State roles & responsibilities in Medicaid managed long-term care
|
|
- Jonathan Watkins
- 5 years ago
- Views:
Transcription
1 State roles & responsibilities in Medicaid managed long-term care Andrea Maresca Director of Federal Policy and Strategy April 24, 2012 Agenda Core State Managed Care Design Considerations Plan Payment Policy Quality and Access Requirements Program Integrity, Data, & Reporting New CMS Requirements
2 Key Elements Often Drive Policy Vehicle(s) Voluntary versus mandatory enrollment Target populations and consumer priorities Outreach and enrollee education Roll-out Plan choice and auto-assignment Continuity of care Care coordination Access to providers Specialty Long Term Care Payment Monitoring Medicaid Payment Policy Rules are the Same for Plans Federal requirements that Medicaid payments be consistent with efficiency, economy, and quality apply Section 1902(a)(30(A)) 1981 legislation added the requirement that capitation payments to risk-based managed care plans be made on an actuarially sound basis 2002 guidance provided regarding actuarial soundness
3 2002: CMS Revised Plan Payment Requirements Capitation rates now must be developed in accordance with generally accepted actuarial principles and practices, appropriate for the population and services, and certified by qualified actuaries Four additional requirements Population appropriate base line Adjustments Rate specificity Additional requirements for high cost populations Renewed Focus on Actuarial Soundness Government Accountability Office 2010 Study Found CMS oversight of state compliance and data quality for rate setting could be improved CMS concurred and made an array of changes New review pursued by Senator Grassley (R-IA) Letter to all State Medicaid Directors requesting information to help determine whether states and CMS are conducting sufficient oversight of Medicaid managed care plan rate setting Minnesota-Medicaid-MLR.pdf Next steps: TBD
4 No Specific Federal Requirements for Provider Network Participants All federal managed care requirements relate to ensuring access to and quality of Medicaid services Provider rates may be set by the state or negotiated by the plans with provider networks with state sign-off Lack of Standard Quality (Outcomes) Measures for LTSS Growing attention to the need and efforts to develop true outcomes measures States rely on process measure requirements to MCOs, including: Demonstrate members have had a LOC determination Provide client a choice between institutional and HCBS services Demonstrate client received visits/services at certain intervals Develop Performance Improvement Projects (PIPs) to establish and monitor progress towards client goals 8
5 Other Process Measures Proxy for Quality State Access Monitoring Monitoring enrollee feedback and provider and community input Reviewing available data (e.g. ER use) Additional contract reporting requirements Provider Supply Monitoring Assess whether providers listed in a managed care plan s network actually accept new patients Monitor compliance standards specified in managed care plan contracts including network adequacy, provider-to-patient ratios, and geo-access analysis Commonly Used Quality Monitoring Strategies External Quality Review Organizations (EQRO) State must provide for an external, independent review of their managed care plans Healthcare Effectiveness Data and Information Set (HEDIS) Consumer Assessment of Healthcare Provider Systems (CAHPS) Nursing Home Surveys Accreditation National Committee for Quality Assurance Unfolding role for National Commission for Quality Long-Term Care
6 Examples of MMLTC Quality Improvement Activities Consumer and provider satisfaction surveys Health Outcomes Survey (HOS) EQRO focus study on care coordination HEDIS performance measures Enrollee records reviews Contractor best practice collaborative Protocols and tools for care coordinators Utilization review Provider credentialing Reviews of clinical outcomes Program evaluation States May Include Various Requirements in Contracts with Plans Sufficient and appropriate provider network Assurances that appropriate services are available and readily obtained Care Coordination Assistance with accessing services Additional services for high need populations
7 Core Federal Accountability Requirements Availability of complete plan records for audit by the federal government and states Prohibition on plan discrimination based on enrollee health status Individuals right to disenroll within the first 90 days without cause and then at least every 12 months thereafter Plans must maintain patient encounter data and provide data to the state Medicaid Managed Care Data is More Limited than FFS Data All states collect some form of encounter data from plans States vary in what and how much of encounter data they report to the federal Medicaid information system States also report information on their managed care plans through the Medicaid Managed Care Data Collection System
8 New Challenges for Medicaid Program Integrity in Managed Care Programs States responsible for the development and oversight of Medicaid's managed care programs and policy including managing MCO States facing new challenges in their Program Integrity (PI) efforts with the growth in managed care, particularly MLTC States must determine when and how to meet new federal requirements for managed care programs For example: requirements for provider screening and enrollment States may take different approaches to meet this requirement CMS currently updating its Medicaid managed care manual 15 Other State Reporting Requirements Driven by Program Authority State Plan Options Section 1915(a) Section 1932 (a) Medicaid Waivers Section 1915(b) Permits states to mandate enrollment into managed care programs Some services may be carved out of managed care Must demonstrate budget neutrality but does not have to be a statewide program Section 1115 Flexibility given to states to test policies not permitted under Medicaid statute Must demonstrate budget neutrality and must be statewide Regular evaluations of the project Public notice and comment requirements for SPAs and waivers (as of April 2012)
9 ACA Included New Requirements New Plan Responsibilities Content requirements for the eligibility transaction Meet certain service and performance timeframes for eligibility and claim status transactions New State Responsibilities Must conduct a gap analysis to determine if operational changes are needed to comply with these operating rules and to be able to provide the newly required information States must analyze their current Medicaid information technology (IT) infrastructure to determine if hardware and/or software modifications are needed in order to meet these requirements and the operating rule compliance date of January 1, What s Next for States CMCS building out principles/requirements/expectations for states CMCS to identify best practices and technical assistance resources for states as they move forward CMCS and states moving forward with proposals in the meantime 18
10 Plan Roles and Responsibilities in MMLTC Programs Amy Ingham Medicaid Policy Manager April 23, Medicaid Health Plans of America (MHPA) 108 Members 33 States + DC 20
11 Our Mission Develop and Advance Public Policy Controlling Costs + Improving Access/Delivery = Quality Health Care States and DC Have Medicaid Health Plans WA OR NV CA ID AZ UT MT WY CO NM ND SD NE KS OK MN WI IA IL MO AR NY MI PA OH IN WV VA KY NC TN SC ME VT NH MA RI CT NJ DE MD DC TX LA MS AL GA AK FL HI Current Medicaid Health Plan Penetration
12 Medicaid Managed Care Options Medicaid Health Plans(full-risk capitation): state contracts with health plan to provide services to enrollees Primary Care Case Management: physician serves as gatekeeper for assigned patients, coordinating care Limited Benefit Plans: state pays plans to provide a fixed set of services Medicaid Health Plans Better Access to coordinated care Quality Assurance and Improvement Delivery System Innovation Predictable Costs Cost Savings Reduced Waste, Fraud and Abuse 24
13 Enrollment in Medicaid Data Sources: 2010 CMS Medicaid Managed Care Enrollment Report 25 State of Medicaid Managed Care All but two states have managed care programs - Alaska, Wyoming Thirty-six states and the District of Columbia have contracts with private Medicaid managed care plans 31 operate primary care case management programs. 26
14 States Addressing Special Populations Difficult, high-risk, high-needs, chronically ill populations are focus for states. Dual Eligibles- Integration Complex, High-Risk Patients Aged, Blind and Disabled Long Term Care States Move to Address Complex Health Needs In 2011, Medicaid programs in 15 states reported expanded efforts to coordinate care for individuals with high-cost/chronic/complex medical conditions. In 2012, 20 states began or expanded initiatives. Some of these initiatives were directly tied to new requirements for managed care, or enhanced coordination already occurring in MCOs. 28
15 States Focus on Aged, Blind and Disabled Together, the aged and/or disabled are 25% of the Medicaid population and account for over 65% of Medicaid spending. Benefits/Services for these populations are costly Many states see benefit in better coordinating care for these populations. Managed Care Plans are making efforts to provide better coordinated care for these populations for example, carving in pharmacy benefits in 2011 and 2012 (NY, OH, TX and IL). 29 Long Term Services and Supports 32 states in 2011 and 33 states in 2012 expanded long term services and support (LTSS). 14 states in 2011 and 11 states in 2012 restricted access to long term care. Many states are looking at integrating acute and long-term care within a managed care delivery system. 30
16 Long Term Services and Supports Medicaid paid for 62.2% of all LTSS rendered in 2010, which is almost 1/3 of total Medicaid spending. Most LTSS services are rendered on a fee-for-service basis. More states are moving toward managed Medicaid LTSS, which currently is established in 12 states AZ, FL, HI, ID, MA, MN, NM, NY, TN, TX, WA, and WI. Managed Medicaid LTSS relies on a reduction of the use of institutionalized care, such as nursing homes, which is the most expensive component of LTSS, and an increased use of home and community based services (HCBS). 31 Initiatives to Expand Care Coordination Among LTSS Beneficiaries States have historically been able to establish HCBS or LTSS in a managed care through Section 1915(b) waiver Section 1915(c) waiver State Plan Option 1915 (a) 1932 (a) Section 1115 waiver 32
17 ACA: New Initiatives to Expand Care Coordination Among LTSS Beneficiaries Section 10202: Balancing Incentive Program Section 2703: Health Homes for Individuals with Chronic Conditions Section 2403: Money Follows the Person Section 2701: Adult Health Quality Measures Section 2602: Innovation Center -Financial Alignement Initiative (Dual Eligibles) 33 States Choose Methods States have mainly operated MLTSS programs using a combination of 1915(b) enrollment authority with 1915(c) home and community-based service waiver authority. April 2011, CMS awarded $1 million to 15 states for designing systems to integrate Dual Eligibles. 37 states and DC submitted letters of intent for the Financial Alignment Initiative, announced in July 2011, and 26 of these states are pursuing the capitatedmodel (one of two options). Dual Eligiblesreceive great interest, but states need more direction on non-duals LTSS programs. 34
18 Plan Responsibility Plan responsibility is subject to particular requirements of the program, state and individual contract, with major responsibilities being to submit encounter data and quality indicators Main responsibilities: Develop/expand care management and coordination practices Ensure access to needed benefits and services Submit encounter data Meet External Quality Review (EQRO) requirements Meet performance measures (HEDIS) 35 Important Responsibilities of Medicaid Health Plans Meeting complex health challenges of the LTSS population Expanding provider networks and ensuring network adequacy Providing robust care management Assessing quality care provided and making improvements Monitoring rates as they impact services and care provided 36
19 Looking Ahead Medicaid health plans continue to engage with states and CMS on ways to better serve the LTSS population. Plans are taking initiative by reaching out to other plans, providers and state leaders in order to create their own partnerships and initiatives to coordinate for LTSS population and Duals. MHPA plans are well equipped to serve as a working model, providing superior care coordination for LTSS beneficiaries now and into the future. 37 Questions? 38
20 Minnesota Managed Care for Seniors Over 90% of Medicaid Seniors in MN are dually eligible for Medicare Most seniors served through managed care: Minnesota SeniorCare Plus (MSC+) Minnesota Senior Health Options (MSHO) a special needs plan (SNP) program that is a voluntary alternative to MSC+ Managed care for seniors in MN Seniors (65+) have been required to enroll in Medicaid managed care since The State s Medicaid seniors in all 87 counties are required to choose from health plan options available in their counties. Health plans provide additional member services, transportation, primary care/care system/medical homes, interpreter services, monitoring and facilitation of access to services above what is normally provided in fee for service. Department of Human Services contracts with 8 health plans to serve seniors statewide.
21 Option #1: MSHO The Minnesota Senior Health Options MSHO program integrates Medicare and Medicaid primary, acute, drugs, home care, and other long term care services as well as Elderly Waiver (EW) services and the first 180 days of care in a nursing facility. MSHO plans provide all Medicare services including Part D drugs. Enrollment is voluntary. Enrollees do not pay a premium to join. Nation s first dual demo in 1995 Operates under 1915 (a) and 1915 (c) Medicaid waivers Option #2 MSC+ The Minnesota Senior Care Plus (MSC+) programs, implemented in June 2005, provides eligible seniors, age 65 and older residing in participating counties, their acute care, home care, Elderly Waiver services and the first 180 days of care in a nursing facility for enrollees who enter a nursing facility after enrollment. MSC+ is similar to MSHO in the long term care services it covers but does not include Medicare services or Medicare Part D drugs.seniors enrolled in MSC+ must obtain their Medicare Part D drugs through a separate Medicare prescription drug plan. Enrollment in MSC+ is mandatory.
22
23 Kathleen Collins Pagels Arizona Health Care Association
24 AHCCCS- Arizona Health Care Cost Containment System Emphasis on Cost Containment approximately 71% of all AHCCCS/Medicaid members are HCBS (Includes AL) 29% reside in a skilled nursing facility
25 Rate increases are generally established by a contractual mandate from AHCCCS to the Medicaid plans. The increases we attained in the early years of this decade were significant and were required by the state as a "pass through from the Plans. This is a result of our focus on administrative advocacy with the state agency, rather than the legislature. These increases leveled off during the state s economic decline, culminating in being held flat for two years and then a Medicaid rate cut of 5% in Specialty rates are always negotiated, scopes of service vary widely. Managing levels of care (1,2,3 and specialty) can change the rate profile of a facility. Extensive documentation and advocacy is required. The level of care assessment tool is vastly out of date. Moving forward a provider assessment legislation currentlywhich poses unique challenges in a managed care state.
26 NF average statewide rates Rate Distribution Weighted Rate Distribution Weighted Rate Distribution Weighted Class 1 $ % $47.91 $ % $50.74 $ % $56.00 Class 2 $ % $52.57 $ % $57.89 $ % $59.68 Class 3 $ % $48.94 $ % $57.46 $ % $58.24 Total % $ % $ % $ Change $12.59 $16.66 $7.83 % of Change 9.20% 11.15% 4.71% Note the high distribution in the Class 1, 2. The highest level of care payment (Class 3) is generally less than 25% of payment to SNF s in aggregate. These rates are based on the FFS rates (which the state pays directly to the Native American tribes only) and are considered the floor. Rates may be negotiated above this floor, if the facility has the leverage. Geographic imperative- being a key point of access to care Specialty service niche- behavioral, dialysis, ventilator, dementia, etc Quality- based on the audits of the Plans, state survey, 5 star etc Relationships
27 Rates low in national context Limited expertise with managed care and negotiation process (particularly large national corporations and multi s) Saturation on HCBS level Focus on the dually eligible (82%) and the impact of Medicare Advantage plans Viability of SNF Network (15% loss in beds) Program Contractor/MCO financial problems Claims and payment concerns; duplication Providers are reducing Medicaid beds; state is monitoring this closely Medicare-only facilities growing Managed care plans are concerned about single point of service entry in rural areas In 1990 there were 188 skilled nursing facilities and currently there are 150. Average age of a SNF in AZ is 50 years +
28 The complexity is overwhelming, little uniformity Moving all to electronic submission- problems detected earlier Definition of a clean claim- interest paid after 30 days Differences between appeals and disputes Plans systems conversion an ongoing nightmare Turnover on both sides presents problems Diplomacy required in settling claims and working with AHCCCS to address systemic problems (they audit the Plans) It is a significant and time consuming member service Administrative advocacy with Plans Legislative advocacy in regard to Medicaid budget and Plan capitation rates Member education in contracting issues Work with Plans collaboratively to enhance the network and advance mutual concerns (workforce, liability, and more) Assistance with claims issues, system concerns, Plan relationships
29 We have experience in the managed care model AZ providers have never known pure cost reimbursement and the rest of the country can learn from our mistakes and our successes Our competitive framework demands quality and promotes best practices There is room for innovation in managed care, with pilot programs and specialty programs and services think about the virtual RFP We are geared up for pay for performance model, and quality incentives The Associations play a powerful and critical role in support to providers- it will transform your member services Get to know the managed care companies in your state, they are likely your future partners Medicaid managed care is a preview of Medicare managed care and understand that the penetration of advantage plans will increase. Focus on learning about the impact of combining the dually eligible. Begin educating providers on managed care contracting and negotiation. Be cognizant of anti trust issues. Be part of the program design, ensure competition and build a truly market driven system. Your relationship with the state Medicaid agency will increase in importance when the program is implemented. Manage the dialogue, and set the tone. Your credibility is at stake. Make sure the discussion is not always about the financial impact of managed care. Always focus on the resident, and the adequacy of the service delivery network, and the rest will follow
Role of State Legislators
Title text here NCSL Fall Forum Preconference Session: Quality & Consumer Issues in Medicaid Managed LTSS December 3, 2013 Wendy Fox-Grage Senior Strategic Policy Advisor AARP Public Policy Institute Role
More informationA Snapshot of Uniform Assessment Practices in Managed Long Term Services and Supports
A Snapshot of Uniform Assessment Practices in Managed Long Term Services and Supports California Department of Health Care Services, Home and Community Based Services Universal Assessment Workgroup February
More informationNational Committee for Quality Assurance
National Committee for Quality Assurance (NCQA) Private, independent non-profit health care quality oversight organization founded in 1990 MISSION To improve the quality of health care. VISION To transform
More informationMedicaid Managed Care 2012 Fiscal Analysts Seminar August 30, 2012
Medicaid Managed Care 2012 Fiscal Analysts Seminar August 30, 2012 National Conference of State Legislatures Neva Kaye Managing Director for Health System Performance National Academy for State Health
More informationMedicaid Reform: The Opportunities for Home and Community Based Providers. All Rights Reserved
Medicaid Reform: The Opportunities for Home and Community Based Providers ILS Background & Experience Care Management Company founded in 2001 Focuses on Duals, Medicaid ABD and Managing Medicaid Long term
More informationNC TIDE 2016 Fall Conference November 14, Department of Health and Human Services NC Medicaid Reform Update
NC TIDE 2016 Fall Conference November 14, 2016 Department of Health and Human Services NC Medicaid Reform Update Agenda National Medicaid Landscape Medicaid Transformation in NC 1115 Waiver Process NC
More informationMedicaid Innovation Accelerator Project
Medicaid Innovation Accelerator Project 2016-2017 Technical Expert Panel In-Person Meeting Community Integration Community-Based Long-Term Services and Supports Breakout Session April 18-19, 2017 Community
More informationNC TIDE SPRING CONFERENCE April 26, NC Department of Health and Human Services Medicaid Transformation and the 1115 Waiver
NC TIDE SPRING CONFERENCE April 26, 2017 NC Department of Health and Human Services Medicaid Transformation and the 1115 Waiver Agenda Medicaid Landscape NC Medicaid Transformation Supporting Legislation
More informationPractice Advancement Initiative (PAI) Using the ASHP PAI Ambulatory Care Self-Assessment Survey
Practice Advancement Initiative (PAI) Using the ASHP PAI Ambulatory Care Self-Assessment Survey Jodie Elder, PharmD, BCPS September 14, 2017 Objectives List the key components of the Practice Advancement
More informationBuilding Blocks to Health Workforce Planning: Data Collection and Analysis
Building Blocks to Health Workforce Planning: Data Collection and Analysis Presented by: Jean Moore, DRPH Director October 22, 2015 Center for Health Workforce Studies School of Public Health University
More informationMedicaid Innovation Accelerator Program (IAP)
Medicaid Innovation Accelerator Program (IAP) HCBS Conference IAP Session: Where We ve Been and Where We re Going September 2, 2015 Karen LLanos, David Shillcutt, & Michael Smith Center for Medicaid and
More informationNational Perspective No Wrong Door System. Administration for Community Living Center for Medicare and Medicaid Veterans Health Administration
National Perspective No Wrong Door System Administration for Community Living Center for Medicare and Medicaid Veterans Health Administration Agenda National Perspective No Wrong Door System What is a
More informationAdvanced Nurse Practitioner Supervision Policy
Advanced Nurse Practitioner Supervision Policy Supervision requirements for nurse practitioners (NP) fall into two basic categories: Full practice and collaborative practice, which requires a Collaborative
More information2016 Edition. Upper Payment Limits and Medicaid Capitation Rates for Programs of All-Inclusive Care for the Elderly (PACE )
2016 Edition Upper Payment Limits and Medicaid Capitation Rates for Programs of All-Inclusive Care for the Elderly (PACE ) R ABSTRACT The Program of All-Inclusive Care for the Elderly (PACE ) is a federal
More informationValue based care: A system overhaul
Value based care: A system overhaul Lee A. Fleisher, M.D. Robert D. Dripps Professor and Chair of Anesthesiology Perelman School of Medicine at the University of Pennsylvania Email: lee.fleisher@uphs.upenn.edu
More informationThe Legacy of Sidney Katz: Setting the Stage for Systematic Research in Long Term Care. Vincent Mor, Ph.D. Brown University
The Legacy of Sidney Katz: Setting the Stage for Systematic Research in Long Term Care Vincent Mor, Ph.D. Brown University A Half Century of Ideas Most Scientists don t have a single field changing idea
More informationThe Next Wave in Balancing Long- Term Care Services and Supports:
The Next Wave in Balancing Long- Term Care Services and Supports: Top Trends Agency restructuring is common States use of variety of resources to fund the programs Loss of historical knowledge is nationwide
More informationReport to Congressional Defense Committees
Report to Congressional Defense Committees The Department of Defense Comprehensive Autism Care Demonstration December 2016 Quarterly Report to Congress In Response to: Senate Report 114-255, page 205,
More informationHome Health Agency (HHA) Medicare Margins: 2007 to 2011 Issue Brief July 7, 2009
Home Health Agency (HHA) Medicare Margins: 2007 to 2011 Issue Brief July 7, 2009 Dobson DaVanzo & Associates, LLC (www.dobsondavanzo.com) was commissioned by the LHC Group to conduct a margin study for
More informationState Innovations in Value-Based Care: ACOs and Beyond
Advancing innovations in health care delivery for low-income Americans State Innovations in Value-Based Care: ACOs and Beyond Rachael Matulis, Senior Program Officer National Academy of Medicine Value
More informationUpgrading Voter Registration in Florida
Upgrading Voter Registration in Florida David Becker Director, Election Initiatives 1 2012: Florida Snapshot Below National Average of 71.2% 2 Change in Voting Age Population (VAP), 2008-2012 U.S. Census
More informationPoverty and Health. Frank Belmonte, D.O., MPH Vice President Pediatric Population Health and Care Modeling
Poverty and Health Frank Belmonte, D.O., MPH Vice President Pediatric Population Health and Care Modeling An iconic image of child poverty Children Living in Poverty 4 Healthcare Services Account for $19.2
More informationDevelopmental screening, referral and linkage to services: Lessons from ABCD
Developmental screening, referral and linkage to services: Lessons from ABCD J I L L R O S E N T H A L S E N I O R P R O G R A M D I R E C T O R N A T I O N A L A C A D E M Y F O R S T A T E H E A L T
More informationPatient-Centered Specialty Practice Readiness Assessment
Patient-Centered Specialty Practice Readiness Assessment Daryn Eikner Vice President, Health Care Delivery National Family Planning & Reproductive Health Association Melissa Kleder Manager, Health Care
More informationMedicaid: Current Challenges and Future Prospects
Medicaid: Current Challenges and Future Prospects Diane Rowland, Sc.D. Executive Vice President, Henry J. Kaiser Family Foundation Executive Director, Kaiser Commission on Medicaid and the Uninsured The
More informationComprehensive Care for Joint Replacement (CJR) Readiness Kit
Comprehensive Care for Joint Replacement (CJR) Readiness Kit Contents CMS Announces Shift From Volume To Value...2 Top Things To Know About CJR Final Rule...3 Proposed Timeline For CJR...4 Who Is Impacted?...5
More informationStates Roles in Rebalancing Long-Term Care: Findings from the Aging Strategic Alignment Project
States Roles in Rebalancing Long-Term Care: Findings from the Aging Strategic Alignment Project Linda S. Noelker, PhD Katz Policy Institute Benjamin Rose Institute on Aging 11900 Fairhill Road, Suite 300
More informationNCCP. National Continued Competency Program Overview
NCCP National Continued Competency Program Overview State Recertification Model Use CA OR WA NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI OH IN KY WV PA VA NY NH VT NJ DE MD ME RI CT MA AZ NM OK AR
More informationSEASON FINAL REGISTRATION REPORTS
Materials Included: 2012-2013 SEASON FINAL REGISTRATION REPORTS 2011-12 & 2012-13 Comparison by Group 2 2012-13 USA Hockey Member Counts 3 2012-13 Non-Participant Membership Information 4 2012-13 8 and
More informationkaiser medicaid and the uninsured commission on O L I C Y
P O L I C Y B R I E F kaiser commission on medicaid and the uninsured 1330 G S T R E E T NW, W A S H I N G T O N, DC 20005 P H O N E: (202) 347-5270, F A X: ( 202) 347-5274 W E B S I T E: W W W. K F F.
More informationThe Value and Use of CME in Medical Licensure
2011 Federation of State Medical 2011 Boards Federation of State Medical Boards The Value and Use of CME in Medical Licensure ACCME Newcomers Workshop July 31, 2013 2011 Federation of State Medical Boards
More informationUnderstanding Medicaid: A Primer for State Legislators
Understanding Medicaid: A Primer for State Legislators Introduction This booklet summarizes key elements of the Medicaid program, including basic answers to questions about the design and cost of the
More informationImproving Care for Dual Eligibles Opportunities for Medicare Managed Care Plans
Improving Care for Dual Eligibles Opportunities for Medicare Managed Care Plans Prepared by James M. Verdier Mathematica Policy Research for the World Congress Leadership Summit on Medicare Falls Church,
More informationPolicies for TANF Families Served Under the CCDF Child Care Subsidy Program
Policies for TANF Families Served Under the CCDF Child Care Subsidy Program Sarah Minton, Christin Durham, Erika Huber, Linda Giannarelli Presentation for NAWRS/NASTA 2012 Context Many TANF families receive
More informationMedicare & Medicaid EHR Incentive Programs Robert Tagalicod, Robert Anthony, and Jessica Kahn HIT Policy Committee January 10, 2012
Medicare & Medicaid EHR Incentive Programs Robert Tagalicod, Robert Anthony, and Jessica Kahn HIT Policy Committee January 10, 2012 Medica re Active Registrations December 2011 December-11 YTD Eligible
More informationDriving Change with the Health Care Spending Benchmark
Driving Change with the Health Care Spending Benchmark Delaware s Road to Value Kara Odom Walker, MD, MPH, MSHS Cabinet Secretary LIFE Conference, January 24, 2018 1 Join us on Twitter: @Delaware_DHSS
More informationPrescription Monitoring Program:
Massachusetts Department of Public Health Prescription Monitoring Program: The Massachusetts Prescription Monitoring Tool (MassPAT) November 1, 2016 Goals of the Session Understand the mission and responsibilities
More information2012 Federation of State Medical Boards
Maintenance of Licensure: An Overview and Update Humayun Chaudhry, DO, MS, MACP, FACOI President and CEO, Federation of State Medical Boards Osteopathic International Alliance Annual Meeting Austin, Texas
More informationIMPROVING THE QUALITY OF CARE IN SOUTH CAROLINA S MEDICAID PROGRAM
IMPROVING THE QUALITY OF CARE IN SOUTH CAROLINA S MEDICAID PROGRAM VICE PRESIDENT, PUBLIC POLICY & EXTERNAL RELATIONS October 16, 2008 Who is NCQA? TODAY Why measure quality? What is the state of health
More informationBUFFALO S SHIPPING POST Serving Napa Valley Since 1992
BUFFALO S SHIPPING POST Serving Napa Valley Since 1992 2471 Solano Ave Napa, CA 94558 707-226-7942 FAX: 707-226-1510 buffship.com October 21, 2017 RE: New Pricing Hi Everyone, Because of continual fuel
More informationAssuring Better Child Health and Development Initiative (ABCD)
Assuring Better Child Health and Development Initiative (ABCD) Presented by Jennifer May National Academy for State Health Policy Act Early Region X Summit Feb 4-5, 2010 Seattle, Washingon Supported by
More informationThe 2015 National Workforce Survey Maryland LPN Data June 17, 2016
1. What is your gender? n=644.9 Male 10.1% Female 89.9% The 2015 National Workforce Survey Maryland LPN Data June 17, 2016 2. What is your race/ethnicity? (Mark all that apply) n=682.4 American Indian
More informationNational Provider Identifier (NPI)
National Provider Identifier (NPI) Importance to the Athletic Training Profession? By Clark E. Simpson, MBA, MED, LAT, ATC National Manager, Strategic Business Development National Athletic Trainers Association
More informationMedicaid Experts 11/10/2015. Alphabet Soup. Medicaid: Overview and Innovations PPO HMO CMS CDC ACO ICF/MR MR/DD JCAHO LTC PPACA HRSA MRSA FQHC AMA AHA
Medicaid Experts DEVELOPING NEW STATE LEGISLATIVE HEALTH LEADERS Medicaid: Overview and Innovations While I can explain the meaning of life, I don t dare try to explain how the Medicaid system works. CMS
More informationGovernor s Office of Electronic Health Information (GOEHI) The National Council for Community Behavioral Healthcare
Governor s Office of Electronic Health Information (GOEHI) The National Council for Community Behavioral Healthcare PBHCI Grantees by HHS Regions AK (2) OR WA (3) Region 10 6 Grantees ID MT Region 8 2
More informationASA Survey Results for Commercial Fees Paid for Anesthesia Services payment and practice manaement
payment and practice manaement ASA Survey Results for Commercial Fees Paid for Anesthesia Services 2015 Stanley W. Stead, M.D., M.B.A. Sharon K. Merrick, M.S., CCS-P ASA is pleased to present the annual
More informationOptions Counseling in and NWD/ADRC System National, State & Local Perspectives
Options Counseling in and NWD/ADRC System National, State & Local Perspectives Introductions Joseph Lugo, Administration on Community Living Sara Tribe, NASUAD Maurine Strickland, Wisconsin Barbara Diehl,
More informationAdult Day Health Services Across States: Results from a 50-State Survey of State Health Policies
Adult Day Health Services Across States: Results from a 50-State Survey of State Health Policies Sandra Howell-White, Ph.D. Nancy Scotto Rosato, M.A. Judith A. Lucas, APRN, BC, Ed.D. Funded by The Robert
More informationCenter for Clinical Standards and Quality /Survey & Certification
TO DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop C2-21-16 Baltimore, Maryland 21244-1850 Center for Clinical Standards and Quality /Survey
More informationMedicaid Managed Care. Long-term Services and Supports Trends
Medicaid Managed Care Long-term Services and Supports Trends Medicaid Managed Care Statistics As of 2011, 74.2% of Medicaid Enrollees were enrolled in a Medicaid Managed Care system As of 2011, California,
More informationMANAGING CHANGE PART II: SERVICE DELIVERY TRENDS
STRENGTHENING THE AGING NETWORK Building Leadership in the Long-Term Services and Supports Network MANAGING CHANGE PART II: SERVICE DELIVERY TRENDS Thursday, April 14, 2011 3:00 4:00 PM EDT Funded by 1
More informationHealth Reform and The Patient-Centered Medical Home
THE COMMONWEALTH FUND Health Reform and The Patient-Centered Medical Home Melinda Abrams The Commonwealth Fund November 3, 2011 Grantmakers in Health Fall Forum Primary Care Foundation At Risk: Patient
More informationNCQA s Patient-Centered Medical Home Recognition and Beyond. Tricia Marine Barrett, VP Product Development
NCQA s Patient-Centered Medical Home Recognition and Beyond Tricia Marine Barrett, VP Product Development National Committee for Quality Assurance (NCQA) Private, independent non-profit health care quality
More informationRehabilitation Research and Training Center on Aging with Developmental Disabilities Department of Disability and Human Development University of Illinois at Chicago http://www.rrtcadd.org/ By 2010 Managed
More informationPrescription Monitoring Programs - Legislative Trends and Model Law Revision
Prescription Drug Monitoring Programs Training and Technical Assistance Center Webinar Series National Alliance for Model State Drug Laws: Legislative Round-Up July 22, 2015 Prescription Monitoring Programs
More informationNCQA PCMH Recognition: 2017 Standards Preview. Tricia Barrett Vice President, Product Design and Support January 25, 2017
NCQA PCMH Recognition: 2017 Standards Preview Tricia Barrett Vice President, Product Design and Support January 25, 2017 CURRENT LANDSCAPE NCQA OVERVIEW RECOGNITION REDESIGN 2017 CONCEPTS Agenda PANEL
More informationPatient Centered Medical Home Foundation for Accountable Care
Patient Centered Medical Home Foundation for Accountable Care Outline of Presentation History and tenants of the patient-centered care and PCMH model Defining, measuring, recognizing, and evaluating the
More informationASA Survey Results for Commercial Fees Paid for Anesthesia Services practice management
practice management ASA Survey Results for Commercial Fees Paid for Anesthesia Services 2013 Stanley W. Stead, M.D., M.B.A Sharon K. Merrick, M.S., CCS-P Thomas R. Miller, Ph.D., M.B.A. ASA is pleased
More informationAlaska (AK) Arizona (AZ) Arkansas (AR) California-RN (CA-RN) Colorado (CO)
Beth Radtke 49 Included in the report: 7/22/2015 11:17:54 AM Alaska (AK) Arizona (AZ) Arkansas (AR) California-RN (CA-RN) Colorado (CO) Connecticut (CT) Delaware (DE) District Columbia (DC) Florida (FL)
More informationNational Association For Regulatory Administration
National Association For Regulatory Administration Annual NARA Licensing Seminar Presenters: Alfred C. Johnson Patricia Adams Agenda Introductions Incident Reports -- Assisted Living Alfred Johnson, Director,
More informationPatient-Centered Primary Care
Patient-Centered Primary Care Greg Moody, Director Office of Health Transformation July 30, 2014 www.healthtransformation.ohio.gov Agenda 1. Health System Challenges 2. Health System Trends in Primary
More informationTransforming Louisiana s Long Term Care Supports and Services System. Initial Program Concept
Transforming Louisiana s Long Term Care Supports and Services System Initial Program Concept August 30, 2013 Transforming Louisiana s Long Term Care Supports and Services System Our Vision Introduction
More informationAward Cash Management $ervice (ACM$) National Science Foundation Regional Grants Conference. June 23 24, 2014
Award Cash Management $ervice (ACM$) National Science Foundation Regional Grants Conference June 23 24, 2014 1 Agenda Introduction of ACM$ itrak Conversion Processes Canceling Funds SAM Registration Program
More informationNCHIP and NICS Act Grants Overview and Current Status
BUREAU OF JUSTICE STATISTICS NCHIP and NICS Act Grants Overview and Current Status Devon B. Adams Criminal Justice Data Improvement Program SEARCH Membership Group Meeting Nashville, TN - February, 2010
More informationFebruary 26, Dear State Health Official:
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, MD 21244-1850 SHO #16-002 February 26, 2016 Re: Federal Funding for
More informationThe Current State of CMS Payfor-Performance. HFMA FL Annual Spring Conference May 22, 2017
The Current State of CMS Payfor-Performance Programs HFMA FL Annual Spring Conference May 22, 2017 1 AGENDA CMS Hospital P4P Programs Hospital Acquired Conditions (HAC) Hospital Readmissions Reduction
More informationDashboard. Campaign for Action. Welcome to the Future of Nursing:
Welcome to the Future of Nursing: Campaign for Action Dashboard About This Dashboard: These graphs and charts show goals by which the Campaign evaluates its efforts to implement recommendations in the
More informationAdvancing Self-Direction for People with Head Injuries
Vermont Department of Disabilities, Aging and Independent Living Advancing Self-Direction for People with Head Injuries NASHIA SOS Conference Des Moines, IA September 27, 2018 Sara Lane Vermont Department
More informationCONTINUING MEDICAL EDUCATION OVERVIEW BY STATE
CONTINUING MEDICAL EDUCATION OVERVIEW BY STATE STATE AL YES M.D./D.O./P.A. 12 hours every year; all must be AMA Category 1 AK YES M.D./D.O. 50 hours every 2 years; all must be AMA Category 1 or AOA Category
More informationASA Survey Results for Commercial Fees Paid for Anesthesia Services payment and practice management
payment and practice management ASA Survey Results for Commercial Fees Paid for Anesthesia Services 2016 Stanley W. Stead, M.D., M.B.A Sharon K. Merrick, M.S., CCS-P ASA is pleased to present the annual
More informationNew Delivery Systems for Long Term Services and Supports: How States are Diving into Affordable Care Act Opportunities
New Delivery Systems for Long Term Services and Supports: How States are Diving into Affordable Care Act Opportunities September 2013 Sarah Barth, JD, Director of Coverage and Access Michelle Herman Soper,
More informationYour Medicaid Matters: Serious Threats from Capitol Hill
Your Medicaid Matters: Serious Threats from Capitol Hill Presented by Joseph C. Isaacs, MSPH, FASAE, CAE Vice President, Public Policy United Spinal Association January 26,2012 Your Medicaid Matters: Serious
More informationThe Affordable Care Act and Its Potential to Reduce Health Disparities Cara V. James, Ph.D.
The Affordable Care Act and Its Potential to Reduce Health Disparities Cara V. James, Ph.D. Director, Office of Minority Health Centers for Medicare & Medicaid Services April 22, 2013 The Affordable Care
More informationThe Use of NHSN in HAI Surveillance and Prevention
The Use of NHSN in HAI Surveillance and Prevention Catherine A. Rebmann Division of Healthcare Quality Promotion (DHQP) Centers for Disease Control and Prevention (CDC) January 12, 2010 Objectives What
More informationFramework for Post-Acute Care: Current and Future Issues for Providers
Framework for Post-Acute Care: Current and Future Issues for Providers Alan G. Rosenbloom Alliance for Quality Nursing Home Care March 2012 Overview of Presentation Post-Acute Care: Background and Trends
More informationCare Provider Demographic Information Update
Care Provider Demographic Information Update Please use this form for a single care provider practitioner update. Incomplete forms will not be processed. Fields with an asterisk (*) are required for practitioners
More informationBEST PRACTICES IN LIFESPAN RESPITE SYSTEMS: LESSONS LEARNED & FUTURE DIRECTIONS
BEST PRACTICES IN LIFESPAN RESPITE SYSTEMS: LESSONS LEARNED & FUTURE DIRECTIONS September 12, 2012 PRESENTERS: Greg Link, MA Program Officer Administration for Community Living U.S. Administration on Aging
More information2017 STSW Survey. Survey invitations were sent to 401 STSW members and conference registrants. 181 social workers responded.
2017 STSW Survey Survey invitations were sent to 401 STSW members and conference registrants. 181 social workers responded. Years Employed 30% As a social worker As a transplant social worker 20% 10% 0-2
More informationEpisode Payment Models:
Episode Payment Models: Cardiac Bundle Initiative HFMA Florida Chapter (North Florida) October 25, 2016 Robert Howey MBA, MHA, CPA Revenue Cycle Manager 2016 MFMER slide-1 Objective After the session,
More informationMEMORANDUM Texas Department of Human Services * Long Term Care/Policy
MEMORANDUM Texas Department of Human Services * Long Term Care/Policy TO: FROM: LTC-R Regional Directors Section/Unit Managers Marc Gold Section Manager Long Term Care Policy State Office MC: W-519 SUBJECT:
More informationCONNECTICUT: ECONOMIC FUTURE WITH EDUCATIONAL REFORM
CONNECTICUT: ECONOMIC FUTURE WITH EDUCATIONAL REFORM This file contains detailed projections and information from the article: Eric A. Hanushek, Jens Ruhose, and Ludger Woessmann, It pays to improve school
More informationHigher Education Employment Report
Higher Education Employment Report First Quarter 2017 / Published September 2017 Executive Summary The number of jobs in higher education increased 0.6 percent, or 22,100 jobs, during the first quarter
More informationRebates & Incentives - WTF. Lee Guthman February 28, 2012
Rebates & Incentives - WTF Lee Guthman February 28, 2012 1 The dilemma we face 2 Who is GreenOhm? Mainstream benefits of energy efficient products and services Drive purchasing behavior for energy efficient
More informationCesarean Delivery Model Meeting the challenge to reduce rates of Cesarean delivery
Cesarean Delivery Model Meeting the challenge to reduce rates of Cesarean delivery Alan Mills FSA MAAA ND November 13, 2014 Agenda 1. Background 2. The U.S. Cesarean delivery challenge 3. Cesarean Delivery
More informationFORGING SUCCESSFUL PARTNERSHIPS BETWEEN HEALTH PLANS AND STATES
FORGING SUCCESSFUL PARTNERSHIPS BETWEEN HEALTH PLANS AND STATES James M. Verdier Second Annual Conference on Reaching, Retaining, and Serving Low Income Beneficiaries Las Vegas, NV July 24, 2007 Introduction
More informationLong-Term Services and Supports (LTSS): Medicaid s Role and Options for States
Long-Term Services and Supports (LTSS): Medicaid s Role and Options for States Erica L. Reaves, Policy Analyst State Variation in Long-Term Services and Supports: Location, Location, Location National
More informationACRP AMBASSADOR PROGRAM GUIDELINES
ACRP AMBASSADOR PROGRAM GUIDELINES The Airport Cooperative Research Program (ACRP) is an industry-driven, applied research program that develops near-term, practical solutions to problems faced by airport
More informationAdvancing Health Equity and Improving Health for All through a Systems Approach Presentation to the Public Health Association of Nebraska
Advancing Health Equity and Improving Health for All through a Systems Approach Presentation to the Public Health Association of Nebraska Lisa F. Waddell, MD, MPH Chief Program Officer Association of State
More informationUnited States Property & Fiscal Officer (USPFO)
United States Property & Fiscal Officer (USPFO) NGAUS 2017 Industry Partner Workshop 7 September 2017 This briefing is UNCLASSIFIED Doing business with The 54 What is a United States Property and Fiscal
More informationWelcome and Introductions
Integrating Care for Dual Eligible Beneficiaries National Conference of State Legislatures Fall Forum: Changing Roles of States in Long Term Services and Supports December 3, 2013 Sarah Barth, JD www.chcs.org
More informationRECOUNT RULES & VOTING SYSTEMS
state s be ed nces is permitted Voter ID Required Voting Systems Manufacturer AL Not more than 1/2 of 1% No provisions for. Non-photo ID AK Tie Vote Losing cand. or 10 voters may. Non-photo ID DRE with
More informationSPACE AND NAVAL WARFARE SYSTEMS COMMAND
SPACE AND NAVAL WARFARE SYSTEMS COMMAND Feb 06, 2018 WEST 2018 Rear Admiral C. D. Becker Commander, Space and Naval Warfare Systems Command DISTRIBUTION STATEMENT A: Approved for public release, distribution
More informationCurrent and Emerging Rural Issues in Medicare
Current and Emerging Rural Issues in Medicare Captain Corinne Axelrod, MPH, L.Ac., Dipl.Ac. Senior Health Insurance Specialist Centers for Medicare and Medicaid Services Center for Medicare, Hospital and
More informationIts Effect on Public Entities. Disaster Aid Resources for Public Entities
State-by-state listing of Disaster Aid Resources for Public Entities AL Alabama Agency http://ema.alabama.gov/ Alabama Portal http://www.alabamapa.org/ AK AZ AR CA CO CT DE DC FL Alaska Division of Homeland
More informationDiversifying AAA/ADRCs Funding Streams: How states and their local partners can draw down federal Medicaid Administrative Match for ADRC/NWD Systems
Diversifying AAA/ADRCs Funding Streams: How states and their local partners can draw down federal Medicaid Administrative Match for ADRC/NWD Systems July 30, 2017 n4a Conference Agenda What is the value
More informationNational School Safety Conference Reno, Nevada / June 24 29, 2018
National School Safety Conference Reno, Nevada / June 24 29, 2018 Saturday, June 23 rd 8:00 am 5:00 pm NASRO Basic Course Capri 1 Sunday, June 24 th 8:00 am 5:00 pm NASRO Basic Course Capri 1 8:00 am 5:00
More informationCounterdrug(CD) Information Brief LTC TACKETT
The Oklahoma Team Army National Guard Air National Guard Counterdrug JTF DRUGS Counterdrug(CD) Information Brief LTC TACKETT OUTLINE National Program Strategic Goals Oklahoma s Program Oklahoma Initiatives
More informationSafe Staffing- Safe Work
Safe Staffing- Safe Work PROFESSIONAL ISSUES CONFERENCE JUNE 2, 2017 SARA MARKLE-ELDER, ALICE BARDEN, RN AFT Nurses and Health Professionals is accredited as a provider of continuing nursing education
More informationSummary of 2010 National Radon Action Month Results
Summary of 2010 National Radon Action Month Results This document summarizes the results of the 2010 National Radon Action Month. The summary describes the total number of 2010 activities compared to 2009
More information2016 STSW Survey. Survey invitations were sent to all STSW members and 2016 conference registrants. 158 social workers responded.
2016 STSW Survey Survey invitations were sent to all STSW members and 2016 conference registrants. 158 social workers responded. Years Employed 30% As a social worker As a transplant social worker 20%
More information