Healthcare reform in the United States

Vizient Offers Approaches to Improve Health Equity to CMS in IPPS Comments

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Monday, June 28, 2021
Public policy, Government, Practice Management, White House, Federal Government, Medical Supplies, Public policy, Health, Healthcare reform, Hospitals, Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Liberalism in the United States, Medicare, Prospective payment system, Medicaid, Health, United States, Government

today submitted its comments to the Centers for Medicare and Medicaid Services (CMS) on their FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.

Key Points: 
  • today submitted its comments to the Centers for Medicare and Medicaid Services (CMS) on their FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.
  • Vizients comments include feedback to the agency regarding future health equity policies, concerns with CMSs proposed changes to organ acquisition payment policies, and recommendations on various topics, including the distribution of new Graduate Medical Education (GME) positions.
  • In its comments on health equity measures, while Vizient supported CMS in exploring ways to report outcomes, Vizient encouraged the agency to prioritize efforts to improve data collection and accuracy.
  • Vizient also offered various recommendations to the agency regarding how best to analyze and interpret data related to health equity.

US Population Health Management Market 2021: ACOs are Increasing their Enrollment into Risk-based Payment Plans - ResearchAndMarkets.com

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Monday, June 28, 2021
Managed care, Hospitals, Health, Health, Healthcare reform in the United States, Health Economics, Articles, Managed care, Accountable care organization, Federal assistance in the United States, Population health, Medicaid, Fee-for-service, Aco, Oncology Care Model

The "US Population Health Management Market 2021: Frost Radar Report" has been added to ResearchAndMarkets.com's offering.

Key Points: 
  • The "US Population Health Management Market 2021: Frost Radar Report" has been added to ResearchAndMarkets.com's offering.
  • Additionally, CMS has launched new guidance for value-based reimbursement among the Medicaid population, in which 67% of reimbursement remains fee-for-service (FFS).
  • Accountable care organizations (ACOs) are increasing their enrollment into risk-based payment plans (from 9% of all ACOs in 2017 to 74% in 2020) and driving adoption of PHM solutions that aid cross-continuum data interoperability and integrated care management.
  • However, next-generation ACOs (NGACOs) that pioneered adoption of VBC payment plans are failing to report the desired business outcomes.

Providence Heart Transplant Program Receives CMS Certification

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Monday, June 28, 2021
Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Organ transplantation, Health care, Heart transplantation, Health, Medicaid, Medicare

PORTLAND, Ore., June 28, 2021 /PRNewswire/ -- Providence Heart Institute's heart transplant program, the largest of its kind in Oregon, has received certification from the Centers for Medicare and Medicaid Services (CMS).

Key Points: 
  • PORTLAND, Ore., June 28, 2021 /PRNewswire/ -- Providence Heart Institute's heart transplant program, the largest of its kind in Oregon, has received certification from the Centers for Medicare and Medicaid Services (CMS).
  • Providence Heart Institute's heart transplant program has received certification from the CMS.
  • Heart transplant programs must perform 10 transplants before they can apply for CMS certification which is critical for reimbursement as many patients are government insured.
  • Providence Heart Institute announced its intent to start a transplant program in March of 2019 after nearly 400 heart failure patients who previously received care at OHSU transferred their care to Providence.

AMS Infection Prevention Partners Lauds U.S. Reps. Bilirakis, Soto for Forming Bipartisan Congressional Caucus on Infection Prevention and Control in Long-Term Care

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Monday, June 28, 2021
Health, Epidemiology, Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Medicine, Infectious diseases, Gus Bilirakis, Long-term care, Medicaid, Medicare, Infection

WASHINGTON, June 28, 2021 /PRNewswire/ -- AMS Infection Prevention Partners , the nation's leading clinical infection prevention and control (IPC) practice serving the long-term care (LTC) community, today announced the formation of a new bipartisan congressional caucus created to protect seniors.

Key Points: 
  • WASHINGTON, June 28, 2021 /PRNewswire/ -- AMS Infection Prevention Partners , the nation's leading clinical infection prevention and control (IPC) practice serving the long-term care (LTC) community, today announced the formation of a new bipartisan congressional caucus created to protect seniors.
  • U.S. Reps. Darren Soto , a Democrat from Florida's 9th District, and Gus Bilirakis , a Republican from Florida's 12th District,are co-chairs of the Infection Prevention and Control in Long-Term Care (IPC-LTC) Caucus.
  • Even before the COVID-19 pandemic, more than 70% of long-term care communities were cited for infection control concerns, according to the Centers for Medicare and Medicaid Services (CMS).
  • "Every day, we see the impacts of proper infection prevention and control efforts firsthand and its importance cannot be understated."

Combination of Verisys Corporation and Aperture Health Creates Market Leader in Healthcare Credentialing and Provider Data Management

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Monday, June 28, 2021
Credentialing, Federal assistance in the United States, Healthcare reform in the United States, Medicaid

"The combined company establishes a market leader in the credentialing, enrollment, and provider data management space that can provide an exceptional level of service, security, and scalability," said Stone Point CEO Chuck Davis.

Key Points: 
  • "The combined company establishes a market leader in the credentialing, enrollment, and provider data management space that can provide an exceptional level of service, security, and scalability," said Stone Point CEO Chuck Davis.
  • "The merger of Aperture and Verisys simply makes sense," said Verisys' Benson.
  • "This combination will accelerate our ability to help our clients fix the many problems associated with siloed and inaccurate provider data.
  • We help health plans, health systems, and state Medicaid agencies improve provider data quality, build and manage provider networks, and publish and maintain provider directories.

U.S. Medical Management, and its Affiliate Visiting Physicians Association, Improves Health and Reduces Costs for the Frail Elderly under the CMS Independence at Home Demonstration - for Sixth Consecutive Year

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Monday, June 28, 2021
Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Healthcare in the United States, Health, Liberalism in the United States, Medicare, Medicaid, Centene Corporation

Five of the 11 current practices participating in the IAH Demonstration are VPA practices, managed by USMM.Together the VPA practices were responsible for caring for patients making up approximately 60 percent of the entire Demonstration in Performance Year 6.

Key Points: 
  • Five of the 11 current practices participating in the IAH Demonstration are VPA practices, managed by USMM.Together the VPA practices were responsible for caring for patients making up approximately 60 percent of the entire Demonstration in Performance Year 6.
  • We are very proud to have contributed in a meaningful way to this important CMS initiative."
  • CMS also highlighted that nine (9) of the eleven (11) participating practices were eligible for shared savings incentive payments in performance year 6; five of those nine were VPA practices.
  • In 2014, the Centene Corporation (NYSE: CNC) acquired USMM, integrating USMM's care delivery model across its Medicaid and dual-eligible membership.USMM also operates a multi-state Medicare Shared Savings Program ACO serving approximately 20,000 complex/fragile Medicare patients.

Trella Health Certified as a Qualified Entity by the Centers for Medicare and Medicaid Services, Further Expanding its Database and Data Offering to Customer's

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Friday, June 25, 2021
Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Child poverty, Medicaid, Medicare, Health, United States, Government

ATLANTA, June 25, 2021 /PRNewswire-PRWeb/ -- Trella Health, the leading source of provider performance insights and analytics, was recently certified as a Qualified Entity (QE) by the Centers for Medicare and Medicaid Services (CMS) under the Qualified Entity Program.

Key Points: 
  • ATLANTA, June 25, 2021 /PRNewswire-PRWeb/ -- Trella Health, the leading source of provider performance insights and analytics, was recently certified as a Qualified Entity (QE) by the Centers for Medicare and Medicaid Services (CMS) under the Qualified Entity Program.
  • The QE Program will allow Trella to receive and provide public and private analyses for providers in all 50 states, in addition to the District of Columbia.
  • Trella plans to provide additional data insights, such as real-time filtering of patient populations and scenario analysis necessary for developing optimal care networks.
  • Trella Health is the leading provider of actionable insights for healthcare networks, ACOs, and the post-acute care market.

Healthfirst to Offer Its Medicare Advantage Members Universal Access to Advance Care Planning Through Iris Healthcare

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Friday, June 25, 2021
Healthcare reform in the United States, Federal assistance in the United States, Presidency of Lyndon B. Johnson, Articles, Health, Liberalism in the United States, Medicare, Science and technology, Telehealth, Medicaid

The goal is to provide universal access to advanced care planning to members who are dually eligible for Medicare and Medicaid as part of Healthfirst's value-based care model.

Key Points: 
  • The goal is to provide universal access to advanced care planning to members who are dually eligible for Medicare and Medicaid as part of Healthfirst's value-based care model.
  • Empower allows health plans with a value-based care model to meet quality targets, while providing a valuable service to its members.
  • Jennifer Yaggy, AVP of Medicare at Healthfirst stated, "We chose Empower to offer ACP more broadly to our Medicare members.
  • Healthfirst is also providing its members facing serious illness with access to Iris Premier, a comprehensive care planning solution offering expert-led facilitations via telehealth to discuss and document care goals and preference.

Michael Monson Appointed Chief Executive Officer and President of Altarum by Board of Trustees

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Friday, June 25, 2021
Technology, Managed care, General Health, Public policy, Government, Infectious diseases, Foundation, Philanthropy, Hospitals, Science, Health, Research, White House, Federal Government, Continuing, Training, State, Local, Education, Data management, Health, Centene Corporation, Healthcare reform in the United States, Medicaid, Managed care, Altarum Institute

The Altarum Board of Trustees has selected Michael Monson, a former executive of the nations largest Medicaid managed care plan, for the role of chief executive officer and president.

Key Points: 
  • The Altarum Board of Trustees has selected Michael Monson, a former executive of the nations largest Medicaid managed care plan, for the role of chief executive officer and president.
  • View the full release here: https://www.businesswire.com/news/home/20210625005287/en/
    Michael previously served as CEO of Social Health Bridge, a solution from Centene to integrate health care providers and community benefit organizations.
  • The Altarum Board of Trustees selected Michael after an extensive succession planning process in partnership with then CEO and president, Lincoln Smith.
  • These qualities position Michael for success as a leader of an organization that is innovative and mission-driven.

Unissant Awarded $37.4 Million CMS Contract to support Electronic Submission of Medical Documentation (esMD)

Retrieved on: 
Friday, June 25, 2021
Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Liberalism in the United States, Medicare, Medicaid, Centers for Medicare & Medicaid Services, Health, Government, United States

HERNDON, Va., June 25, 2021 (GLOBE NEWSWIRE) -- Unissant is announcing it received a $37.4 million contract award from the Centers for Medicare & Medicaid Services, Center for Program Integrity to provide support services to Electronic Submission of Medical Documentation (esMD).

Key Points: 
  • HERNDON, Va., June 25, 2021 (GLOBE NEWSWIRE) -- Unissant is announcing it received a $37.4 million contract award from the Centers for Medicare & Medicaid Services, Center for Program Integrity to provide support services to Electronic Submission of Medical Documentation (esMD).
  • For this program, Unissant will assist providers, CMS, review contractor (RC)s, and Health Information Handler (HIH)s in the Medicare Fee-For-Service (FFS) program.
  • In its role, Unissant will provide software development, testing, cloud migration and hosting support, and software maintenance services for the esMD System.
  • Unissant will also partner with CMS to provide incident and problem resolution, and technical architecture and infrastructure oversight.