The CMS Innovation Center held the second in a series of webinars for potential applicants to Health Care Innovation Awards Round Two. The webinar held Wednesday, June 12, 2013 1:30pm – 3:00pm EDT, focused specifically on the first two of the four innovation categories.
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CMS Innovations
http://innovations.cms.gov
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The webinar introduced the Comprehensive Primary Care initiative to the primary care provider community and covered the service delivery model, including the 5 Comprehensive Primary Care functions, and the milestones participating practices will need to achieve in the first year. The process for applying was also discussed, including information about the application itself.
More at: http://innovations.cms.gov/resources/CPCi-Webinar-for-PCPs.html
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http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Wednesday April 9, 2014 to provide an overview of the Medicare Care Choices Model and the application process. Subject matter experts from the CMS Innovation Center provided details and answered questions.
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CMS Innovation Center
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The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
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CMS Innovation Center
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The Part D Enhanced Medication Management (MTM) Model team hosted a webinar on Wednesday, October 21, 2015. Attendees received an introduction to the model and related details.
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CMS Innovation Center
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted a webinar to discuss various aspects of the Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Incentive Payment Model; and changes to the Comprehensive Care for Joint Replacement Model final rule on Wednesday, February 22, 2017, from 12:00 p.m. – 1:00 p.m. EST. The final rule was displayed at the Federal Register on December 20, 2016 and is effective on February 18, 2017.
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CMS Innovation Center
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Staff from the CMS Innovation Center and the Center for Medicare and CHIP Services hosted a webinar that provided an overview of the Strong Start initiative and the application process and requirements for the Medicaid funding opportunity.
More at: http://innovations.cms.gov/resources/StrongStart_overview.html
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CMS Innovation Center
http://innovation.cms.gov
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February 9, 2012
These slides are designed for Post-Acute Care (PAC) providers seeking additional information about how Model 3 works and a better understanding of the opportunities for PAC providers within the Bundled Payment for Care Improvement (BPCI) initiative to achieve better care, better health and lower costs for their patients through care redesign.
More at: http://innovations.cms.gov/resources/Bundled-Payments-Model-3-Deep-Dive.html
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CMS Innovation Center
http://innovation.cms.gov
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The State Innovation Models initiative is a competitive funding opportunity for states to design and test multi-payer payment and service delivery models that deliver high-quality health care and improve health system performance.
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CMS Innovations
http://innovation.cms.gov
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The webinar introduced the Comprehensive Primary Care initiative to the primary care provider community and covered the service delivery model, including the 5 Comprehensive Primary Care functions, and the milestones participating practices will need to achieve in the first year. The process for applying was also discussed, including information about the application itself.
More at: http://innovations.cms.gov/resources/CPCi-Webinar-for-PCPs.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The CMS Innovation Center hosted a webinar on Wednesday April 9, 2014 to provide an overview of the Medicare Care Choices Model and the application process. Subject matter experts from the CMS Innovation Center provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Part D Enhanced Medication Management (MTM) Model team hosted a webinar on Wednesday, October 21, 2015. Attendees received an introduction to the model and related details.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted a webinar to discuss various aspects of the Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Incentive Payment Model; and changes to the Comprehensive Care for Joint Replacement Model final rule on Wednesday, February 22, 2017, from 12:00 p.m. – 1:00 p.m. EST. The final rule was displayed at the Federal Register on December 20, 2016 and is effective on February 18, 2017.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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Staff from the CMS Innovation Center and the Center for Medicare and CHIP Services hosted a webinar that provided an overview of the Strong Start initiative and the application process and requirements for the Medicaid funding opportunity.
More at: http://innovations.cms.gov/resources/StrongStart_overview.html
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CMS Innovation Center
http://innovation.cms.gov
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February 9, 2012
These slides are designed for Post-Acute Care (PAC) providers seeking additional information about how Model 3 works and a better understanding of the opportunities for PAC providers within the Bundled Payment for Care Improvement (BPCI) initiative to achieve better care, better health and lower costs for their patients through care redesign.
More at: http://innovations.cms.gov/resources/Bundled-Payments-Model-3-Deep-Dive.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The State Innovation Models initiative is a competitive funding opportunity for states to design and test multi-payer payment and service delivery models that deliver high-quality health care and improve health system performance.
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CMS Innovations
http://innovation.cms.gov
We accept comments in the spirit of our comment policy: http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Center for Medicare & Medicaid Services (CMS) recently announced 23 additional participants for the Community-based Care Transitions Program (CCTP). These participants will join seven other community-based organizations already working with local hospitals and other health care and social service providers to support high-risk Medicare patients in maintaining the healing process as they transition from hospital stays to home, a nursing home, or other care setting.
This webinar will allow stakeholders to hear directly from some of the newly selected sites. CMS Innovation Center staff will provide additional information about the program and will be available to answer questions.
More at: http://innovations.cms.gov/resources/CCTP-RdcReadmiss.html
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CMS Innovation Center
http://innovation.cms.gov
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The Maternal Opioid Misuse (MOM) Model team presented a notice of funding opportunity and application review webinar on Thursday, February 21 from 2:00 p.m. to 3:15 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Wednesday, July 2, 2014, from 4:15pm-5:15pm EDT. The webinar reviewed Model Test Proposal Format Requirements, the ‘Population Health Plan’ Portion of the Model Test Project Narrative, and the Population Health Plan Deliverable of the Model Test Project Period.
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CMS Innovation Center
http://innovation.cms.gov
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The Oncology Care Model team hosted a webinar on OCM Frequently Asked Questions and Application Overview on Wednesday, April 22, 2015 at 12:00pm EDT. No password was required for the webinar.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Medicare Advantage Value-Based Insurance Design (VBID) Model team hosted a webinar on Thursday, January 30, 2020 to provide information and answer questions about the hospice benefit component recently added to the Value Based Insurance Design (VBID) Model. The Centers for Medicare & Medicaid Services announced in January 2019 that beginning in calendar year 2021, the VBID Model will test including the Medicare hospice benefit in Medicare Advantage.
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CMS Innovation Center
http://innovation.cms.gov
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In this July 26, 2012 webinar, CMS Innovation Center staff provided an overview of the State Innovation Models Initiative.
More information can be found at: http://innovations.cms.gov/initiatives/state-innovations/index.html.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Innovation Center, Center for Medicaid and CHIP Services staff will be hosting a webinar that will discuss how applicants can work with States and the role of States in the Strong Start funding opportunity. A series of follow up webinars will provide more in-depth information about other aspects of this initiative.
More at: http://innovations.cms.gov/resources/Strong-Start-Webinar-State-Partnerships.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The CMS Innovation Center held the sixth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Thursday, July 11, 2013 from 1:00–2:00pm EDT, focused on developing payment models.
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CMS Innovations
http://innovations.cms.gov
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The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center offered a kickoff webinar event for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Tuesday, May 31, 2016 from 4:00–5 p.m. EDT. This webinar focused on model objectives, terms of the award, eligibility criteria, changes from the first public solicitation and important deadlines. A 20 minute question and answer period followed the presentation.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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In this Thursday, July 12, 2012 webinar, presentations focused on learning more about program requirements, preferences, and other keys to success from CMS Innovation Center staff and communities currently participating in the CCTP program. The final CCTP review panel for 2012 convened on September 20, 2012. Applications must have been received by September 3rd to be considered for this review. Future panels may be announced as funding permits.
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CMS Innovation Center
http://innovation.cms.gov
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This Accountable Health Communities Model webinar was held on Wednesday, February 10, 2016 from 3:00 – 4:00pm EST. The webinar focused on the anticipated role of state Medicaid agencies in the model.
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CMS Innovation Center
http://innovation.cms.gov
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As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare and Medicaid Innovation hosted a webinar on Thursday, October 8, 2015. The webinar provided an opportunity to learn more about efforts to solicit public comment on a variety of alternative payment pathways to increase value over volume.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted an introduction webinar about the Oncology Care Model (OCM) on Thursday, February 19, 2015 from 12:00pm – 1:00pm EST. The webinar focused on introducing core concepts of OCM and application instructions. Advance registration was not required.
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CMS Innovation Center
http://innovation.cms.gov
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The first in a series of Accountable Health Communities Model webinars was held on Thursday, January 21, 2016 from 2:00 – 3:30pm EST. The webinar focused on an overview of the model and application requirements. A repeat of the webinar covering the same topic was held Wednesday, January 27, 2016 from 3:00– 4:30pm EST.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare and Medicaid Innovation released a Request for Information (RFI) in late 2013 entitled the “Evolution of ACO Initiatives at CMS.” These are the first of two batches of responses received by the Center for Medicare and Medicaid Innovation to the RFI.
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CMS Innovation Center
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The CMS Innovation Center hosted an informational webinar March 11, 2014 on the parameters of Models 2-4 of the Bundled Payments for Care Improvement Initiative. This webinar was geared towards physicians, specialty practices and physician group practices.
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CMS Innovation Center
http://innovation.cms.gov
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The Primary Care First Model Options team hosted a payment webinar on Wednesday, July 24, 2019 from 12:00 p.m. - 1:00 p.m. EDT. Topics discussed included how eligible practices can participate in the SIP payment model option of Primary Care First, eligibility requirements, quality measures, and payment.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center held the second in a series of webinars on Wednesday, July 6, 2016 for the Support and Alignment Networks under the Transforming Clinical Practice Initiative (TCPI). This webinar focused on providing information regarding the application process.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center held the third in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Tuesday, June 18, 2013 from 1:30–3:00pm EDT, focused on the remaining two of the four innovation categories.
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CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
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The Center for Medicare & Medicaid Services (CMS) recently announced 23 additional participants for the Community-based Care Transitions Program (CCTP). These participants will join seven other community-based organizations already working with local hospitals and other health care and social service providers to support high-risk Medicare patients in maintaining the healing process as they transition from hospital stays to home, a nursing home, or other care setting.
This webinar will allow stakeholders to hear directly from some of the newly selected sites. CMS Innovation Center staff will provide additional information about the program and will be available to answer questions.
More at: http://innovations.cms.gov/resources/CCTP-RdcReadmiss.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Maternal Opioid Misuse (MOM) Model team presented a notice of funding opportunity and application review webinar on Thursday, February 21 from 2:00 p.m. to 3:15 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center hosted a webinar on Wednesday, July 2, 2014, from 4:15pm-5:15pm EDT. The webinar reviewed Model Test Proposal Format Requirements, the ‘Population Health Plan’ Portion of the Model Test Project Narrative, and the Population Health Plan Deliverable of the Model Test Project Period.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Oncology Care Model team hosted a webinar on OCM Frequently Asked Questions and Application Overview on Wednesday, April 22, 2015 at 12:00pm EDT. No password was required for the webinar.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Medicare Advantage Value-Based Insurance Design (VBID) Model team hosted a webinar on Thursday, January 30, 2020 to provide information and answer questions about the hospice benefit component recently added to the Value Based Insurance Design (VBID) Model. The Centers for Medicare & Medicaid Services announced in January 2019 that beginning in calendar year 2021, the VBID Model will test including the Medicare hospice benefit in Medicare Advantage.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In this July 26, 2012 webinar, CMS Innovation Center staff provided an overview of the State Innovation Models Initiative.
More information can be found at: http://innovations.cms.gov/initiatives/state-innovations/index.html.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
CMS Innovation Center, Center for Medicaid and CHIP Services staff will be hosting a webinar that will discuss how applicants can work with States and the role of States in the Strong Start funding opportunity. A series of follow up webinars will provide more in-depth information about other aspects of this initiative.
More at: http://innovations.cms.gov/resources/Strong-Start-Webinar-State-Partnerships.html
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center held the sixth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Thursday, July 11, 2013 from 1:00–2:00pm EDT, focused on developing payment models.
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CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center offered a kickoff webinar event for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Tuesday, May 31, 2016 from 4:00–5 p.m. EDT. This webinar focused on model objectives, terms of the award, eligibility criteria, changes from the first public solicitation and important deadlines. A 20 minute question and answer period followed the presentation.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In this Thursday, July 12, 2012 webinar, presentations focused on learning more about program requirements, preferences, and other keys to success from CMS Innovation Center staff and communities currently participating in the CCTP program. The final CCTP review panel for 2012 convened on September 20, 2012. Applications must have been received by September 3rd to be considered for this review. Future panels may be announced as funding permits.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This Accountable Health Communities Model webinar was held on Wednesday, February 10, 2016 from 3:00 – 4:00pm EST. The webinar focused on the anticipated role of state Medicaid agencies in the model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
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The Center for Medicare and Medicaid Innovation hosted a webinar on Thursday, October 8, 2015. The webinar provided an opportunity to learn more about efforts to solicit public comment on a variety of alternative payment pathways to increase value over volume.
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The Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted an introduction webinar about the Oncology Care Model (OCM) on Thursday, February 19, 2015 from 12:00pm – 1:00pm EST. The webinar focused on introducing core concepts of OCM and application instructions. Advance registration was not required.
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The first in a series of Accountable Health Communities Model webinars was held on Thursday, January 21, 2016 from 2:00 – 3:30pm EST. The webinar focused on an overview of the model and application requirements. A repeat of the webinar covering the same topic was held Wednesday, January 27, 2016 from 3:00– 4:30pm EST.
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The Center for Medicare and Medicaid Innovation released a Request for Information (RFI) in late 2013 entitled the “Evolution of ACO Initiatives at CMS.” These are the first of two batches of responses received by the Center for Medicare and Medicaid Innovation to the RFI.
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The CMS Innovation Center hosted an informational webinar March 11, 2014 on the parameters of Models 2-4 of the Bundled Payments for Care Improvement Initiative. This webinar was geared towards physicians, specialty practices and physician group practices.
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The Primary Care First Model Options team hosted a payment webinar on Wednesday, July 24, 2019 from 12:00 p.m. - 1:00 p.m. EDT. Topics discussed included how eligible practices can participate in the SIP payment model option of Primary Care First, eligibility requirements, quality measures, and payment.
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The CMS Innovation Center held the second in a series of webinars on Wednesday, July 6, 2016 for the Support and Alignment Networks under the Transforming Clinical Practice Initiative (TCPI). This webinar focused on providing information regarding the application process.
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The CMS Innovation Center held the third in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Tuesday, June 18, 2013 from 1:30–3:00pm EDT, focused on the remaining two of the four innovation categories.
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Staff from the CMS Innovation Center hosted an overview webinar of the Health Care Innovation Awards Round Two to give interested potential applicants the opportunity to hear more about the Funding Opportunity Announcement. CMS Innovation Center staff were also available to answer questions. Advance registration was required.
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NVTC Capital Health Tech Summit: Dr. Shannon KeynoteAlexa Magdalenski
The 2017 Capital Health Tech Summit took place on June 15, 2017 at the Inova Center for Personalized Health. Dr. Richard Shannon, Executive Vice President, Health Affairs, University of Virginia provided the Summit's second keynote.
The Near Future of Healthcare Delivery - 2015 Policy Prescriptions® SymposiumCedric Dark
The symposium is designed for clinicians – physicians, nurses, nurse practitioners, physician assistants, and students – and healthcare executives interested in expanding their scope of knowledge about currently popular health policy topics.
The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
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Due to popular demand, the Comprehensive Primary Care Plus (CPC+) team hosted a repeat of the webinar that was originally held on Wednesday, April 27, 2016. During this webinar Model team members provided an overview of the model specifically for interested payers.
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Mr James Downie, CEO, presented on the topic 'IHPA 2017 and beyond' at the Enhancing Performance & Efficiency in Paediatric Care - CHA Annual Benchmarking Forum, hosted by Children's Healthcare Australasia on 25 May 2017.
How to Achieve a PCMH Certification - Small Practice - Practice-centered medi...Donte Murphy
This is a PowerPoint presentation from Dr. Khan, Medical Director, MedPeds Medical Clinic. He has a small practice and is a certified PCMH. In this presentation he shares his strategy that led to his success. This is a powerful presentation for practices of all sizes, whether large or small. For more information, feel free to email us at: marketing@amazingcharts.com.
Healthcare Consumerism and Cost: Dispelling the Myth of Price TransparencyHealth Catalyst
The world of healthcare costs is confusing and messy for both patients and providers. Many providers don’t fully understand their costs and therefore struggle to meet the increasing pressure for greater price transparency for consumers. With price transparency rules finalized and implementation looming, many providers are racing against the clock to adapt business practices to meet regulations and communicate the implications to consumers. And each organization’s financial health depends on transparency, as uncertainty about costs keeps many patients from seeking care.
Deb Gordon, seasoned healthcare executive and author of the book, “The Health Care Consumer’s Manifesto: How to Get the Most for Your Money,” and Pat Rocap, Director of Cost Management Services at Health Catalyst, examine the relationship between cost and pricing as the path to transparency for consumers. Deb and Pat provide expert analysis and practical advice to help you become a savvier provider and consumer when it comes to healthcare pricing and spending.
- The implications of federal price transparency regulations.
- The connection between healthcare costing and pricing.
- How to start your organization’s journey to understand costs and why it matters.
- Why price transparency is important to both patients and providers.
The Medicare Advantage Value-Based Insurance Design (VBID) Model team at the Center for Medicare and Medicaid Innovation (CMMI) and national leaders participated in a discussion around pathways for addressing food and nutritional insecurity at webinar event of our Health Equity Incubation Program on Thursday, March 31, 2022, from 3:00-4:30 PM ET.
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The CMS Innovation Center hosted an office hours session on Tuesday, April 5, 2022 from 3:00-4:00 PM ET to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component. Attendees received an overview of the Model and the CY 2023 application process, and had an opportunity for questions and answers with the Model team.
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The ACO REACH Model Team will hosted a health equity webinar on Tuesday, April 5, 2022 from 4:00 - 5:00 p.m. EDT. The ACO REACH Model team highlighted Health Equity provisions added to the ACO REACH Model.
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This webinar focuses on the new financial policies featured in the ACO REACH webinar. For more information on the financial methodology for the ACO REACH Model that will be transitioned from the Global and Professional Direct Contracting (GPDC) Model, please refer to prior released financial webinars available on the GPDC Model webpage.
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During this webinar, a high-level overview of the ACO REACH Model was provided including information on the participation and eligibility requirements, Accountable Care Organization (ACO) types, payment mechanisms, and beneficiary alignment methodology.
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The CMS Innovation Center will host a webinar on Thursday, March 10, 2022 from 3:00-4:00 PM ET. During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2023 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component as well as the payment design related to the Hospice Benefit Component of the VBID Model. This session will also offer attendees an opportunity to ask follow-up questions.
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This webinar provided an overview of the Model and the Part D Sponsor application process, as well as included a Q&A session for interested Part D sponsors.
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The CMS Innovation Center hosted a webinar on Wednesday, March 2, 2022 at 3pm – 4pm ET, during which presenters shared updates on the Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model, the Kidney Care Choices (KCC) Model, and the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This event was available to the first 1,000 registrants. Presentation materials will be available on the respective model webpages following the session.
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The Medicare Advantage Value-Based Insurance Design (VBID) Model Team hosted an office hours session on Thursday February 3rd, 2022 on the Hospice Benefit Component to provide technical and operational support to interested stakeholders. During this office hours session, presenters answered questions submitted in advance to the VBID Mailbox and offered attendees an opportunity to ask additional questions.
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Has your organization prioritized addressing health inequities? How can a Center for Medicare and Medicaid Innovation (CMMI) Model factor into your organization’s health equity strategy? How can you structure your plan’s benefits to have the greatest impact on underserved communities? What partnership opportunities are available with CMMI?
These are important questions CMMI plans to answer in a new webinar series focused on health equity! CMMI is sponsoring a series of webinars for current and potential Medicare Advantage Organization (MAO) participants in the Value-Based Insurance Design (VBID) Model.
The first webinar in the series provided an overview of the Model’s Health Equity Incubation Sessions effort, articulated a business case for MAOs to leverage VBID Model Components to address health inequities in their member populations, and provided specific guidance and clarification on the full extent of health equity focused flexibilities that fall under the Model’s waiver authority.
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CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
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The ET3 Model and Medicaid: Opportunities for Alignment webinar provided background on the ET3 Model, discussed the benefits for states of aligning coverage and payment policies with ET3, and explored considerations for states seeking to implement new Medicaid services that align with the ET3 Model. This webinar was intended for state Medicaid agencies, ET3 Model Participants, and other stakeholders interested in learning more about optional Medicaid alignment with the ET3 Model.
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CMS announced an Office Hour event for potential applicants to ask questions ahead of the PCF application deadline.
The PCF Model Team was available to answer questions on key topics including eligibility, payment design and attribution, and more.
You may also refer to the materials from the two PCF webinars held in March: Introduction to PCF and Ready, Set, Apply.
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In order to help ETC Model Participants prepare for the ETC Model, CMS conducted an introductory webinar on Wednesday, December 9, 2020 from 1 p.m. to 2 p.m. The webinar provided an overview of the ETC Model, including:
Participant selection
The Home Dialysis Payment Adjustment
The Performance Payment Adjustment
The ETC Model timeline, including the timing of payment adjustments
Information about how to communicate with CMS about the ETC Model
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The Value-Based Insurance Design (VBID) Model team hosted a webinar on January 28, 2021 from 4:00-5:00 PM EST. During this webinar, presenters provided a brief review of the recently released Calendar Year (CY) 2022 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component. This session also offered attendees an opportunity to ask follow-up questions.
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The Medicare Advantage Value-Based Insurance Design (VBID) Model team hosted a webinar on Wednesday, March 17, 2021 from 4:00 - 5:00 PM EDT. During this webinar, presenters provided a preview of the Calendar Year 2022 payment design related to the Hospice Benefit Component of the VBID Model. The session also offered attendees an opportunity to ask follow-up questions.
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The Part D Senior Savings Model and Part D Payment Modernization Model teams hosted a webinar on Tuesday, March 23, 2021 from 1:00 to 2:00 PM EDT. During this webinar, presenters provided an overview of the two Models and the Calendar Year (CY) 2022 application process. The session also offered attendees an opportunity to ask follow-up questions.
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CMS hosted a virtual office hour session on April 13, 2021 from 4:00-5:00 PM EDT. During this office hour, presenters provided a review of the Calendar Year 2022 payment design and payment rates related to the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model. This session also offered attendees an opportunity to ask follow-up questions.
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The Emergency Triage, Treat, and Transport (ET3) Model Medical Triage Line Notice of Funding Opportunity (NOFO) webinar provided an overview of the application process and NOFO requirements for implementing 911 medical triage lines. This webinar was intended for those interested in learning more about the ET3 Model’s Notice of Funding Opportunity, which was released March 12.
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The Primary Care First Model (PCF) Options team provided an overview of the PCF payer partnership. Participants were able to learn about current PCF Model participants, benefits to payer partnership, the framework against which payer proposal alignment will be evaluated, and the payer solicitation process and timeline.
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More from Centers for Medicare & Medicaid Services (CMS) (20)
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Couples presenting to the infertility clinic- Do they really have infertility...
Webinar: Health Care Innovation Awards Round Two - Overview of Categories One and Two
1. Health Care Innovation Awards
Overview of Innovation
Categories One and Two
June 12, 2013
2. Agenda
• Introduction
• Innovation Category 1: Rapidly reduce Medicare,
Medicaid and/or CHIP costs in outpatient and/or
post-acute settings
• Innovation Category 2: Improve care for populations
with specialized needs
• Upcoming Webinar Series and Next Steps
2
3. The CMS Innovation Center
Identify, Test, Evaluate, Scale
“The purpose of the Center is to test innovative
payment and service delivery models to reduce
program expenditures under Medicare, Medicaid
and CHIP…while preserving or enhancing the quality
of care.
—The Affordable Care Act
3
4. Innovation Awards Round Two Goals
Engage innovators from the field to:
• Identify new payment and service delivery models
that result in better care and lower costs for
Medicare, Medicaid and CHIP beneficiaries
• Test models in Four Innovation Categories
• Develop a clear pathway to new Medicare, Medicaid
and Children’s Health Insurance Program (CHIP)
payment models
4
5. Measuring Success
• BETTER HEALTH
Improved overall health outcomes
• BETTER HEALTH CARE
• LOWER COSTS THROUGH IMPROVED QUALITY
Reduced total cost of care for Medicare, Medicaid and
CHIP beneficiaries
5
6. Four Innovation Categories
1. Rapidly reduce Medicare, Medicaid and/or CHIP costs
in outpatient and/or post-acute settings
2. Improve care for populations with specialized needs
3. Transform the financial and clinical models of
specific types of providers and suppliers
4. Improve the health of populations through better
prevention efforts
6
7. Today’s Webinar
Focus on Innovation Categories 1 and 2:
• Category 1: Rapidly reduce Medicare, Medicaid and/or CHIP costs in
outpatient and/or post-acute settings
• Category 2: Improve care for populations with specialized needs
Please keep in mind:
• Examples described in today’s webinar are illustrative only, and not
intended to convey a preference or preferred approach
• Applicants will identify a primary innovation category in which to be
considered
• Applicants must propose a payment model to support the proposed
service delivery model
7
8. Agenda
• Introduction
• Innovation Category 1: Rapidly reduce Medicare,
Medicaid and/or CHIP costs in outpatient and/or
post-acute settings
• Innovation Category 2: Improve care for populations
with specialized needs
• Upcoming Webinar Series and Next Steps
8
9. Category 1: Rapidly reduce costs in
outpatient and/or post-acute settings
Priority Areas
• Diagnostic services
• Outpatient radiology
• High-cost physician-administered drugs
• Home-based services
• Therapeutic services
• Post-acute services
CMS will consider submissions in other outpatient
and/or post-acute areas within this Category
9
10. Why these areas?
Growth in spending
Outpatient spending is larger than and growing much more rapidly than
inpatient spending
Geographic variation
Post-acute spending is the biggest contributor to geographic spending
variation
Untapped opportunities
To balance our portfolio, which is well-developed in inpatient settings
Source: CMS claims data 10
11. 2011 Medicare costs by category (billions)
Part A, $189
Part B, $164
MA: Part A, $70
MA: Part B, $63
Part D, $69
Medicare
Advantage
Medicare
FFS
Part D
Source: CMS claims data 11
12. Inpatient hospital PBPM costs growing
slower compared to post-acute
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
$500
2005 2006 2007 2008 2009 2010 2011
Part A: Hospice
Part A: Home Health
Part A: Skilled Nursing
Part A: Inpatient Hospital
~$356 ~$360
~$388 ~$405
~$429 ~$432 ~$441
Source: CMS claims data 12
13. Part B PBPM costs continue to grow
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
2005 2006 2007 2008 2009 2010 2011
Part B: Lab
Part B: Other Intermediary
Part B: Home Health
Part B: Outpatient Hospital
Part B: Other Carrier
Part B: Durable Medical Equipment
Part B: Physician Services
~$328 ~$324 ~$337
~$364
~$381
~$286
~$301
Source: CMS claims data 13
14. From 2008 to 2012, outpatient and post-
acute services increased most rapidly
14%
5%
15%
42%
17%
31%
8%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Total Inpt Hospital SNF Outpt
Hospital
Phys
Services
Hospice Home
Health
Total Trend
Source: CMS claims data
14
15. Medicare spending varies widely across
the country
Geographic Variation in Spending, MS-DRG 291 Heart Failure and Shock with Major
Complications
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
Ridgewood, NJ Hudson, FL Lancaster, PA Raleigh, NC Owensboro, KY
All Other
Outpatient
Physician
Readmissions
Post-Acute
Inpatient
~$26,815
~$20, 727 ~$17,993
~$15,279 ~$12,713
atio to
.S. Average
1.49 1.15 1.00 0.85 0.71
R
U
Source: CMS Office of Information Products and Data Analytics, Medicare Claims Analysis - 2010
15
16. Variation in post-acute spending
is even greater
Geographic Variation in Spending on Post-Acute Care, MS-DRG 291 Heart Failure and
Shock with Major Complications
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
Ridgewood, NJ Hudson, FL Lancaster, PA Raleigh, NC Owensboro, KY
Therapy
LTC Hospital
Inpatient Rehab.
Home Health
Skilled Nursing
~$7,956
~$5,379
~$2,368
~$4,769
~$2,336
Ratio to
U.S. Average
2.02 1.37 1.21 0.60 0.59
Source: CMS Office of Information Products and Data Analytics, Medicare Claims Analysis - 2010 16
17. Outpatient and post-acute settings
Definitions
Outpatient settings
• Outpatient settings may include hospital outpatient care
• Most of identified priority areas are outpatient
Post-acute settings
• Post-acute services may be outpatient or inpatient
oHome health agencies
o Inpatient rehabilitation facilities
o Skilled nursing facilities
oLong term care hospitals
17
18. Diagnostic Services and Outpatient
Radiology
Examples
• Radiology and other imaging
• EKGs, cardiac monitoring, and laboratory
Examples of Settings
• Hospital Outpatient
• Ambulatory Surgical Centers
• Physician Office and SNF Outpatients
• Independent Diagnostic Testing Facilities
Some Payment and Service Delivery Issues
• Appropriate use, duplication, overlap, roles of multiple parties (ordering
physician, technical service provider, professional interpretation)
• Shared decision support and Clinical Decision Support for clinicians
18
19. Physician Administered Drugs
Examples
• Injectable drugs used in the physician office setting, e.g.: Chemotherapy,
Rheumatology, Ophthalmology
• Vaccines: Hepatitis B; Pneumococcal and Influenza Vaccines
• Erythrocyte Stimulating Agents
Examples of Settings (outpatient)
• Physician offices, pharmacies, durable medical equipment suppliers
• Hospital outpatient departments, ambulatory surgical centers
• Outpatient SNF
• Home health agencies: only certain vaccines covered under Medicare
Some Payment and Service Delivery Issues
• Drug pricing; administration fees
19
20. Agenda
• Introduction
• Innovation Category 1: Rapidly reduce Medicare,
Medicaid and/or CHIP costs in outpatient and/or post-
acute settings
• Innovation Category 2: Improve care for populations
with specialized needs
• Upcoming Webinar Series and Next Steps
23
21. Home-Based Services
Examples
• Home health care
• Home and community-based services
Examples of Settings
• Patient homes
Some Service delivery and payment issues
• Payment tied to therapy utilization
• Home Health Prospective Payment System augments payments for more
therapy visits reaching certain thresholds
• Home Health Agencies may focus on therapy payment incentives
20
22. Post-Acute Services
Examples
• Rehabilitation services and therapy
• Prolonged ventilator support
Examples of Settings
• Skilled Nursing Facility, Inpatient Rehabilitation Facilities, Home Health
Agencies, Long Term Acute Care Hospitals
Some Service Delivery and Payment Issues
• Same patient, different payments
o By setting
o By lengths of stay and therapy use
• Avoidable Hospital Readmissions
• Poor care coordination
• Geographic variations in PAC spending drive payment variations nationally
• Shared decision making and clinical decision support
21
23. 2: Improve care for populations with specialized needs
Priority Areas
• Pediatric populations requiring high-cost services
• Persons with Alzheimer’s disease
• Persons living with HIV/AIDS
• Children at high risk for dental disease
• Children in foster care
• Adolescents in crisis
• Persons requiring long-term services and supports
• Persons with serious behavioral health needs
CMS will consider submissions that improve care for other
populations with specialized needs
24
24. Therapeutic Outpatient Services
Examples
• Surgical and other procedural care
• Physical Therapy, Occupational Therapy, Speech and Language Pathology
Examples of Settings
• Hospital outpatient
• Ambulatory Surgical Centers
• Physician Office
Some Service Delivery and Payment Issues
• Large relative expenditure growth outpatient compared to inpatient care
• Medicare Ambulatory Payment Classifications not diagnosis based in
contrast to inpatient DRGs
• Payment for services, not for outcomes and efficiency
• Off-campus provider based services
22
25. Why these areas?
High Unmet Need
There are significant opportunities to improve care
Growth in spending
Costs for populations with complex care needs are increasing
Delivery System Change
Significant amount of policy work to integrate care models and
payment models
Portfolio Expansion
Create new model tests to cover these patient populations
25
26. Pediatric populations requiring high-cost services
Description of Population
• Includes children with multiple medical conditions, behavioral health issues,
congenital disease, chronic respiratory disease, and complex social issues
• Medicaid and CHIP pay for half of all pediatric ambulatory care visits and inpatient
care for children 1
Examples of Cost Drivers
• Lack of integration of care across settings, social determinants of health
• Inappropriate use of specialists to provide primary care services
• Fragmentation of services provided by physical and occupational therapists,
developmental psychologists
Examples of Opportunities
• Includes improving early screening, assessment and diagnosis; increasing compliance
to care plans; coordination of community settings; slowing progression of chronic
illness; and reducing avoidable services including hospitalizations and readmissions
261 http://hcupnet.ahrq.gov/
27. Persons with Alzheimer’s disease
Description of Population
• Five million people, onset of the disease normally occurring after age 60
o 13 percent of men and women aged 65 and over have Alzheimer’s disease1
• Groups unequally challenged by Alzheimer’s disease: racial and ethnic minorities,
people with intellectual disabilities, and people with young onset of the disease
Examples of Cost Drivers
• Care not always provided in settings best for beneficiaries, including home and
community based care vs. institutional care
• Breadth of providers providing duplicative services
Examples of Opportunities
• Implementing new models of dementia-capable service delivery focusing on
identifying those with the disease, specialized dementia care, care coordination
and/or caregiver support
27
Source: 2012 Alzheimer’s Facts and Figures, Alzheimer’s Association, 2012
28. Persons living with HIV/AIDS
Description of Population
• Nearly half of the people with HIV/AIDS that are estimated to be in regular care are
covered under Medicaid
• Many people living with HIV/AIDS historically have inadequate access to care
Examples of Cost Drivers
• Uncoordinated care, behavioral health integration, unmet need for other social
supports
Examples of Opportunities
• Improve early screening, diagnosis and treatment
• Improve care coordination service with social support services
• Improve efforts to link and retain patients in care
• Improve medication adherence that addresses drug resistance issues
28
29. Children at high risk for dental disease
Description of Population
• Medicaid and CHIP beneficiaries identified as high risk through risk assessment
tools
Examples of Cost Drivers
• Emergency department visits, surgery in operating room, over-utilized restorative
services
Examples of Opportunities
• Risk-based intensive prevention and chronic disease management approach to
childhood caries that leads to less oral disease, fewer surgical interventions, and
lower per capita costs
29
30. TRAUMA HAS A DISTINCT IMPACT ON THE HEALTH AND
DEVELOPMENT OF CHILDREN
Symptoms of Child Trauma that Overlap with Symptoms of Mental Illness
Mental Illness Overlapping Symptoms Trauma
Attention Deficit/Hyperactivity
Disorder
Restless, hyperactive, disorganized, and/or agitated
activity; difficulty sleeping, poor concentration, and
hypervigilant motor activity
Child Trauma
Oppositional Defiant
Disorder/Conduct Disorder
A predominance of angry outbursts and irritability Child Trauma
Anxiety Disorder (incl. Social
Anxiety, Obsessive-Compulsive
Disorder, Generalized Anxiety
Disorder, or phobia)
Avoidance of feared stimuli, physiologic and
psychological hyperarousal upon exposure to
feared stimuli, sleep problems, hypervigilance, and
increased startle reaction
Child Trauma
Major Depressive Disorder
Self-injurious behaviors as avoidant coping with
trauma reminders, social withdrawal, affective
numbing, and/or sleeping difficulties
Child Trauma
Griffin, McClelland, Holzberg, Stolbach, Maj, & Kisiel , 2012
33
31. Children in Foster Care and Adolescents in
Crisis
Bryan Samuels, MPP
Commissioner
Administration on Children, Youth and Families
30
32. Opportunities to Innovate for Improved
Outcomes for Vulnerable Children and
Youth
BRYAN SAMUELS, COMMISSIONER
ADMINISTRATION FOR CHILDREN, YOUTH, AND FAMILIES
31
33. RATES OF MALTREATMENT AMONG
AT-RISK YOUTH ACROSS SYSTEMS
Any
Maltreatment
Multiple Types
of
Maltreatment
Child Welfare 85% 68%
Substance
Abuse
Treatment
86% 64%
Mental Health 75% 54%
Juvenile Justice 78% 57%
Miller et al., 2012
34
34. CHILDREN KNOWN TO CHILD WELFARE
HAVE COMPLEX HEALTH CARE NEEDS
• The behavioral and physical health of children who have been maltreated
are inextricably linked.
• 22.7% of children known to child welfare have at least one chronic health
condition (AIDS, asthma, autism, Down syndrome, developmental delay,
diabetes, cystic fibrosis, cerebral palsy, or muscular dystrophy).
• Among children who use any mental health service, the prevalence of
chronic health conditions is much higher:
Children using mental health services who ALSO have a chronic health
condition, by age group
1.5-2 Years <2-5 Years 6-10 Years 11-15 Years 16+ Years
4.1% 38.9% 53.6% 44.9% 31.6%
Horwitz, et al., 2012
32
35. PSYCHOTROPIC MEDICATION USE AMONG CHILDREN
KNOWN TO CHILD WELFARE AND IN FOSTER CARE
Psychotropic Use and Polypharmacy among Children Known to Child Welfare, by
Age Group
AGE GROUP
Any Psychotropic
Medication
One Psychotropic
Medication
as % of Any
Two or More
Psychotropic
Medications
as % of Any
1.5-5 Years Old 1.5% 1.0% 0.5%
6-11 Years Old 19.6% 11.6% 8.0%
12-17 Years Old 16.0% 7.9% 8.1%
Ringeisen, Casanueva, Smith & Dolan, 2011
• Children known to child welfare are three times more likely to use psychotropic
medications than Medicaid child enrollees without apparent child welfare
involvement (Raghavan et al., 2012).
• There is significant geographic variation in rates of psychotropic medication use
among children in foster care, ranging from less than 1% to 22% in 2008, with a
median of 13% (Rubin et al., 2012).
35
36. FOSTER CHILDREN INCUR SIGNIFICANT COSTS
TO MEDICAID
• Children in foster care account for 38% of total Medicaid
expenditures (physical health and behavioral health) for children
(Allen, 2013).
• On average states spend three times more for this population than
for nondisabled children in Medicaid — approximately $4,336 for
children in child welfare versus $1,315 for the general child
population without disabilities (Geen, Sommers & Cohen, 2005).
• It is estimated that children known to child welfare incur
approximately $1,482 in costs for psychotropic medications – 50%
to 75% more than non-foster care Medicaid child enrollees
(Raghavan et al, 2012).
36
37. IMPROVED OUTCOMES FOR
CHILDREN IN FOSTER CARE
• Reduced trauma symptoms and improved functioning across physical, social-
emotional, cognitive, and developmental domains
• Reduction in use of acute services, including ER visits and inpatient
hospitalization
• Reduction in unnecessary physical exams, immunizations, and routine labs
• Reduction in the use of residential care
• Reduction in use of psychotropic medications and prescribing practices that do
not conform to best practice guidelines
• Increased use of evidence-based/evidence-informed, trauma-informed,
screening, assessment, and psychosocial interventions as first-line treatments
for behavioral health needs
37
38. USING DATA TO DRIVE INNOVATION
• Address complex clinical needs by integrating
physical and behavioral health
• Leverage EPSDT to provide validated trauma-
informed screening and assessment
• Intervene effectively by implementing
evidence-based psychosocial interventions
• Improve quality by using standard measures
• Share information across child-serving systems
38
39. Long-Term Supports and Services
Mimi Toomey
Director, Office of Policy Analysis and
Development
Center for Disability and Aging Policy
Administration for Community Living
39
40. What Are Long-Term Services and
Supports (LTSS)?
• LTSS help older adults and people with disabilities accomplish everyday
tasks
• Persons requiring LTSS:
o Medicaid is the largest payer of LTSS but not the only payer
o More states are rethinking their delivery systems under Medicaid LTSS
for services including Medicaid Managed Care
LTSS are directly related to health and health outcomes
o Greater volume of attendant care, homemaking services and home-
delivered meals is associated with lower risk of hospital admissions
o Increased spending on home-delivered meals was associated with
fewer residents in nursing homes with low-care needs
•
40
42. Opportunities for LTSS
• Better integration of the health care systems with families
and community supports systems through:
o Support infrastructure and coordination of the LTSS system
o Building a common language between the health and the LTSS
systems
o Packaging services and supports for the highest impact
o Health information technology (HIT) opportunities
o Promoting self direction and person-centered planning
o Creating a gateway for employment
o Quality/Evidence Based
o Paying more attention to individual preference for their
settings that are home and community based
45
43. LTSS Systems: Networks of Partners and Services
Partnerships
• Hospitals for discharge planning
• Home Care Agencies
• Community Health Centers
• Transportation
• Public Health Departments
• Assisted Living/Nursing Facilities
• Social Security
• Medicaid
• HUD Public Housing
• Alzheimer’s Associations
• Senior Centers
• Volunteer Groups
• Home delivered meals providers
• Area Agencies on Aging
Services
• Care Transitions
• Chronic Disease Self-Management
• Information & Referral
• Adult Day Care
• Respite Care
• Home Delivered Meals
• Congregate Meals
• Grocery shopping/meal preparation
• Personal Care/Attendants—Assistance
with ADL/IADL
• Socialization/Senior Centers
• Benefits Counseling
• Transportation
42
44. Referrals to Long Term Services and Supports During Transitions
(n=739 participants and 2,129 referrals)
Personal care/
homemaker/
choremaker services
19%
Home Delivered
Meals
15%
Transportation
15%
Nutrition Services
or Counseling
14%
Falls Management
and Prevention
13%
Other Services
and Supports
11%
Caregiver Support
5%
Mental Health and
Substance Misuse
3%
Exercise Program
2%
Alzheimer’s
Programs
2%
CDSMP
1%
DSMP Home Injury/Risk
Screenings
Data Source: ADRC Semi-Annual Report April – September 2012 43
45. Persons with serious behavioral health needs
Suzanne Fields, MSW, LICSW
Senior Advisor on Health Care Financing
Substance Abuse and Mental Health Services
Administration
46
46. High-Risk Medicare Beneficiaries without Medicaid Look Like Those
with Medicaid Except Their High Health Costs Put Them on a
Slippery Slope to Medicaid Spend Down
44
PBPY PBPY
PBPY PBPY
PBPY
PBPY
Data source: 2006 Medicare Current Beneficiary Survey Cost and Use File
47. 6/19/201347
ADULTS
• Over 2/3 of adults with serious mental illness have comorbid
physical health conditions such as diabetes, heart disease and
chronic obstructive pulmonary disease
• Adults aged 18 or older with any mental illness or major
depressive episode in the past year were more likely than to have
high blood pressure, asthma, diabetes, heart disease, and stroke
• Those with mental illness were more likely to use an emergency
room and to be hospitalized
*SAMHSA NSDUH Report, “Physical Health Conditions among Adults with
Mental Illnesses,” 4/5/12
49. ADULTS
Past Year Emergency Room Use and Past Year
Hospitalization among Persons Aged 18 or Older with and
without Serious Mental Illness in the Past Year: 2008 and
2009
49
6/19/2013
51. 6/19/201351
CHILDREN & YOUTH
• Around 1 in 5 young people have a mental, emotional, or behavioral health
disorder, at an estimated annual cost of $247 billion
• About 1 in 4 pediatric primary care office visits involve behavioral and
mental health problems
• About 1 in 3 Medicaid-enrolled children who use behavioral health care
have serious medical conditions (primarily asthma)
• In contrast to adults with SPMI and chronic physical conditions (COPD,
diabetes, etc.) Medicaid expenditures for children with co-morbid
conditions are driven primarily by behavioral health
• Integrated care strategies for children differ from those for adults in a
number of important ways, including duration, diagnoses, provisions for
consent, involvement of families in peer services, increased staffing ratios
for care coordination, etc.
51
52. 6/19/201352
OPPORTUNITIES
• Implement new financing models for integrated care for
individuals with serious behavioral health needs
• Support new service delivery models for coordinating and
integrating physical and behavioral health treatments and
services, with a focus on broader social and educational
supports
• Support new service delivery models that address the
primary care and behavioral health treatment needs for
individuals with substance use disorders
• Create person/family-centered systems of care that
improve outcomes, services, and value
• The use of data and the inclusion of functional outcomes
52
53. Agenda
• Introduction
• Innovation Category 1: Rapidly reduce Medicare,
Medicaid and/or CHIP costs in outpatient and/or post-
acute settings
• Innovation Category 2: Improve care for populations
with specialized needs
• Upcoming Webinar Series and Next Steps
53
54. Upcoming Webinars
June 18, 2013:
• Webinar 3: Overview of Innovation
Category 3–4
Webinar 4: Achieving Lower Costs Through
Improvement; Cost Categories and the Financial
Plan; Submitting a Letter of Intent
• Demonstrating how applicants can
achieve lower costs through
improvement
• Describing the cost categories and
completing the Financial Plan
• Technical assistance for LOI submission
Webinar 5: Performance Measures/Developing an
Operational Plan
• Driver Diagrams/Theory of Change
• Demonstrating measurable impact on
Better Health and Better Care
• Rapid cycle improvement
Webinar 6: Payment Models
• What is a Payment Model?
• What makes a Payment Model “Fully
Developed”?
• What is a sustainable Payment Model?
Webinar 7: Application Narrative and Road Map
• Application Narrative
• Awardee Selection Process & Criteria
• Helpful Hints
Webinar 8: Technical Assistance for Submitting an
Application
Slides, transcripts and audio will be posted at
http://innovation.cms.gov
54
55. Next Steps
• Letters of Intent (LOI) are due June 28, 2013
o LOI is available online in a web-based form through the Innovation
Awards website.
• Additional information regarding the Innovation Awards
will be posted on http://innovation.cms.gov
• Register for your DUNS number
http://www.dunandbradstreet.com … ASAP
• Register in the System for Award Management (SAM) at:
https://www.sam.gov/portal/public/SAM/
• More Questions? Please Email
InnovationAwards@cms.hhs.gov
55