Hospitals are increasingly turning to value-based care initiatives to transform care delivery, lower the total cost of care, and improve patient outcomes. Unlike traditional fee-for-service (FFS) models that reimburse providers based on volume (i.e., the number of patient visits), providers are reimbursed based on the quality of care delivered in value-based care. Ultimately, success under these reimbursement models hinges upon seamless coordination between all stakeholders across the continuum
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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant
Health Net, MedArrive Partner to Bring In-Home COVID-19 Vaccine to At-Risk Medicaid Members
What You Should Know:
- One of California's longest-serving and most-experienced Medi-Cal partners, Health Net (a Centene plan), and virtual care and in-home health services provider MedArrive is collaborating to bring the most vulnerable, at-risk Medicaid members in-home access to COVID-19 vaccinations.
- Eligible Health Net members in the Los Angeles, Sacramento, and Fresno regions who opt into the innovative program can schedule their home visit at their
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Breaking Down the Implications of New No Surprises Act Regulations
The importance of the No Surprises Act (NSA) cannot be overstated, as surprise medical bills have long been burdensome for patients in the U.S. healthcare system. In fact, more than half of all U.S. consumers have received an unexpectedly large medical bills.
The purpose of the No Surprises Act is to prevent surprise out-of-network bills, often for emergency services. For example, if your appendix bursts while at work, you would be rushed to the nearest hospital for an emergency
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Unlocking Interoperability with a Blockchain-Powered Network
Achieving fluid data interoperability has been a complex and challenging goal for the U.S. healthcare system. The result of which has led to excessive administrative costs, delays in providing care, and significant patient frustration.
According to the Centers for Medicare and Medicaid Services, U.S. healthcare spending grew 9.7% in 2020, reaching $4.1 trillion, or $12,530 per person. This is forecasted to grow to $6.2 trillion by 2028, which will only exacerbate the current spending
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The No Surprises Act: How Payers Can Stay Compliant
As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a topic discussed by consumers and policymakers. Surprise billing can occur when a patient unknowingly receives care from providers that are outside their network. This can result in balance billing, the practice of billing a patient the difference between what their health plan covers and what the provider charges. Unfortunately, these bills are often the result of care provided in
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Healthcare Interoperability Has Arrived: 3 Ways to Harness the Potential
This year’s HIMSS Conference offered some exciting insights and a renewed focus on data-sharing and interoperability. While the healthcare industry has been extolling the virtues of data interoperability for years until recently it has remained one of the biggest obstacles to providing quality healthcare today. Yet, the tides are turning. New government regulations, like the Centers for Medicare & Medicaid Services’ interoperability rules and the Fast Healthcare Interoperability Resources
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Is It Finally Time for Hospital-at-Home or is Time Up?
All the signs point to a bright and expansive future for hospital-at-home programs, which have been growing steadily since the Centers for Medicare and Medicaid (CMS) created the Acute Hospital at Home waiver program in November 2020. As of March, nearly 100 health systems and more than 200 hospitals in 34 states had been approved for the program. Meanwhile, Forrester predicts the number of hospitals delivering acute care at home will triple in 2022. The reasons why are compelling: a study
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Polygon to Partner with MSP on Healthcare Blockchain Initiative
What You Should Know:
- Today, Polygon Networks, a leading blockchain and scaling solution, announced a partnership with Tokenology and MSP Recovery to deliver LifeChain - a new healthcare claims platform.
- LifeChain will leverage blockchain technology to solve healthcare's biggest problems, including fraud, inefficiency in payments and antiquated processes.
Tokenize Healthcare Claims On-Chain
LifeChain will be developed by MSP Recovery and Tokenology as a fully tokenized Medicare,
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SimpliFed Raises $6M for Virtual Breastfeeding & Baby Feeding Support
What You Should Know:
- SimpliFed, the telehealth platform dedicated to democratizing access to baby feeding services, announced it has closed $6M in its seed round, led by Morningside Ventures and The Venture Collective, with participation from NY Ventures, Elizabeth Street Ventures, Waterline Ventures, and 3CC.
- SimpliFed provides virtual breastfeeding and baby feeding support fully covered by your health plan from pregnancy to weaning.
Virtual Inclusive Baby Feeding Support for
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COVID-19 Fell Out of Top 5 Telehealth Diagnoses Nationwide in February 2022
What You Should Know:
- After two months in the top five telehealth diagnoses nationally and in every US census region, COVID-19 fell out of that ranking nationally and in every region in February 2022, according to FAIR Health's Monthly Telehealth Regional Tracker.
- The change coincided with a sharp decline in new cases of COVID-19, as reported by the Centers for Disease Control and Prevention, following the January
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