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Showing posts from June, 2024

Making Care Primary Model is Launching Soon: What's Next?

The healthcare landscape is evolving rapidly, presenting primary care practices with various challenges. In fact, CMS’ Making Care Primary (MCP) model is launching on July 1, 2024, requiring practices to thoroughly understand its patient population, financial drivers and care outcomes.  The Making Care Primary model , lasting 10+ years, aims to:  improve care management and care coordination; equip primary care clinicians with tools to form partnerships with health care specialists; and leverage community-based connections to address patients’ health needs and their health-related social needs (HRSNs), such as housing and nutrition.  CMS is working with State Medicaid Agencies in eight states to engage in full care transformation across payers, with plans to engage private payers in the coming months.  The CMS MCP Model will provide a pathway for primary care clinicians with varying levels of experience in value-based care to gradually adopt prospective, population-based payments whil

NCQA Health Equity Accreditation: Advancing Equitable Care

Health equity isn’t a one-size approach  The COVID-19 pandemic highlighted the crucial connection between Social Determinants of Health (SDOH) and patient outcomes. Addressing medical and behavioral health needs requires a comprehensive understanding of a patient’s social context.   Effective interventions and care plans must meet patients "where they are," and one-size-fits-all approaches fail to address diverse vulnerabilities and needs.  For healthcare organizations looking to begin or enhance their equity initiatives, the National Committee for Quality Assurance's (NCQA's) Health Equity Accreditation (HEA) is an excellent starting point. HEA is a comprehensive framework that aligns with many other recognized programs, such as those from the Joint Commission and CMS, providing a holistic approach to advancing health equity. It aims to improve the quality of care and patient experience within the United States.  3 Reasons why NCQA HEA is the perfect starting point 

FFY 2025 Medicare Inpatient Prospective Payment System proposed rule

Key IPPS updates you need to know about  On April 10, Centers for Medicare & Medicaid Services (CMS) released the federal fiscal year (FFY)   2025 Medicare Inpatient Prospective Payment System proposed rule . This rule proposes significant changes and updates to Medicare fee-for-service (FFS) payments and policies.  Understanding these changes is crucial for healthcare professionals, state hospital associations and multi-state health systems. This blog aims to break down the key points and implications of this proposed rule to help you stay informed and prepared.  Overview of the proposed rule  The proposed rule includes regular updates to wage indexes and the market basket. Below are some policies being proposed.  1. Data utilization for standard calculations  CMS plans to use FFY 2023 Medicare Provider Analysis and Review (MedPAR) claims data and FFY 2022 Hospital Cost Reporting Information System (HCRIS) data for standard calculations. Using MedPAR and HCRIS data ensures that th