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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant

AHIMA, AHCA Partner to Train Skilled Nursing Facilities in ICD-10 Coding to Prepare for New Patient Driven Payment Model

by Jasmine Pennic 04/04/2019 Leave a Comment

AHIMA, AHCA Partner to Train Skilled Nursing Facilities in ICD-10 Coding to Prepare for New Patient Driven Payment Model

The American Health Information Management Association (AHIMA) has announced a collaboration with the American Health Care Association (AHCA) to provide in-depth coding and clinical documentation improvement (CDI) training programs. The goal of the collaboration is to help professionals in skilled nursing facilities (SNF) prepare for the upcoming payment reimbursement change.New, Value-based Patient Driven Payment Model (PDPM) Beginning October 1, 2019, the Centers for Medicare and Medicaid
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Blue Cross NC, Duke Health Form New Company to Offer Medicare Advantage Plan for Seniors

by Fred Pennic 04/03/2019 Leave a Comment

Blue Cross NC, Duke Health Form New Company to Offer Medicare Advantage Plan for Seniors

Blue Cross and Blue Shield of North Carolina and Duke University Health System have together formed Experience Health, a new health insurance company to offer a Medicare Advantage Plan in 2020. Jointly owned by Blue Cross NC and Duke Health, Experience Health brings together two of the most trusted and innovative names in healthcare to create a locally owned and operated non-profit health plan.Why Experience Health?Blue Cross NC and Duke Health formed Experience Health to take advantage of the
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AMA, UnitedHealthcare Develop ICD-10 Codes to Support Social Determinants of Health

by Fred Pennic 04/03/2019 Leave a Comment

Social determinants of health

UnitedHealthcare and the American Medical Association (AMA)  are teaming up to support using data for social determinants of health (SDOH) to improve and simplify how referrals are made to social services. The collaboration builds off work initiated by UnitedHealthcare to standardize how data is collected, processed and integrated regarding critical social and environmental factors that contribute to patient well-being. New ICD-10 related to Social Determinants of Health (SDOH) Today, nearly 80%
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GlobalHealth to Launch Medicare Advantage (MA) Marketplace with Evolent Health

by Jasmine Pennic 03/28/2019 Leave a Comment

GlobalHealth to Launch Medicare Advantage (MA) Marketplace with Evolent Health

GlobalHealth, an Oklahoma-based health maintenance organization, today announced it has entered into a definitive agreement to create a partnership in the Medicare Advantage (MA) plan marketplace with Evolent Health, a company providing an integrated value-based care platform to the nation's leading providers and payers. Together, both companies will launch and scale MA health plans under the True Health brand in targeted geographies. True Health Medicare Advantage (MA) Marketplace DetailsThe
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Allscripts Expands Relationship with Ephraim McDowell Health to Drive Patient Engagement

by Jasmine Pennic 03/26/2019 Leave a Comment

Allscripts Expands Relationship with Ephraim McDowell Health to Drive Patient Engagement

Allscripts FollowMyHealth announced a partnership with Ephraim McDowell Health on its enterprise and mobile patient engagement platform. FollowMyHealth offers a mobile, enterprise patient/consumer engagement platform for providers, hospitals and health systems who want to promote healthy patient populations and manage quality. Platform Approach BenefitsFollowMyHealth’s total connected patients hit over 17 million during 2018 with portal alone. With their expanded HealthGrid platform, that number
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Current State of Value-based Care in Oncology: 13 Key Trends to Know

by Fred Pennic 03/22/2019 Leave a Comment

Value-Based Health Care is Antithetic to Patient-Centered Care_ Value-based Care in Oncology

New data on the state of value-based care in oncology has found that while community oncologists are optimistic about the beneficial potential of value-based care, they see a conflict between the need to decrease episode costs and the rising prices of the most innovative novel therapies. In an effort to dig deeper into current attitudes toward new value-based reimbursement models and novel therapies in cancer care, Integra Connect surveyed leaders and decision-makers in oncology practices.
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FHA and Caravan Health Partner to Sponsor Statewide Medicare ACO in Florida

by Jasmine Pennic 03/22/2019 Leave a Comment

FHA and Caravan Health Partner to Sponsor Statewide Medicare ACO in Florida

  Caravan Health and the Florida Hospital Association (FHA) have teamed up to sponsor a statewide accountable care organization (ACO) under which hospitals throughout the state will work together to provide coordinated, high-quality healthcare while delivering lower costs for patients.   Statewide ACO Model to Build Primary Care   Through the statewide ACO, hospitals in Florida can access Caravan Health's proven population health management model to build primary care capacity and
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How Our Texas ACO Saved Medicare $14M with Population Health Approach

by Victoria Farias, Program Administrator at Rio Grande Valley Health Alliance 03/20/2019 Leave a Comment

How Texas ACO Aces the MSSP with Hands-On Population Health Approach

Only about a third of the accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) qualified for bonuses in 2017. Our ACO, the Rio Grande Valley Health Alliance (RGVHA), was one of them. In fact, we’ve generated enough MSSP savings to net bonuses for five years in a row. In 2015, RGVHA saved Medicare $14.2 million, of which our providers received half. In 2016, our ACO’s first year in Track 3 of the MSSP, we received 75% of the $8.5 million we saved. And in 2017,
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Stanford Health Taps Lumeris to Optimize Medicare Advantage Plan

by Jasmine Pennic 03/19/2019 Leave a Comment

Lumeris, Stanford Health Partner to Optimize Medicare Advantage Plan

Stanford Medicare Advantage plan seeks sustainable value-based care growth and continued innovations to serve seniors in collaboration with Lumeris.Lumeris, a provider of value-based care, and Stanford Health Care are partnering on a long-term collaboration for the further development of Stanford Health Care Advantage, a Medicare Advantage (MA) plan in Northern California. Once finalized, Lumeris will help optimize and grow the MA plan throughout the region and support Stanford Health Care's
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The Blueprint to Scaling Social Determinants of Health (SDOH) Data Collection

by Lindee Chin, MD, Senior Clinical Director of Value-Based Care at Edifecs 03/18/2019 Leave a Comment

In the value-based care world, cost-effective treatment, quality of care, and patient outcomes determine payment. Social determinants of health (SDOH) represent the economic, psychological, educational, environmental and social barriers that limit healthy behaviors, access to care and adherence to treatment resulting in poor health outcomes. Many stakeholders in health care are trying to address social determinants as part of their value-based care strategy. However, many organizations are
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