The value-based payment wave is starting to enter Medicaid policy, and one early-adopter state has posted quite positive early financial returns but still faces regulatory, technology and financial hurdles.
If the ACA's goal of insuring every American is to be realized, states like Texas and Florida will have to expand Medicaid, Congress will have to amend the law, or states and HHS will have to craft waivers.
Coding took twice as long for the ICD-10 frontrunner and it was proving inaccurate during the first phase, despite putting their best coders on the project. Both improved in phase 2. Here's what they learned.
By bringing behavioral health into the statewide HIE, expanding medical home model practices, and tracking the results, Maine health stakeholders are eyeing an iterative, locally-designed approach to reform.
Today, as states struggle with budget pressures and brace for the national reform, interest in various managed care strategies continues to grow. A well-executed managed care effort can help control costs while improving access and quality of care. This paper addresses how to evaluate, deploy, and administer managed care systems in the Medicaid environment.
Medicare Advantage (MA) plans are private health plans that have contracted with Medicare to receive a fixed monthly fee in exchange for providing comprehensive healthcare to plan members. In order to provide appropriate care to beneficiaries with varying medical conditions, plans are paid according to the Risk Adjustment Factor (RAF) score of each patient. Insufficient documentation of chronic conditions can be an obstacle to MA reimbursement. However, even when a condition has been properly documented by the provider, it is often not coded and submitted to Medicare. Read this white paper to learn how to take the complexity out of MA reimbursement.
In this solution brief we recommend a reference architecture that can be implemented with Intel® Expressway Service Gateway for Healthcare (Intel® ESG for Healthcare) – reflecting the unique legacy protocols in healthcare, the services required for the exchanges, and the impact of strict security laws on the overall architecture. This paper is intended for healthcare solution specialists, technology architects, business analysts in the healthcare industry, Healthcare SMEs, executives, state level health and human services implementers, system integrators who are looking to build state HBE systems, and other potential customers.
In this Web seminar, learn firsthand from five healthcare organizations how, after integrating Perceptive Software enterprise content management (ECM) products, they are realizing cost and time-saving benefits enterprise-wide. The customer panel will share lessons learned and best practices for deploying ECM technology with their business and health information systems.
Even if the administration and CGI Federal, the contractor doing much of the health insurance marketplace IT work, did actually share the code with developers could the open source community put it to work?
The third annual National Health IT Week comes just before the public start of CMS's largest responsibilities, insurance exchanges and Medicaid expansion, and before a critical juncture in nationwide HIE.