Healthify Blog

Using Dual Eligible Plans to Improve Care for our Most Costly Patients

Dennis Heaphy, a Boston resident and 30-year quadriplegic, received new health care coverage in 2014. As part of initiatives ushered in with the Accountable Care Act, Heaphy, a low-income disabled individual, was able to stay home and in his community. This was a drastic change from the expensive and disruptive alternative he was all too familiar with—frequent visits to the hospital and long-term stays at skilled nursing facilities.

Now, improvements are being tested in a pilot program—“dual eligible” plans—aimed at providing better coordinated care for patients like Heaphy, who is among a group of the most costly and complex patients.  

Topics: Medicaid coordinated care ACA Medicare dual eligibles elderly

A Breath of Fresh Air for Smoking Cessation Efforts­­­­

More than 50 years ago, the Surgeon General first reported that cigarette smoking was very bad for our health. At the time, 42% of Americans smoked. Even now that the percentage has dropped dramatically to less than 15%, smoking is still a deadly problem. 

The deleterious effects of smoking are well known, including the increased risk for heart disease, stroke, and lung cancer. Smoking causes 480,000 deaths annually, which is more deaths each year than the following causes combined: HIV, illegal drug use, alcohol use, motor vehicle injuries, and firearm-related incidents. 

Topics: Healthify social determinants of health Medicaid coordinated care

Collaborative Healthcare Series: The Advent of Medicaid Managed Care

While we previously touched on the history of managed care, this next post for Healthify Insights’ Collaborative Care Series will focus on the coordination and development of Medicaid managed care.

Topics: Healthify Medicaid managed care

Collaborative Healthcare Series: A Brief History of Managed Care

Healthcare policy is at the forefront of many Americans’ minds, especially during this tumultuous election season. This next series on Healthify Insights will focus on collaborative healthcare and its development, with an emphasis on the concept of managed care.

Topics: Medicaid managed care Accountable Care Organizations

Accountable Health Communities: Track 3 Alignment

Next week — May 18 — is the deadline for bridge organizations to submit their applications to CMS for the Accountable Health Communities (AHC) model. For the past few weeks, Healthify has been reviewing how software can support the goals of Track 1 Awareness and Track 2 Assistance. Today we review Track 3 Alignment — the largest and most complex of the three interventions proposed by CMS. Track 3 is a $4.5 million grant that will be awarded to 20 bridge organizations to answer the following question: Will a combination of community service navigation and partner alignment at the community level improve total health care costs and inpatient and outpatient health care utilization?

Topics: healthcare delivery social determinants of health Medicaid

Accountable Health Communities: Track 2 Assistance

With the grant deadline for the CMS Accountable Health Communities (AHC) model just a couple of weeks away, Healthify is continuing its review of all three tracks of the AHC model. Today we take a look at Track 2 Assistance — a $2.5 million dollar grant over five years — that will allow 12 bridge organizations to answer the following question raised by CMS: “Will providing community service navigation to assist high-risk beneficiaries with accessing community services to address identified health-related social needs impact their total health care costs, inpatient and outpatient health care utilization, and health and quality of care?”

Topics: social determinants of health Medicaid community resources

Accountable Health Communities: Track 1 Awareness

Last week, the Healthify Editorial discussed implementing the Accountable Health Communities (AHC) model. The AHC model is premised on finding the answers to three large questions around social determinants. Track 1 Awareness, the model we are examining today, awards $1 million over five years to answer the following question: "Will increasing beneficiary awareness of available community services through information dissemination and referral impact total health care costs, inpatient and outpatient health care utilization, and health and quality of care?"

Topics: social determinants of health Medicaid community resources

Build versus Buy

Implementing CMMI's Accountable Health Communities Model

The $157 million that Health and Human Services (HHS) has promised to fund CMMI’s Accountable Health Communities has certainly set hundreds of healthcare institutions scrambling to become one of the 44 bridge organizations that will pioneer the new care model for addressing social determinants in Medicaid and Medicare beneficiaries.  

Topics: Healthify social determinants of health Medicaid

CMS Launches New Model to Test Social Determinants

The Innovation Center at the Centers for Medicare and Medicaid Services (CMS) announced the creation of the Accountable Health Communities Model yesterday. It is the first-ever CMS innovation model to focus on the social determinants of health.

Topics: social determinants of health Medicaid public health

The New Normal: Preventative Healthcare to Improve Population Health

From innovative laws and regulations to the development and rollout of new best practices, healthcare in America is rapidly evolving and the industry is transforming dramatically as a result.

Topics: healthcare delivery social determinants of health Medicaid public health