Vesta Healthcare的动态

Check out my first Health Affairs publication! https://lnkd.in/efcHQvEQ ? The article highlights linkages that connect existing policies and programs to coordinate Medicare and Medicaid benefits for those most vulnerable among us, the frail elderly and people living with disabilities, who are overwhelmingly dually eligible for both government programs. This work is being done by an outstanding heterogenous group of long-term care focused organizations consisting of a health plan (VNS Health), a group of home care providers (Coalition for Excellence in VBC at Home), and a clinical care technology company specializing in older adults (Vesta Healthcare).? ? I hope that this publication can provide an example of why a state-driven plan is needed to grow enrollment in New York’s fully integrated arrangements (e.g., PACE and MAP) for the majority of dually eligible beneficiaries with long-term care needs, and how innovative and incremental approaches by New York's healthcare delivery partners can be embraced to maximize the benefits of Medicare-Medicaid integration along the way.?

#Aetna Better Health of Florida, Florida Community Care, #Humana Medical Plan, #Molina Healthcare of Florida, Simply Healthcare Plans, South Florida Community Care Network (which does business as Community Care Plan), Sunshine State Health Plan(#Centene), and #UnitedHealthcare of Florida are the bid winners. Florida wants all 4.3 million #Medicaid members covered under #ManagedCare. State to pay contractors an estimated $143B over the 6-year terms of the contracts. #PublicPrivatePartnership #PublicPrivatePartnerships #PrimaryCare #HealthEquity #DSNP #HealthcareReform #HealthcareTransformation

Kansas #MedicaidManagedCare bidding results get attention from the state’s legislators. Three winning contractors (out of 10 competitors) were to be chosen based on the state’s healthcare authority’s #TripleAim-based scoring of the bids. There was an exact tie for third place between #CVS/#Aetna & #Amerigroup. (How the heck does that happen?) Some of the legislators with long memories don’t like one of those two third-place finishers. #KanCare #Medicaid #publicprivatepartnership #publicprivatepartnerships #SDoH #HealthEquity #BehavioralHealth #PrimaryCare #UHC #UHG

?? ?????? ?????????????? could be on the horizon for dual enrollees of ???????????????? and ????????????????. ?? A ???????????????????? ?????????? of U.S. senators have proposed the ?????????? ?????? ???? ????????, aiming to integrate the two plans and improve patient outcomes. ?? If passed, this could impact about ????.?? ?????????????? low-income or disabled Americans.?? ?? ???????? ?????? ???????? about the bill and what it could mean for healthcare by reading the ???????? ??????????????! ?? #medicare #medicaid #dualsact #healthcare #benefitrepresentativesofamerica

New changes to Medicaid are rolling out, promising a more equitable delivery of community services to engage more meaningfully with members and address Social Determinants of Health. This article presents principles to thoughtfully prepare for these changes, such as developing strategies to increase diversity and inclusion within advisory boards, as well as building trust within marginalized communities. At Hygieia, we work with organizations to develop these implementation strategies to effectively engage with communities and improve program outcomes.? ? https://lnkd.in/eNq3_psq? ? #Medicaid #SDOH #Hygieia #CommunityEngagement #ImplementationStrategies? ?

Interesting article in Health Affairs today highlighting both the opportunities associated with #Medicaid Section 1115 waivers and the current bottlenecks including lack of dedicated funding and limited capacity at the Centers for Medicare & Medicaid Services? #CMCS to review Section 1115 waiver requests in a timely manner. Initiatives such as expanding Medicaid eligibility, addressing health-related social needs such as food or housing security, and expanding benefits for behavioral health services can meaningfully improve #populationhealth, #publichealth, and #patientaccess to care. The article is certainly worth a read.

HHSC's recent biannual report highlights the effectiveness of Community Health Workers (CHWs) in reducing avoidable ER visits. According to a study from the University of Chicago in 2020, patients who received support from CHWs experienced remarkable benefits, including a 75% decrease in HF-related ED visits, an 89% decrease in HF-related readmissions, and significant cost savings for inpatient care. #CHWs #Medicaid #HB1575

In a recent survey, over $10.6 billion in 2022 was “wasted arguing over claims that should have been paid at the time of submission.” That's an incredibly large amount of money for hospitals to spend trying to fight denied claims... not to mention the time and energy spent by their staff. ERISA Recovery's technology and team of experts efficiently identifies denied claims that we can appeal and win on behalf of hospitals. Contact us to find out how we can win back lost revenue for your hospital in just 3 weeks. #erisa #erisarecovery #erisaappeals #revenuecycle #revenuecyclemanagement #rcm #healthcarefinance #healthit #healthcareit #hospitalfinance #hospitalmanagement #denials #claimdenials #deniedclaims #denialmanagement #denialsmanagement #healthcare #healthtech

One of the many great topics that came out of the recent?National Association of Medicaid Directors?was how to improve care and sustainability for dual-eligible individuals— As dual-eligible populations grow, states face increasing demands to provide seamless, coordinated services that address complex health and social needs. If your state is looking to strengthen its duals program,?CITIZ3N?is here to help. I wanted to give my perspective on how our VERIFY product can help states successfully navigate dual eligibility in this recent blog: https://bit.ly/3Z6PbkA #Medicare #Medicaid #Healthcare

Some highlights from the https://buff.ly/2k94HIh survey of #communityhealthcenters (FQHCs): https://buff.ly/46DJYmh -Most #FQHCs find it difficult to obtain #specialtycare appointments for their patients (73%) (particularly those covered by #Medicaid or those without insurance). -More FQHCs have made substance use treatments (66%) available to patients in recent years. -FQHCs face serious #workforce challenges, with more than 70% reporting primary care physician, nurse, or mental health professional shortages.