The COVID-19 pandemic has completely transformed the World Order and exposed striking realities of the global healthcare infrastructure by revealing the tendencies of various countries to deal with public healthcare emergencies. It has further raised the curtain on global hegemons like the U.S.A., which lacked the capacity and finances to counter this disaster. This has intensified the need for reforms and strong legislation to mitigate the pandemic’s devastation on healthcare facilities.
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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant
Aetna Taps Emcara Health to Deliver Home-Based Primary Care to 240k Medicaid Patients
What You Should Know:
- Emcara Health and Aetna Better Health, which announced that the two companies will be partnering to deliver primary care in the home to more than 240,000 Medicaid patients in the Miami/Dade and Tampa, Florida regions.
- The relationship extends Emcara Heath’s comprehensive primary care model – which includes behavioral health and social determinants of health assessments – to adult Aetna Medicaid members.
Partnership
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State Price Transparency Requirements Are No Longer Cut and Paste
For pharmaceutical manufacturing firms, the amount of documentation required around state price transparency regulations continues to expand. As it now stands, more than 22 states have transparency laws on the books, and each of these states requires a complicated and diverse set of reporting information, which was not the case five years ago.
These transparency requirements – including the need to provide data in different formats and on different dates due to “triggering events” – mean that
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Grow Therapy Raises $75M to Expand Insurance Coverage for Mental Healthcare Nationwide
What You Should Know:
- Behavioral health company, Grow Therapy secures $75 million in series B funding to expand insurance coverage including Medicare and Medicaid in all 50 states.
- This round of funding was led by TCV, co-led by Transformation Capital, with support from existing backers SignalFire and SVB.
Medicare/Medicaid Coverage Expansion
Specifically, the areas that the company will focus on are: expanding commercial insurance and Medicare and Medicaid coverage (which are
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Cityblock Health & MDwise Brings VBC to 10K Medicaid Members in IN
What You Should Know:
- MDwise and Cityblock Health, the first tech-driven healthcare provider for communities with complex health and social needs announced that they will be collaborating to provide high-quality, comprehensive care to 10,000 Medicaid members at launch in select Indiana communities, including Indianapolis.
- As part of this strategic collaboration, Cityblock will open comprehensive care clinics to provide care services for these individuals, addressing physical
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Edifecs Launches Solution to Automate Prior Authorization at the Point of Care
What You Should Know:
- The full automation of prior authorization at the point of care leads to improved member experiences, enhanced outcomes, ongoing compliance, and reduced administrative burden. Edifecs’ automated prior authorization solution integrates with electronic health records (EHR) and leverages artificial intelligence (AI), natural language processing (NLP), and industry standards such as FHIR to instantly deliver authorization.
- This innovation comes on the heels of
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30% of First-Time Opioid Prescribed Patients Developed Dependency
What You Should Know:
- Gainwell Technologies, a leading innovator in healthcare technology solutions, has partnered with top academic institutions to drive research addressing some of the nation’s biggest healthcare challenges.
- Using Gainwell’s advanced research platform and de-identified Medicaid claims data from select clients, Stanford concluded that 30 percent of patients prescribed opioids for the first time developed a dependency. This is a critical finding in the search for
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Why Health Systems Need a New Transition Strategy to APMs
There is an adage that change in healthcare moves at the speed of tectonic plates. The slow adoption of Alternative Payment Models (APMs), the central feature of value-based care, is a good example of constraint despite immense pressure to control costs.
Data from 2020 demonstrate almost zero change from 2018 in the proportion of straight Fee-for-Service (FFS) reimbursement. Other results show a slight uptick in APMs with or without downside risk at 34.6 percent. However,
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AI-Powered Pop Health and SDOH – The Good, The Bad and The Best Practices
Artificial intelligence (AI) has emerged as a powerful tool for making population health analytics more accurate and interventions more effective. Not all AI-powered pop health tools are created equal, and while many still exhibit different types of bias that limit their ability to accurately identify issues affecting certain populations, we have learned a lot about the sources of bias in AI and how to eliminate them. AI shortcomings aside, pop health analytics have advanced to the point that we
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Why Healthcare Needs Tech-Enabled Human Intervention
There's a "perfect storm" facing healthcare today: Chronic disease prevalence, physician shortages, and a growing population aging into Medicare are set to overwhelm our healthcare system if action isn't taken. Over 133 million Americans have at least one chronic disease, and as that number continues to rise, delivering adequate care to these patients has never been more challenging. It's widely understood that factors beyond the clinic primarily influence health. Yet the expectation remains
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