In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, and this week CMS is expected to make a first set of...more
7/5/2024
/ Budgets ,
Centers for Medicare & Medicaid Services (CMS) ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Hospitals ,
Medicaid ,
Medicare ,
Revenue ,
Rural Health Care Providers
A recent study published in JAMA estimated that more than six million people in the U.S. have diet-sensitive conditions and activity limitations that could benefit from medically tailored meals, a type of Medically Supportive...more
The Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS) recently released initial specifications for its Medicare Hospital Global Budget methodology under the States Advancing...more
High-quality primary care is foundational to providing “whole person care” that emphasizes prevention, as well as team-based and relationship-based care. To help improve primary care, the Center for Medicare and Medicaid...more
The CMS Center for Medicare and Medicaid Innovation (CMMI) is launching a new Alternative Payment Model (APM) focused on Dementia Care: The GUIDE model. It will launch in July 2024 and run for eight years. More details will...more
On July 31, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new eight-year voluntary nationwide model – the Guiding an Improved Dementia Experience (GUIDE) Model that aims to support people living with...more
The Big Picture -
On January 4, the Centers for Medicare & Medicaid Services (CMS) issued a new State Medicaid Director (SMD) letter on how states can make expanded use of ILOS authority, including to address social...more
California’s Advancing and Innovating Medi-Cal (CalAIM) seeks to transform the Medi-Cal (California Medicaid) delivery system for more than 14 million Californians, embracing a population health approach that prioritizes...more
Introduction -
The vision of primary care as the foundation for all health care is one shared by many who work in and around the U.S. health care system. Patients, policymakers, providers, payers and purchasers generally...more
The vision of primary care as the foundation for all health care is one shared by many who work in and around the U.S. health care system. Patients, policymakers, providers, payers and purchasers generally agree that primary...more
The Centers for Medicare & Medicaid Services (CMS) has long acknowledged the disparities in care and outcomes affecting the one in five Americans who live in rural areas, as well as the financial challenges faced by rural...more
10/2/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Fee-for-Service ,
Health Care Providers ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Medicare Advantage ,
Public Health Emergency ,
Rural Health Care Program ,
Rural Health Care Providers ,
State Medicaid Programs
Remote Patient Monitoring (RPM) is real-time or near real-time evaluation of a patient’s clinical status outside of a traditional healthcare setting. RPM leverages wireless devices (e.g., weight scale, blood pressure...more
During 2018, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS) announced two new opportunities for state governments and their partners to improve their delivery...more
The Promise of Data-Driven Healthcare: Megatrends for 2018 -
Editor’s Note: For state health programs, payers, providers and life sciences companies, data and analytics have become essential to facilitating efficient and...more
1332 Waivers Under Review at CMS -
The Trump administration has approved one 1332 waiver to date, but four more are pending, including a sweeping Iowa waiver. Here is where things stand today...more
BCRA Implications: Affordability of Coverage -
In making the case for repealing and replacing the Affordable Care Act (ACA), the president and congressional leadership have cited “rising premiums,” “unaffordable...more
Actions to Advance Infant and Early Childhood Mental Health -
Editor's Note: Children's earliest experiences—both positive and negative—impact their brain formation and in turn their social and emotional, physical,...more
5/24/2016
/ Employee Retirement Income Security Act (ERISA) ,
Federal Trade Commission (FTC) ,
Gobeille v Liberty Mutual Insurance Com. ,
Health Insurance ,
Long-Term Care ,
Manufacturers ,
Mental Health ,
Pay-For-Delay ,
Preemption ,
Public Health Insurance Marketplace ,
SCOTUS
Since the passage of the Affordable Care Act (ACA), both federal and state policies have promoted the adoption of alternative payment models (APMs), providing financial incentives for groups of providers to improve care...more
5/23/2016
/ ACOs ,
Alternative Payment Models (APM) ,
Anti-Kickback Statute ,
Antitrust Violations ,
Children's Health Insurance Program (CHIP) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Federal Trade Commission (FTC) ,
Fraud and Abuse ,
Hospital Mergers ,
Hospitals ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Physicians ,
Sherman Act ,
Stark Law