On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final rule, Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality. The rule aims to promote consistency and transparency, with an increased focus on improving access, driving quality, and advancing equity for Medicaid beneficiaries. CMS has been moving in this direction for several years, and states managed care organizations, and providers have
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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant
Cityblock, Sunshine Health Partner to Deliver Care to Florida Medicaid Members in Central Florida
What You Should Know:
- Cityblock, a value-based healthcare provider specializing in Medicaid, announced a new partnership with Sunshine Health, a Florida managed care plan. This collaboration aims to provide high-quality primary care and care coordination services to Medicaid beneficiaries with complex needs in Central Florida.
- The partnership expands Centene Corporation's, Sunshine Health's parent company, existing relationship with Cityblock. Cityblock has already established
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Pair Team Secures $9M to Connect Underserved Communities to Care
What You Should Know:
Pair Team, a virtual and community-based primary care solution connecting Medicaid's highest-risk patients to high-quality care, today announced it has raised $9 million in Series A funding. The financing was led by NEXT VENTURES, with participation from PTX Capital, Kapor Capital, Kleiner Perkins, Y Combinator, and several notable healthcare angel investors including Jay Desai.The funding will be used to help Pair Team accelerate its
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Waymark Secures $42M to Expand Community-Based Care for Medicaid Patients
What You Should Know:
- Waymark, a San Francisco, CA-based Medicaid provider enablement company raises $42M in new financing to scale technology-enabled, community-based care for primary care providers and their patients enrolled in Medicaid programs. The round was led by Lux Capital and CVS Health Ventures joins as a new investor.
- Existing investors Andreessen Horowitz (a16z) and New Enterprise Associates (NEA) also participated in the round. The investment consists of $22M in
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Innovation Key to Tackling Medicaid Redetermination Challenge
As a result of the Families First Coronavirus Response Act (FFCRA), Medicaid programs were required to keep citizens continuously enrolled through the COVID-19 public health emergency (PHE). These continuous enrollments ended on March 31, 2023, resulting in what many call the unwinding of Medicaid.
In June, the Kaiser Family Foundation (KFF) estimated that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision. The
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Why Accurate Data is a Lifeline to Care in the Medicaid Redetermination Cycle
During the pandemic, Medicaid enrollment grew by nearly 30% to cover more than 93 million Americans, due in large part to COVID-19 provisions that included continuous Medicaid enrollment. With the unwinding of these pandemic emergency orders, annual cycles of Medicaid redetermination have returned. As a result, states have removed close to 4 million Americans from Medicaid to date. The ongoing redetermination process is likely to expand health inequities across the nation, including in
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TytoCare Report Reveals Providers’ Key to Virtual Care Adoption
What You Should Know:
A new report released by TytoCare, a virtual care company enabling accessible, high-quality primary care from home, revealed insights into how health plans and organizations can drive virtual care engagement.While key elements that patients value in virtual care offerings include cost and time savings, and the ability to reduce Emergency Department (ED) or urgent care visits, people want to see doctors they trust or and are more likely to adopt virtual care when
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Improving Non-Emergency Medical Transportation: Driving Better Outcomes for Patients and Health Plans
As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. Non-emergency medical transportation (NEMT) plays a crucial role in helping patients get to where care is delivered. As healthcare reform efforts continue to gain momentum, transportation benefits have become an increasingly critical component of providing equitable care to patients. NEMT helps close the health equity gap
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Report: 20% of Americans Skip Healthcare Due to Transportation Barriers
What You Should Know:
A new analysis shows more than 21% of U.S. adults without access to a vehicle or public transit went without needed medical care last year. These individuals were significantly more likely to skip care than those who reported neighborhood access to public transit services (9%).This analysis examining the association between transportation and access to healthcare was conducted by Urban Institute researchers with support from the Robert Wood Johnson
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NCQA Launches Race and Ethnicity Stratification Learning Network
What You Should Know:
- The National Committee for Quality Assurance (NCQA) today launched the Race and Ethnicity Stratification Learning Network, a free, interactive, online tool that offers data and best practices to help health plans improve how they collect race and ethnicity data on their enrollees. Improving data collection of race and ethnicity data is vital to improving health equity.
- The data available in this new resource summarize the care of 20 million people
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