Blog

1. Evaluate your practice’s capacity to meet the three domains of MCP’s care delivery approach*: care management, care integration, and community connection: Care management: focus on designing and developing care management and chronic condition self-management services, with an emphasis on chronic disease prevention and management Care integration: strengthen connections with specialty care (Track 2 […]

Healthcare delivery has traditionally reimbursed providers on a fee-for-service (FFS) basis. This reimbursement system incentivizes volume over quality and leads to unsustainable growth in healthcare costs. In an effort to contain costs and reform the healthcare delivery system to prioritize value over volume, CMMI and commercial payers have introduced a multitude of value-based payment (VBP) […]

Discover innovative strategies to establish hiring pipelines for students and entry-level positions, and explore creative solutions for addressing workforce and nursing shortages. Speakers:: Annette Greenwood, MSN, BSN, RN, Far West Division Chief Nursing Officer, HCA Healthcare Pat Patton, DNP, MSN, RN, NEA-BC, Chief Nursing Officer, Providence Swedish Medical Center – First Hill Campus Margaret […]

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 […]

Expanded access to claims, EMR, ADT (Admission, Discharge and Transfer information), health related social need and other health care data sources through maturing health information exchanges, integration solutions and other avenues is creating new opportunities for both providers and payers. At the same time the volume of data available and diversity of data sources can […]

Over the course of the past decade, as more practices have entered the arena of Value-Based Care, practice operational functions have increasingly become an after-thought. The promise of big bonus checks (real or imagined) has created an environment in which small and mid-sized practices have shifted their focus toward RAF, gap closure activity, quality indicator […]

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 3: Applications for the first two […]

As CalAIM continues through year three of implementation, Enhanced Care Management (ECM), Community Health Workers (CHWs) and Community Supports (CS) continue to scale. These services are increasing integration with primary care provider organizations, whether an in-house service, contracted or a referral partner, who are ultimately accountable to managed care plans (MCPs) and the State for […]

Background: Federally Qualified Health Centers (FQHCs) are designated entities in the national Health Center Program that are instrumental in providing healthcare services to underserved communities and increasing access to high quality, affordable healthcare. The fee for service model does not reimburse most providers at an adequate level to be sustainable with the growing Medicaid […]

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 […]