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Medi-Cal 2020: What You Need to Know About PRIME

March 22, 2016

Overview: California’s next Section 1115 Medicaid Waiver, Medi-Cal 2020, was approved on December 31, 2015. The Medi-Cal 2020 initiatives include a Global Payment Program, a Whole Person Care Pilot program, a Dental Transformation initiative and the introduction of the Public Hospital Redesign and Incentives in Medi-Cal program (PRIME). PRIME builds upon the successes of […]

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Preparing for the Texas 1115 Waiver Renewal – DSRIP Project Sustainability vs. Project Replacement

March 22, 2016

The Texas Medicaid 1115 Waiver is going through a transformation. The sooner providers prepare, the better. As the current Texas Medicaid 1115 Waiver Demonstration nears a close in late 2016, many health care providers across the state find themselves pondering the “what ifs” of operations post-DSRIP. DSRIP, or Delivery System Reform Incentive Payment, is a […]

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Making Post-Discharge Calls Sustainable in High-Volume Patient Care Environments

March 17, 2016

Background: Post-discharge phone calls are an empirically supported best practice for improving the patient experience and reducing readmissions in hospitals1. The Agency for Healthcare Research and Quality (AHRQ) recommends that follow-up calls be made to patients within 48-72 hours of discharge2. To meet industry standards and stay connected with their patients, providers are working […]

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Using CRM for Network Development

February 22, 2016

Overview:: Customer Relationship Management (CRM) platforms have exploded in popularity in the health care industry. Pharmaceutical companies, health insurers and third-party vendors use them in relatively traditional ways to manage sales, marketing and customer support. But, healthcare providers can use CRM in a novel way to streamline network development and take advantage of their […]

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Stephanie King – Team Member Spotlight

February 22, 2016

Stephanie King is a Senior Consultant at COPE Health Solutions. In this position, she has the opportunity to strategically partner with clients to transform the way health care is delivered. She has previous experience in ambulatory operations, project management and 1115 Waiver programs. Her previous experience working at large academic medical centers and with the […]

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Afternoon Tea Service: Simple Ideas for the Patient Experience

February 22, 2016

At approximately 2:00PM each day, the participants of the Health Scholar Program round on each patient in the Mother-Infant Unit of St. John’s Regional Medical Center to offer a light afternoon snack of cookies and refreshments. Known as “Tea at Two” within the hospital, the concept was first implemented by the unit leaders in 2010. […]

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Customizing Health Care Reform with Section 1332 State Innovation Waivers

February 22, 2016

Overview: Beginning January 1, 2017, states can become a laboratory for new ideas by seeking to waive or alter certain provisions of the Affordable Care Act (ACA). Section 1332 outlining State Innovation Waivers under the ACA allows states to request alternative provisions to enhance state health markets if coverage and cost would remain the […]

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Collaborative Care for Enrolls With Multiple Conditions: A Triple Aim Strategy

February 22, 2016

Our current health care system has become financially unsustainable with gaps in care, silos and duplication in care delivery, and lacks bridges to critical support services necessary for improving health outcomes. One challenge is that overall population health is determined by factors and social determinants outside the health care delivery system. Per the Healthy People […]

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Value-Based Payments in New York DSRIP

January 26, 2016

Background Information : Basic concepts of value-based payments: As the healthcare industry continues to implement many aspects of the Accountable Care Act (ACA), much of the focus is on payment reform. One of the most commonly utilized terms about payment reform is value-based payments (VBP). As an umbrella term, VBPs can cover a wide […]

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The Role of Medicaid Waiver Transformation Projects in Transforming the Core Strategic and business planning framework of health care organizations

January 26, 2016

Overview: Across the United States over the last 10 years, 1115 Medicaid Waiver projects — initially known as Delivery System Reform Incentive Payments (DSRIP) projects — are driving health care transformation on a large scale in California, Texas and New York with other states such as Washington preparing to launch. These waiver-funded projects represent […]

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