New York for a panel with experts discussing the 1115 Waiver and AHEAD opportunities

Blog

ACO REACH: Selecting the Right Track and Risk Profile is Not Easy

January 30, 2024

A year ago, we explored the first results of the Global & Professional Direct Contracting (GPDC) program¹ (renamed to ACO REACH for performance year 2023) and found four themes:  Most participants could have earned greater savings by selecting a different risk arrangement (Professional or Global); “New Entrant” REACH ACOs tended to earn larger savings than […]

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5 Things to Know About Community Health Workers

January 30, 2024

Community Health Workers (CHWs), also known as Promotores, are community-based professionals who provide culturally competent, person-centered support. CHWs provide a range of services for vulnerable populations to close gaps in care and navigate resources to help members better self-manage their health and social needs. In September 2022, the Biden Administration announced it was awarding $225 […]

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Medicaid Global Budgets for Downstate New York Safety Net Hospitals

January 24, 2024

On January 9, 2024, CMS approved an amendment to New York’s Medicaid 1115 Waiver, allowing the state to make investments in Medicaid initiatives that expand access to primary and behavioral health, address health-related social needs (HRSN) to reduce disparities and promote health equity, and strengthen the healthcare workforce. The term of the demonstration amendment will […]

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What to Expect in 2024 for Healthcare

January 18, 2024

Greetings health care colleagues: Well, we’re through the Yuletide season and most folks are back from holiday travels or hibernations. It’s 2024 and an election year. What can we expect to see this year and for those of us updating strategic plans and reviewing our priority initiatives what should we be considering? 1. Significant ongoing […]

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Webinar: Building a Successful Strategy to Embrace New Advanced Practice Providers

January 18, 2024

In this insightful webinar, speakers delve into the transformative power of Nurse Practitioner/Physician Assistant new hire, post graduate training programs in preparing healthcare providers for unparalleled success. Discover how these programs serve as a solution, addressing critical challenges faced by healthcare organizations, including workforce shortages and physician burnout.   

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New York State 1115 Waiver: An Overview of Its Contents

January 10, 2024

On January 9, 2024, CMS approved a just under $7 billion amendment to New York’s Medicaid 1115 Waiver, allowing the state to make investments in Medicaid initiatives that expand access to primary and behavioral health, address health-related social needs (HRSN) to reduce disparities and promote health equity, and strengthen the healthcare workforce. The term of […]

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5 Things for Health Systems in Potential Participating States to Know About the AHEAD Program

January 3, 2024

5 Things for Health Systems in Participating States to Know About the AHEAD ProgramOn September 5, 2023, CMS released a new, voluntary state total cost of care model called the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. CMS plans to collaborate with states to increase investment in primary care, improve overall population […]

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Understanding Utilization Management, Part II: Best Practices

December 28, 2023

In the first part of this series on Utilization Management (UM), we discussed the basics and some of the newer rules and regulations on entities conducting (UM) required by CMS beginning January 2024.  In this section, we will dive deeper into the process of UM and start to examine some of the best practices used […]

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Strategic Relationships in Partnerships

December 28, 2023

As in any relationship, strategic relationships require time and commitment to develop a partnership with mutual benefits. It all begins with an introduction which will test the chemistry and the objectives between the two parties. At times, even when all the strategies are aligned, the interactions may not be comfortable. It’s an indication that the […]

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Webinar: Moving Ahead – Exploring New York’s Forthcoming 1115 Waiver

December 19, 2023

In this webinar, industry experts discuss how the pending New York State Medicaid Waiver and aligned CMS value based payment programs will present new opportunities for healthcare organizations in both upstate and downstate New York. We’ll cover how the NY Waiver aligns with specific CMS models in upstate and downstate New York, lessons learned from […]

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