Inside Angle

From 3M Health Information Systems

Tag: Medicaid

The Florida Medicaid approach to quality improvement in managed care

April 12th, 2019 / By Richard Fuller, MS

One of the fundamental objectives of Medicaid programs contracting out their sizeable budgets to managed care companies is to improve the quality of care for their beneficiaries. As we frequently […]

Understanding the EAPG transition and its impact on payment

June 22nd, 2018 / By Elena Nezdurova

How hospitals and physicians get paid is changing as the U.S. healthcare system transitions from volume-based to value-based care. Reimbursement methodologies need to allow for a plan to control costs, […]

CMS: Low Volume Appeals Settlement Initiative

January 17th, 2018 / By Barbara Aubry, RN

I attended the January 9, 2018 CMS Medicare Learning Network conference call covering the logistics of the settlement process offered by CMS for providers with pending appeals. This impacts: “The […]

White Paper: Medicaid value-based care: Best practice strategies for success

Discussion of five best practices that help Medicaid agencies transition toward value-based care.

How can we match the right resources and interventions to patient needs? Better risk stratification

September 11th, 2017 / By L. Gordon Moore, MD

With the unrelenting pressure to reduce unnecessary costs in healthcare delivery and despite (or maybe because of) the lack of clear direction from the federal government, Medicaid plans across the […]

Pay for better risk-adjusted outcomes and let’s cut down on waste

April 19th, 2017 / By Richard Fuller, MS, Norbert Goldfield, MD

While Congress is finding it difficult to reach consensus on how to improve health care in the United States, the one thing we all can agree on is that ever-rising […]

Tackling health care’s ever-decreasing competition

November 18th, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD

In a recent perspective piece in JAMA Forum, Dr. Ashish Jha of the Harvard School of Public Health argues that increased provider consolidation is threatening the financial viability of the […]

Early adopters of Value-Based Payment: A digital dialogue on what works

October 28th, 2016 / By Michael Keyes

Value-Based Payment (VBP) is top of mind for all who work with a Medicaid population in states across the U.S. Through its Delivery Service Reform Incentive Payment (DSRIP) Program and […]

Balance billing dual eligibles: Taking advantage of the system

August 8th, 2016 / By Barbara Aubry, RN

I was catching up on regulatory reading today (yes, reading CMS regulations is part of my job responsibilities) and saw something troubling—providers are still balance billing qualified Medicare beneficiaries (QMBs, […]

Incentives Empower Providers to Improve Care

June 26th, 2015 / By Norbert Goldfield, MD, Richard Fuller, MS

For the last decade, we have been fortunate enough to work with many state Medicaid programs and commercial payers on reform efforts incorporating outcomes targets for health care providers. The […]

Predicting Medical Resource Utilization with Patient Surveys

April 15th, 2015 / By L. Gordon Moore, MD

Success in population health management rests in part on being able to identify high cost/high utilization population segments and provide interventions that help achieve better outcomes. With enough of a […]

eGuide: Medicaid – Innovation and the future of health care

Stay on top of the latest state innovations in health care as Medicaid programs continue to shift away from volume and toward value, efficiency and analytics.