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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant

Opioid Settlements are Making Headlines; Is Now The Time to Soften Guidelines?

by Jeremy Bloom, CEO, NorthSight Recovery 03/15/2023 Leave a Comment

Opioid Settlements are Making Headlines; Is Now The Time to Soften Guidelines?

The United States only represents five percent of the world’s population; however, Americans consume 80 percent of the world’s opioids.1 The U.S. is the world’s leader in the use of opioid medications to cope with physical and emotional difficulties. And the recent Walgreens and Wal-Mart multi-state opioid settlement agreement disclosures have only hammered home the point. America continues to have an opioid addiction problem.  In light of all these circumstances, the recent CDC
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Fully Modular Medicaid System Enables Kansas to Achieve CMS Certification

by Fred Pennic 03/10/2023 Leave a Comment

Fully Modular Medicaid System Enables Kansas to Achieve CMS Certification

What You Should Know: - Gainwell Technologies (Gainwell), an innovator in healthcare technology solutions, announced that the nine-module Medicaid system it designed and implemented for Kansas is the first fully modular system to achieve the Centers for Medicare & Medicaid Services (CMS) Streamlined Modular Certification. The deployment marks Kansas as the first state with a completely modular system to receive federal matching funds from the day
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Enabling a Better Future for All by Embracing Healthcare Interoperability

by Rajesh Sharma, Vice President and General Manager of Systems Integration, Data Analytics and Interoperability Product Offerings, Gainwell Technologies 03/10/2023 Leave a Comment

Enabling a Better Future for All by Embracing Healthcare Interoperability

The Centers for Medicare and Medicaid Services (CMS) has laid the critical groundwork to create a connected healthcare system in which patients, providers, and payers can easily exchange information. This is thanks in part to the release of the Interoperability and Patient Access Final Rule. With new policies now in place, CMS aims to generate better health outcomes through improved interoperability and better access to health information for all stakeholders. CMS has also identified a new
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How Home Health Tech Can Solve a Stubborn $290B Healthcare Challenge

by Trenholm Ninestein, Director of Product and Digital Health Lead at Rightpoint 03/07/2023 Leave a Comment

How Home Health Tech Can Solve a Stubborn $290 Billion Health Care Challenge

The good news on the medical front is that with advances in therapy, people with chronic diseases are able to remain in their homes and even live active lifestyles, which improves their quality of life and can save them, the government (Medicaid/Medicaid), and the insurance industry money. But -- and it’s a big one -- those savings can only be achieved if those patients adhere to their medication schedules. Non-adherence first came to the forefront of awareness back in 2009, when the New
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Maryland HIE to Expand Medicaid Redetermination Notification Project

by Fred Pennic 03/06/2023 Leave a Comment

Maryland HIE to Expand Medicaid Redetermination Notification Project

What You Should Know: - CRISP, the nonprofit state-designated health information exchange (HIE) of Maryland, announced plans to expand its Medicaid Redetermination Notification project across the state to support care teams as they navigate redetermination for 1.6 million Medicaid enrollees. - The project is a collaboration across state agencies and began as a pilot supporting federally qualified health centers who expressed concerns about lacking resources that would contribute to
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CMS Awards Accenture Federal Services with $628M Contract to Support Healthcare.gov

by Fred Pennic 03/02/2023 Leave a Comment

CMS Awards Accenture Federal Services with $628M Contract to Support Healthcare.gov

What You Should Know: - Accenture Federal Services has won a five-year, $628 million recompete of a contract award from the U.S. Centers for Medicare and Medicaid Services (CMS) to continue its work supporting Healthcare.gov. CMS made this award through the Strategic Partners Acquisition Readiness Contract (SPARC) vehicle. - In 2014, Accenture Federal Services was awarded a prime contract to take over management of the Federally-Facilitated Exchange (FFE). FFE is the backbone of
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Walmart & CareSource Partner to Address Racial Health Inequities

by Fred Pennic 02/28/2023 Leave a Comment

Walmart & CareSource Partner to Address Racial Health Inequities

What You Should Know: - Today, Walmart announced a three-year agreement with the nonprofit organization, CareSource to address cardiometabolic conditions and maternal health in under-resourced and underserved communities. - The partnership expands the work Walmart and CareSource are doing to help improve care around maternal and child health in Georgia - the two launched a pilot in Georgia earlier this year to help Black maternal health across the state. Address
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Apixio Launches EHR-Integrated Post-Visit Solution

by Syed Hamza Sohail 02/23/2023 Leave a Comment

Apixio Unveils AI-Powered Risk Adjustment Auditing Solution

What You Should Know: - Apixio, a leading AI platform that powers value-based care launches its new Apicare Post-Visit™ offering, an EHR-integrated intelligent workflow solution for health plans and providers. With the Centers for Medicare & Medicaid Services' recent Medicare Advantage Risk Adjustment Data Validation Final Rule, healthcare organizations need to have complete diagnosis capture and accurate documentation for reimbursement to ensure compliance. - The new Post-Visit
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It’s Time to Stop Accepting the Payer-Provider Dynamic as ‘Adversarial’ and Work Toward Alignment

by Heather Bassett, M.D., Chief Medical Officer, XSOLIS 02/22/2023 Leave a Comment

It’s Time to Stop Accepting the Payer-Provider Dynamic as ‘Adversarial’ and Work Toward Alignment

Today’s relationship between payers and providers is more fraught than ever. With a history of transactional, often adversarial, fee-for-service contract negotiations, it’s no wonder that the healthcare industry has grown too comfortable pitting payers and providers against each other. The lack of trust and transparency between the two groups has led to a perceived misalignment of vision. Across the board, the administrative staff has shouldered the brunt of this friction, which in the end
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Aledade Acquires Curia, Adds More Than 450 New Practices

by Jasmine Pennic 02/21/2023 Leave a Comment

Aledade Acquires Curia, Adds More Than 450 New Practice

What You Should Know: - Aledade today announced the acquisition of Curia, a leader in value-based care analytics using practical applications of artificial intelligence (AI) to optimize the targeting of patient care and engagement programs.  The acquisition will enhance Aledade’s ability to extract valuable insights from disparate data sources, provide more accurate predictions using past data, and optimize primary care workflows through cutting-edge AI algorithms. - In addition, the
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