Blog

In this webinar, our speakers from COPE Health Solutions, Health Tech 4 Medicaid, Transform Health and LTIMindtree discuss how California and other states are working toward streamlining the way agencies share data to improve care for members. Changes to policy will have real impacts to data sharing and how payers and providers use data to […]

Utilization Management (UM) has been employed by organizations to ensure that patients get the right care at the right time in the right place in a cost-effective manner while maintaining high quality patient care and services. Many programs have recently come under fire because of the administrative impact the process has on health care providers […]

As of August 2022, preliminary federal estimates showed that Medicaid enrollment stood at more than 90.9 million people, or more than one in four Americans, following the impact of the Families First Coronavirus Response ACT, which enabled continuous enrollment for Medicaid beneficiaries through the COVID-19 pandemic. As of March 31, 2023, Congress has stopped continuous coverage […]

The Medicaid population is a mosaic of individuals, each with unique needs and challenges. For clinicians and caregivers navigating this complexity, the integration of longitudinal patient data, outcome data, and financial data offers a beacon of clarity. The following represent some potential real-world applications for this integrated approach:   Elderly and Dual-Eligible Beneficiaries: :: […]

During the HLTH 2023 Conference, on Monday, October 9, speakers emphasized the urgent need to advance and accelerate Value-Based Care, highlighting key challenges in qualifying, rate setting, data accuracy, and goal alignment. They additionally emphasized the importance of evidence-based models, community engagement, and comprehensive programs to foster warm handoffs and collaborative, patient-centered care within a […]

In the rapidly evolving landscape of healthcare, the shift towards value-based care is gaining momentum. This paradigm shift, which emphasizes patient outcomes over volume of services, presents a unique opportunity for primary care providers to redefine their role and create a more sustainable and effective healthcare system. The key to success in this new era […]

While we are well into the second year of implementation, there remains a significant portion of the eligible population and provider community who have yet to realize the benefits of this waiver. We will discuss key pain points, as well as the resources and infrastructure development opportunities CalAIM offers to providers, community-based organizations, counties, and […]

Yesterday, September 5, 2023, the CMS Innovation Center released the AHEAD Model focused on improving overall population health of a specific state or region, advancing health equity by reducing disparities in health outcomes and curbing the growth of health care costs. Key aspects of the model: State accountability and alignment with Medicaid Waivers: States will […]

This webinar will delve into the transformative impact of data analytics in the context of value-based care, bringing together providers and payers to explore strategies for leveraging disparate data sources and enhancing performance. Speakers will address key topics, including how we can use data to improve health and patient outcomes in relation to value-based care, […]

Understanding Drivers of Performance: Engaging providers at a higher rate and with the right data and insights early on leads to improved clinical, quality and financial outcomes, improved provider and health plan performance, provider and member retention, and overall efficiency.  Nationally, health plans and their contracted provider networks are actively working to improve performance […]