Nevada Lawmakers Approve Funding for Statewide Medicaid Managed Care
…groundbreaking move, lawmakers in Nevada have given the green light to a project that is set to shake up the healthcare landscape in the state – a statewide Medicaid managed…
Search Results for: Behavioral Health
VBP Risk Capitation Pros and Cons
…Payments, in today’s blog we look at the capitation model. As the ever-challenging task of lowering healthcare costs continues to come to the forefront, organizations may look to capitation, which…
Alternative Payments Making a Splash
…payment for health services has run on a model called fee-for service (FFS). This simple model means that physicians and healthcare providers delivered in units. This has little to do…
Humana Expanding Value-Based Home Care Subsidiary to Virginia
…accountability that accounts for the needs of patients, physicians, hospitals, and health plans for home care. Care will be delivered through a network of local home care providers. onehome coordinates…
CMS Announces Changes That Will Improve Quality of Care for Medicare Beneficiaries in 2023
…our greatest health care challenges,” said CMS Administrator Chiquita Brooks-LaSure. “Health care providers coming together as Accountable Care Organizations provide high quality and equitable care to people with Medicare while…
UnitedHealthcare Challenges Minnesota’s Ban on For-Profit HMOs in Medicaid Managed Care
…Envelope August 7, 2024 – UnitedHealthcare has initiated a lawsuit against the state of Minnesota following a new legislative measure that prohibits for-profit Health Maintenance Organizations (HMOs) from administering Medicaid…
Medicaid Challenges and Potential Reforms
Medicaid Challenges and Potential Reforms At the 2021 AcademyHealth National Health Policy Conference, a panel was led by Rebekah Gee, MD, MPH with a look at the challenges that Medicaid…
2023 Medicare Advantage Part D Rate Gets 8.5% Revenue Hike
…Rate Announcement. Through the announcement, CMS touts its drive to address social determinants of health and health disparities. While many reactions are positive, there are some concerns with the pharmacy…
Indiana Set to Go Live with Managed Care Transition in July 2024
…(MCEs): Anthem Blue Cross and Blue Shield, Humana Healthy Horizons in Indiana, Molina Healthcare of Indiana and United Healthcare Community Plan. The Family and Social Services Administration (FSSA) webpage about…
Home Recovery Lowers Hospital Return Post-Hip Surgery Compared to Nursing Facilities
…two distinct post-discharge pathways: home health care, which accommodated the bulk of the study’s participants (11,000), and skilled nursing facilities, hosting 1,800 patients. The research team considered various factors including…