There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb. While many MA plans offer services that align with social determinants of health (SDOH) goals, there are still gaps in how these services reach and support vulnerable populations. This challenge is multifaceted. Critical issues include:
An incomplete understanding of how MA services impact different SDOHs
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Population Health Management (PHM) in Healthcare | News, Analysis, Insights - HIT Consultant
Optimizing MIPS Value Pathways (MVPs) for Oncology Practices in 2025
The Centers for Medicare and Medicaid Services (CMS) introduced the MIPS Value Pathways (MVPs) as part of its ongoing revisions to the Merit-Based Incentive Payment System (MIPS) program, which was established in 2017 to encourage ongoing and consistent quality, efficiency, and improvement in medical practices. The MVP framework was designed to ease the burden imposed on clinicians and their administrators who participate in the MIPS program. Traditionally, MIPS scores have been calculated based
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Systems Thinking: The Future of Equitable, Efficient, and Effective Population Health Management
Healthcare in the United States consists of a tangled web of complex interconnected drivers, including payment models, regulations, processes, and facilities. However, the lack of a cohesive system design has resulted in less than optimal care industry for the US population and highlighted the need for a more comprehensive approach.
Year over year, data from the Commonwealth Fund demonstrates that despite high costs for healthcare, the patients in United States experience worse outcomes with
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Medical Home Network and Instacart Partner to Address Food Insecurity
What You Should Know:
- Medical Home Network (MHN), an organization supporting value-based care in federally qualified health centers (FQHCs) forms a collaboration with Instacart, the North American grocery technology leader, to integrate Instacart's SNAP eligibility screener into MHNConnect, its care management platform.
- The strategic partnership aims to address food insecurity among vulnerable populations and improve health outcomes.
Tackling Food Insecurity in
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Unpacking Medicare Advantage Terminations and How Plans Can Navigate Them
The U.S. healthcare system has been undergoing its own stress test. Stakeholders are currently experiencing a variety of pressures with a primary focus on finances, including administrative costs. The COVID-19 pandemic is often used as a convenient delimiter for the emergence of these problems, but in reality, tensions were brewing long before now and were caused by a variety of factors. Medicare Advantage (MA) is facing the headwinds of these issues – and as a result, MA
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Food is Medicine: Thrive Global and Blue Shield of California’s Cookbook Initiative
What You Should Know:
- Just in time for the holiday season, Arianna Huffington's Thrive Global will be releasing a new budget friendly, healthy-eating cookbook tomorrow, Tuesday, Nov. 26, in partnership with Blue Shield of California Promise Health Plan.
- At a time when rates of chronic diseases including obesity and diabetes are rising, and many people struggle to afford and access healthy food, the Thrive Global Cookbook does more than just share recipes- it reflects Thrive
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Millions of Americans Remain Uninsured or Underinsured Despite ACA Gains
What You Should Know:
- A new report from the Commonwealth Fund reveals that despite significant progress in expanding health insurance coverage under the Affordable Care Act (ACA), millions of Americans still lack adequate and affordable healthcare.
- The report highlights the prevalence of coverage gaps, high out-of-pocket costs, and the burden of medical debt, underscoring the need for further policy action to achieve truly universal coverage.
Uninsured and
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Bed Shortages: How AI Can Help Reduce Length of Stay in Hospitals
Length of stay management in acute care facilities represents a critical frontier for providers and payers to improve their own bottom lines, and also improve patients’ experience with the healthcare system.
Let’s take a closer look at how today’s systemic inefficiencies arose, and how collaboration within provider networks, and between payers and providers, might improve length-of-stay procedures and inefficiencies in the future.
Acute care facility bed shortages, and how they
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Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care
As a physician, the odds that you’ve had a negative experience related to the prior authorization process are (unfortunately) highly likely. According to the American Medical Association’s (AMA) 2023 Prior Authorization Physician Survey, 1 in 4 physicians report that prior auths “have led to a serious adverse event for a patient in their care.” Think about the toll that this takes on professionals whose primary job is providing lifesaving care, and the thing preventing this care is outside their
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Suicide is NOT a Symptom: Healthcare Is Missing the Mark on Suicide Prevention
Too many have lost a loved one to suicide. Every 11 minutes someone dies by suicide in the US, often without warning. Suicidality has historically been regarded as a symptom of major depression and mental illness in general. During my training, when someone was at risk of suicide, we were taught to treat the underlying mental illness and the patient will get better. However, in many cases that has proven to not be correct.
In fact, a large percentage of severely depressed
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