This document provides a summary of Virginia's Medicaid program and the status of health care reform efforts in the state. It outlines Virginia's Medicaid eligibility levels, enrollment trends, expenditures, and service delivery structure. It then discusses the state's goals for Medicaid reform, including implementing the Affordable Care Act expansion and establishing a more efficient, coordinated system. The document reviews the progress and estimated savings of Virginia's multi-phase Medicaid reform plan, including initiatives involving the dual eligible population, program integrity, and behavioral health services.
Carisa Magee, Manager, Medicaid/CHIP Program Policy Texas Health and Human Services Commission, presented an overview of Medicaid at the "Designing Healthcare in Texas" conference hosted by One Voice Texas, Harris County Healthcare Alliance and Kinder Institute on June 3, 2014.
This document discusses managed care plans and integrated delivery systems. It defines managed care and explains the origins and characteristics of managed care plans, including their use of tools like primary care physicians, guidelines, utilization review, and financial incentives to manage costs and quality. The document also describes different types of managed care plans along a continuum and their use in government programs. Finally, it defines integrated delivery systems and types of system integration and consolidation in healthcare.
This document provides an overview of the Community Health Access and Rural Transformation (CHART) Model, which tests whether aligned financial incentives, operational flexibility, and technical support can help rural healthcare providers transform care delivery and achieve goals like improved access, quality, and financial sustainability. The webinar agenda includes introductions, discussing rural healthcare challenges, the CHART Model goals and design, timeline and next steps, and a question and answer session. The CHART Model has two participation tracks - the Community Transformation Track provides upfront funding and payments to communities that implement care redesign strategies, while the ACO Transformation Track provides advance shared savings payments to encourage Accountable Care Organizations (ACOs) to participate in risk-bearing models.
Virginia AFP's lobbyist Hunter Jamerson's presentation from the 2013 SLC on the unique Medicaid reform approach being followed in the state of Virginia.
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.
- - -
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
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.
- - -
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 Accountable Health Communities Model team hosted a webinar to provide an overview of the new funding opportunity and application requirements for Track 1 on Wednesday, September 14, 2016 from 2:00p.m. – 3:00p.m. EDT.
- - -
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 document provides a summary of Virginia's Medicaid program and the status of health care reform efforts in the state. It outlines Virginia's Medicaid eligibility levels, enrollment trends, expenditures, and service delivery structure. It then discusses the state's goals for Medicaid reform, including implementing the Affordable Care Act expansion and establishing a more efficient, coordinated system. The document reviews the progress and estimated savings of Virginia's multi-phase Medicaid reform plan, including initiatives involving the dual eligible population, program integrity, and behavioral health services.
Carisa Magee, Manager, Medicaid/CHIP Program Policy Texas Health and Human Services Commission, presented an overview of Medicaid at the "Designing Healthcare in Texas" conference hosted by One Voice Texas, Harris County Healthcare Alliance and Kinder Institute on June 3, 2014.
This document discusses managed care plans and integrated delivery systems. It defines managed care and explains the origins and characteristics of managed care plans, including their use of tools like primary care physicians, guidelines, utilization review, and financial incentives to manage costs and quality. The document also describes different types of managed care plans along a continuum and their use in government programs. Finally, it defines integrated delivery systems and types of system integration and consolidation in healthcare.
This document provides an overview of the Community Health Access and Rural Transformation (CHART) Model, which tests whether aligned financial incentives, operational flexibility, and technical support can help rural healthcare providers transform care delivery and achieve goals like improved access, quality, and financial sustainability. The webinar agenda includes introductions, discussing rural healthcare challenges, the CHART Model goals and design, timeline and next steps, and a question and answer session. The CHART Model has two participation tracks - the Community Transformation Track provides upfront funding and payments to communities that implement care redesign strategies, while the ACO Transformation Track provides advance shared savings payments to encourage Accountable Care Organizations (ACOs) to participate in risk-bearing models.
Virginia AFP's lobbyist Hunter Jamerson's presentation from the 2013 SLC on the unique Medicaid reform approach being followed in the state of Virginia.
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.
- - -
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
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.
- - -
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 Accountable Health Communities Model team hosted a webinar to provide an overview of the new funding opportunity and application requirements for Track 1 on Wednesday, September 14, 2016 from 2:00p.m. – 3:00p.m. EDT.
- - -
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 Centers for Medicare and Medicaid Services (CMS) State Innovation Models Initiative provides funding to support states in developing and testing innovative healthcare payment and service delivery models. States can apply for one of two types of awards - planning grants of $1-3 million to support model design or testing grants of $20-60 million over 3 years to implement models. The goal is to engage multiple payers and stakeholders to transform healthcare delivery from a volume-based system to one that rewards better health outcomes at lower cost. States must demonstrate how their models will achieve improved health, care experience and affordability through payment and delivery system reform.
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
- - -
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 Model team presented a webinar discussing the CY2020 application cycle on Friday, January 25 from 4:00 p.m. to 5:00 p.m. EST.
- - -
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 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.
- - -
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 Model and Part D Payment Modernization Model teams provided a deep dive webinar of the two models on Thursday, February 28 from 3:00 p.m. to 4:00 p.m. EST.
- - -
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 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
- - -
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
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
This document discusses potential data sources for collecting baseline data before implementing a public health intervention program. It describes how baseline data is collected before a program begins to later compare outcomes. Sources discussed include birth certificates, CDC databases, state vital records, local health departments, hospitals, Medicaid programs, March of Dimes, and several CDC surveillance systems. The document provides examples of the type of baseline data that could be collected and considerations for selecting a data source.
This document summarizes information from a webinar hosted by the Centers for Medicare and Medicaid Services (CMS) about the Strong Start initiative. The initiative has two main strategies: 1) reducing early elective deliveries before 39 weeks through partnerships and an awareness campaign, and 2) testing enhanced prenatal care models through cooperative agreements to improve outcomes and lower costs for Medicaid-covered births. States, providers, managed care organizations, and conveners are eligible to apply. The webinar provided details on CMS's goals for the initiative and the roles and requirements for various partners, especially states.
This webinar is designed to ensure that all applicants to Models 2-4 of BPCI have a clear understanding of the three different roles an applicant must choose from when applying to this initiative. The applicant roles are linked to the applicant's partner types, as well as to how the applicant decides to partner with these Bundled Payment participating organizations.
More at: http://innovations.cms.gov/resources/Bundled-Payments-Applicant-Roles.html
- - -
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
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The document summarizes key aspects of Ohio's executive budget and Medicaid reform plan, which aims to address an $8 billion budget deficit. Some key points include: reducing funding to local governments and schools by over $2.2 billion, agency reductions of over $2.3 billion, and Medicaid savings of $4.3 billion through reforms to payment rates, eligibility, and care coordination programs. The reforms restructure Ohio's Medicaid program and shift its focus toward home and community-based care through initiatives like Accountable Care Organizations and integrated care delivery systems.
This document is a lecture on financing health care in the United States. It discusses how health insurance works by spreading risk over large pools of people. Insurers pay providers based on diagnosis and procedure codes, using contracted rates. The lecture describes the types of private health insurance like indemnity plans, Blue Cross/Blue Shield, and various managed care plans. It also discusses the roles of government programs like Medicare and Medicaid, as well as laws regulating private insurance such as ERISA, COBRA, HIPAA, and the Affordable Care Act.
Obama & Biden's health reform: ACCESSIBLE HEALTH COVERAGE FOR ALLWayne Wei
The document describes Barack Obama and Joe Biden's plan to lower healthcare costs and ensure affordable and accessible health coverage for all Americans. It outlines four main parts of the plan: 1) investing in electronic health records systems, 2) improving access to prevention and disease management programs, 3) lowering costs by addressing anticompetitive practices in the drug and insurance industries, and 4) reducing costs of catastrophic illnesses for employers and employees.
While at Good Shepherd Fairview Home my final project for my internship was to make a presentation to give to leadership about the Medicaid Redesign in New York State. I did research about Governor Cuomo and the Medicaid redesign team that he instated to redesign New York’s Medicaid program in January 2011 to ensure that it was sustainable. The main goal of the presentation was to inform the staff about how things will change when managed care organizations will be present.
Alliances between AMCs and Community HospitalsPYA, P.C.
PYA Principal Jeff Ellis spoke on alliances between academic medical centers (AMCs) and community hospitals April 16, 2015, at a Greater Kansas City Society of Healthcare Attorneys luncheon meeting.
Sustainable Growth Rate? Goodbye for Good!PYA, P.C.
PYA Staff Consultant Aaron Elias spoke to attendees of the Georgia Healthcare Financial Management Association’s (HFMA) Spring Institute May 6, 2015, on the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Larry Wolf, Kindred’s Health Information Technology Strategist, addressed the importance of information technology as one component for improving care at the Alliance for Home Health Quality and Innovation Symposium.
Privacy and Security: Challenges and Opportunities in Healthcare IdentityPaul Brian Contino
Paul Brian Contino
Corporate Chief Technology Officer
New York City Health & Hospitals Corporation
HIMSS14 Annual Conference & Exhibition, Orlando Florida
CLOSING KEYNOTE: Best Practices - Panel Of end Users
February 23, 2014 3:00-4:15pm
Financial, accounting and taxation services accuprosysAccuprosys
Accuprosys is equipped with a well experienced team of Chartered Accountants, Tax Consultants and Financial Advisors with specialized skills who can offer effective financial interventions to corporates, by strictly adhering to quality standards & industry practices. Through Accuprosys we provide wide range of services including Auditing and Assurance Services, Financial and Accounting services. Size doesn’t matter for us & every client is vital to us. We aim to serve you in the most effective manner.
The document discusses human resources transformation through outsourcing key functions like administration, payroll, and call centers. It provides examples of companies that have outsourced HR functions and the types of processes typically outsourced. The perceived benefits of outsourcing include cost reduction, accessing external expertise, and allowing HR to focus more on strategic activities. Critical success factors for outsourcing initiatives include performing a feasibility study, selecting the right vendor partner, and establishing strong governance during the transition and oversight.
The Centers for Medicare and Medicaid Services (CMS) State Innovation Models Initiative provides funding to support states in developing and testing innovative healthcare payment and service delivery models. States can apply for one of two types of awards - planning grants of $1-3 million to support model design or testing grants of $20-60 million over 3 years to implement models. The goal is to engage multiple payers and stakeholders to transform healthcare delivery from a volume-based system to one that rewards better health outcomes at lower cost. States must demonstrate how their models will achieve improved health, care experience and affordability through payment and delivery system reform.
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
- - -
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 Model team presented a webinar discussing the CY2020 application cycle on Friday, January 25 from 4:00 p.m. to 5:00 p.m. EST.
- - -
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 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.
- - -
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 Model and Part D Payment Modernization Model teams provided a deep dive webinar of the two models on Thursday, February 28 from 3:00 p.m. to 4:00 p.m. EST.
- - -
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 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
- - -
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
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
This document discusses potential data sources for collecting baseline data before implementing a public health intervention program. It describes how baseline data is collected before a program begins to later compare outcomes. Sources discussed include birth certificates, CDC databases, state vital records, local health departments, hospitals, Medicaid programs, March of Dimes, and several CDC surveillance systems. The document provides examples of the type of baseline data that could be collected and considerations for selecting a data source.
This document summarizes information from a webinar hosted by the Centers for Medicare and Medicaid Services (CMS) about the Strong Start initiative. The initiative has two main strategies: 1) reducing early elective deliveries before 39 weeks through partnerships and an awareness campaign, and 2) testing enhanced prenatal care models through cooperative agreements to improve outcomes and lower costs for Medicaid-covered births. States, providers, managed care organizations, and conveners are eligible to apply. The webinar provided details on CMS's goals for the initiative and the roles and requirements for various partners, especially states.
This webinar is designed to ensure that all applicants to Models 2-4 of BPCI have a clear understanding of the three different roles an applicant must choose from when applying to this initiative. The applicant roles are linked to the applicant's partner types, as well as to how the applicant decides to partner with these Bundled Payment participating organizations.
More at: http://innovations.cms.gov/resources/Bundled-Payments-Applicant-Roles.html
- - -
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
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The document summarizes key aspects of Ohio's executive budget and Medicaid reform plan, which aims to address an $8 billion budget deficit. Some key points include: reducing funding to local governments and schools by over $2.2 billion, agency reductions of over $2.3 billion, and Medicaid savings of $4.3 billion through reforms to payment rates, eligibility, and care coordination programs. The reforms restructure Ohio's Medicaid program and shift its focus toward home and community-based care through initiatives like Accountable Care Organizations and integrated care delivery systems.
This document is a lecture on financing health care in the United States. It discusses how health insurance works by spreading risk over large pools of people. Insurers pay providers based on diagnosis and procedure codes, using contracted rates. The lecture describes the types of private health insurance like indemnity plans, Blue Cross/Blue Shield, and various managed care plans. It also discusses the roles of government programs like Medicare and Medicaid, as well as laws regulating private insurance such as ERISA, COBRA, HIPAA, and the Affordable Care Act.
Obama & Biden's health reform: ACCESSIBLE HEALTH COVERAGE FOR ALLWayne Wei
The document describes Barack Obama and Joe Biden's plan to lower healthcare costs and ensure affordable and accessible health coverage for all Americans. It outlines four main parts of the plan: 1) investing in electronic health records systems, 2) improving access to prevention and disease management programs, 3) lowering costs by addressing anticompetitive practices in the drug and insurance industries, and 4) reducing costs of catastrophic illnesses for employers and employees.
While at Good Shepherd Fairview Home my final project for my internship was to make a presentation to give to leadership about the Medicaid Redesign in New York State. I did research about Governor Cuomo and the Medicaid redesign team that he instated to redesign New York’s Medicaid program in January 2011 to ensure that it was sustainable. The main goal of the presentation was to inform the staff about how things will change when managed care organizations will be present.
Alliances between AMCs and Community HospitalsPYA, P.C.
PYA Principal Jeff Ellis spoke on alliances between academic medical centers (AMCs) and community hospitals April 16, 2015, at a Greater Kansas City Society of Healthcare Attorneys luncheon meeting.
Sustainable Growth Rate? Goodbye for Good!PYA, P.C.
PYA Staff Consultant Aaron Elias spoke to attendees of the Georgia Healthcare Financial Management Association’s (HFMA) Spring Institute May 6, 2015, on the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Larry Wolf, Kindred’s Health Information Technology Strategist, addressed the importance of information technology as one component for improving care at the Alliance for Home Health Quality and Innovation Symposium.
Privacy and Security: Challenges and Opportunities in Healthcare IdentityPaul Brian Contino
Paul Brian Contino
Corporate Chief Technology Officer
New York City Health & Hospitals Corporation
HIMSS14 Annual Conference & Exhibition, Orlando Florida
CLOSING KEYNOTE: Best Practices - Panel Of end Users
February 23, 2014 3:00-4:15pm
Financial, accounting and taxation services accuprosysAccuprosys
Accuprosys is equipped with a well experienced team of Chartered Accountants, Tax Consultants and Financial Advisors with specialized skills who can offer effective financial interventions to corporates, by strictly adhering to quality standards & industry practices. Through Accuprosys we provide wide range of services including Auditing and Assurance Services, Financial and Accounting services. Size doesn’t matter for us & every client is vital to us. We aim to serve you in the most effective manner.
The document discusses human resources transformation through outsourcing key functions like administration, payroll, and call centers. It provides examples of companies that have outsourced HR functions and the types of processes typically outsourced. The perceived benefits of outsourcing include cost reduction, accessing external expertise, and allowing HR to focus more on strategic activities. Critical success factors for outsourcing initiatives include performing a feasibility study, selecting the right vendor partner, and establishing strong governance during the transition and oversight.
Human resources technology and service delivery trends in 2014Andrew Gumenniy
The document summarizes the key findings of a survey conducted by Information Services Group (ISG) on trends in human resources technology and service delivery in 2014. The survey found that improving the user experience was the top expected benefit of implementing new HR technologies like SaaS HCM solutions and new HR delivery models. Many companies plan to adopt technologies like SaaS, social/mobile, analytics and integrated talent management within the next two years to transform HR service delivery and improve the employee experience.
cleaHRsky is NGA HR's next generation HR-as-a-Service solution, featuring end-to-end HR administration, time, service delivery, payroll, talent management, and analytics, ready to run in 145+ countries.
Presentation held by Mr. Tamar Jinchveladze, Head of the Human Resources Department at the Ministry of Justice of Georgia, within the Regional Workshop on Georgia's anti-corruption and public service delivery reforms (22-24 September 2011).
The document discusses employee retention strategies and the manager's role in retention. It outlines objectives like identifying how retention strategies reduce turnover and how employees feel engaged. Retention strategies discussed include hiring the right people, empowering and valuing employees, feedback, recognition, and maintaining morale. Managers play a key role through creating a motivating environment, coaching, delegation, and focusing on employees' future careers. The overall goal of retention strategies is to keep desirable employees at an organization.
Chapter 16: Managing
Information
Chapter Objectives
• Appreciate the interconnected nature of
computerized devices in hospitals and other
organizations.
• Be able to define and explain the elements of an
electronic health record system.
• Appreciate the growing use of information systems
in support of public health activities.
• Understand that many health care providers and
members of the public do not share the same
enthusiasm for information systems that managers
have.
Outline
• Electronic Health Records
• Managing Public Health Information
• Managing Inventory
• Managing Human Resources
Definitions
• Health Information and Data
• Result Management
• Order Management
• Decision Support
• Electronic Communication and Connectivity
• Patient Support
• Administrative Processes
• Reporting
Health Information and Data
• Provide immediate access to information such
as individual diagnosis, medications, allergies,
and laboratory test results to improve the
ability or service to make sound clinical
decisions in a timely manner.
Result Management
• Provide access to new and past test results,
thus allowing all participating providers to
make more informed decisions about the
effectiveness of treatment regimens and
patient safety.
Order Management
• Ensure that providers have the ability to enter
and store orders for prescriptions, tests, and
other services. This capability is intended to
improve legibility, reduce duplication, and
allow orders to be completed in a timely
manner.
Decision Support
• Provide reminders, prompts, and alerts to
facilitate diagnoses and treatments by
improving compliance with best clinical
practices, promoting regular screenings and
other preventive practices, and identifying
possible drug interactions.
Electronic Communication and
Connectivity
• Promote secure, open, and readily accessible
channels of communication among providers
and patients to improve the continuity of care,
increase the timeliness of diagnoses and
treatments, and reduce the frequency of
adverse events.
Patient Support
• Provide tools that give individuals access to
their health records, provide interactive
education on relevant health topics, and
protocols to help people conduct home-
monitoring and self-testing activities to
improve control of chronic conditions such as
diabetes and hypertension.
Administrative Processes
• Include computerized administrative tools,
such as scheduling and record-keeping
systems; such equipment should greatly
improve the efficiency and performance of
hospitals and clinics, allowing them to provide
more timely services to patients and other
clientele.
Reporting
• Provide sufficient supportive equipment
(software, hardware, and memory capacity)
that meets uniform data standards and
enables health care organizations to respond
more quickly to federal, state, and private
reporting requirements, including those .
Chapter 1: Context of Health Care Financial ManagementNada G.Youssef
This document discusses key topics in health care financial management including lowering costs, goals of the health care system, and changing methods of financing and delivery. It outlines reforms under the Affordable Care Act to expand access through insurance marketplaces and Medicaid expansion while controlling costs through value-based purchasing. It also covers trends like the rise of the uninsured and accountable care organizations, as well as factors affecting the cost of care and impacts to provider reimbursement models.
This document summarizes a webinar about a Centers for Medicare and Medicaid Services initiative called Strong Start that has two strategies: reducing early elective deliveries and delivering enhanced prenatal care. It provides information on funding opportunities for applicants to test models of enhanced prenatal care for Medicaid beneficiaries, including three approaches: Centering/group care, care at birth centers, or care at maternity homes. Key details are provided on eligibility, required number of beneficiaries, total funding, budget requirements, and next steps.
The Strong Start initiative is an initiative to reduce preterm births and early elective deliveries while improving outcomes for newborns and pregnant women.
Under this initiative, the Innovation Center will award up to $43 million through a competitive process to providers, States, managed care plans, and conveners to achieve better care, improved health, and lower costs for these women and their newborns.
CMS Innovation Center and Center for Medicaid and CHIP Services staff will be hosting a webinar that will discuss how applicants can prepare their budget for the Strong Start Medicaid funding opportunity.
More at: http://innovations.cms.gov/resources/Duals_rahnfr_apply.html
- - -
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
William Shrank: Payment reform activities at CMSNuffield Trust
The document discusses activities at the CMS Innovation Center to test new payment and service delivery models. It outlines several initiatives to improve care coordination, such as ACO models and medical home programs. It also discusses initiatives to improve care quality like Partnership for Patients and reduce costs through bundled payments. Rapid-cycle evaluation is highlighted as important to provide feedback to support continuous quality improvement and identify successful models to scale nationally.
This document summarizes Virginia's efforts to reform its Medicaid program and debates around expanding Medicaid eligibility. It outlines Virginia's 3-phase reform process, including integrating behavioral health and long-term care services. It also reviews expansion proposals in other states and debates in Virginia, including concerns about long-term federal funding and provider capacity. Family physicians are asked to consider how Medicaid expansion may impact their practices and whether the existing program needs changes first.
Implementing the Affordable Care Act: Redesigning and Coordinating Eligibilit...NASHP HealthPolicy
The document discusses the challenges states will face in implementing the Affordable Care Act's requirements for coordinating eligibility and enrollment across Medicaid, CHIP, and health insurance exchanges. It notes that Kansas' current eligibility system is outdated and unable to handle the increased load. Kansas plans to use an HRSA grant to build a new integrated online eligibility system that can determine eligibility for Medicaid, subsidies, and private plans in real time. However, many questions around coordination and operational details between state and federal agencies remain unanswered as deadlines approach.
How do medicaid waivers expand the possibilities of whole person care 032117Jennifer D.
This document discusses how Medicaid waivers can expand whole-person care approaches. It provides examples of whole-person care pilots in California and Minnesota that integrate services across medical, behavioral health, and social services. These pilots aim to improve outcomes, patient experience, and lower costs. The document also discusses how care coordination platforms can help overcome challenges of data sharing, privacy, and interoperability across different provider types to better coordinate whole-person care.
In this August 15, 2012 webinar CMS Innovation Center staff provided additional information for states that are interested in applying for a Model Testing award. Governors' offices were strongly encouraged to onvite their health care innovation team, key stakeholders and appropriate State officials such as State health department directors, Medicaid directors, and insurance commissioners.
- - -
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
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Pharmacy Services and Accountable Care Organizations Discussion.pdfsdfghj21
Pharmacy services can help accountable care organizations (ACOs) improve patient care and outcomes. A 1-page proposal should identify pharmacy services like chronic disease management, medication reconciliation after discharge, or annual wellness visits. These services help with benchmarks like readmissions, adherence to preventive screenings, and management of chronic conditions. Pharmacists can enhance care coordination, patient education, and medication optimization within ACOs.
The document summarizes the proposed Medicare Shared Savings Program which aims to promote accountable care through accountable care organizations (ACOs). It discusses key elements of the proposed rule including ACO qualification requirements, benchmark calculations for determining savings, performance measures tied to quality, and a timeline for implementation beginning in 2012. The overall goal is to align payments with value through shared savings models to reduce costs while improving care quality.
The 10th Annual Utah Health Services Research Conference: Data: What's available and how we are use it is changing. By: Danielle A. Lloyd, MPH - Premier
Health Services Research Conference: March 16, 2015
Patient Centered Research Methods Core, University of Utah, CCTS
In this August 14, 2012 webinar CMS Innovation Center staff provided additional information for states that are interested in applying for a Model Design award. Governors' offices were strongly encouraged to onvite their health care innovation team, key stakeholders and appropriate State officials such as State health department directors, Medicaid directors, and insurance commissioners.
- - -
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
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Pharmacy Services Development within ACO MSO Business Proposal.pdfsdfghj21
The document discusses implementing pharmacy services within an ACO/MSO business proposal. It provides background on ACOs, MSOs, and the evolving healthcare landscape. The proposal should include 1) pharmacy services to implement like medication therapy management, annual wellness visits, or chronic disease management and 2) how these services will improve patient care by impacting benchmarks for quality, care coordination, preventive health, and management of at-risk populations. The literature demonstrates benefits of these pharmacy services including reduced costs and improved outcomes.
Clinical Integration: The Foundation for Accountable Care - Presentation delivered by Keynote Speaker Marvin O’Quinn, Senior Executive Vice President and Chief Operating Officer, Dignity Health at the National Healthcare CXO Summit held in Las Vegas Oct 19-21, 2014.
mHealth Israel_US Health Insurance Overview- An Insider's PerspectiveLevi Shapiro
Presentation about the US Health Insurance Sector by Lori Rund, VP, Product Management and Market Intelligence at Health Alliance Plan, a managed care organization owned by the Henry Ford Health System, with 650,000 lives. Lori is responsible for the identification, concept building, researching and business case developments for new products, services and markets. She develops and leads comprehensive market intelligence functions to help the organization better understand industry trends and identify business opportunities.
Prior to joining Health Alliance Plan, Lori was Director of Product Development and Market Intelligence at Health Alliance Medical Plans in Illinois and Director of Market Research and Strategy at Carle Clinic Association, also in Illinois.
The document discusses Accountable Care Organizations (ACOs) which were created by the Affordable Care Act to improve quality and lower costs. It provides frequently asked questions about ACOs, including whether they are viable, how providers can save money through ACOs, examples of successful ACO programs like Marshfield Clinic, and the healthcare IT components needed to support ACOs. Providers are encouraged to invest in quality, innovation, and data/analytics to prepare for value-based payment models like ACOs.
The document discusses value-driven healthcare in Medicaid and outlines several strategies and initiatives to improve quality of care, including:
1) Using evidence-based practices and quality measurement, health IT, and partnerships to ensure safe, effective, timely and equitable care.
2) Promoting transparency of quality and price information to support value-based payment models.
3) Providing incentives for high-quality, high-value care through pay-for-performance programs and other initiatives.
4) Collaborating across states and with CMS to share best practices around quality improvement, health IT adoption, and value-based purchasing.
Similar to Re-Shaping Virginia Public and Private Health and Human Services Delivery System (20)
Merrifield Nursery Emergency Gravity Sewer ReplacementFairfax County
During a routine Closed-Circuit Television (CCTV) Camera inspection by Wastewater Collection Division (WCD), it was found that 45 linear feet of 8-inch asbestos reinforced concrete pipe (RCP) between MH-292 to MH-291 was within imminent danger of failing. The bottom of the RCP was missing within the 45 linear feet of repair and the pipe was on the verge of surcharging. After an immediate pre-construction meeting with Merrifield Nursery, it was agreed to work from 6pm-10am everyday of the week to avoid disruption and potentially placing patrons at risk during the biggest time of the year for Merrifield Garden Center. The contractor mobilized to the site and began the 20-foot excavation to replace 45 linear feet of broken gravity sewer. The project started on March 14th, 2022 and was substantially complete on March 23, 2022.
The Sully Basins Stormwater Pond Retrofits project was substantially completed on April 19, 2022. The project is located within the Cub Run watershed. The project consisted of repair and enhancement of multiple stormwater basins, 0326DP, 0964DP and 1484DP. The project also included construction of new stone cascades, stone weir basin structures and the construction of wetlands with high and low marsh areas. The project will facilitate improved sediment removal and improve downstream water quality using forebays and micro pools. Aquatic and natural habitat were also added within the three basins.
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This document summarizes a pedestrian access improvement project along Clarks Crossing Road in Fairfax County, Virginia. The project improved pedestrian and bicycle access by constructing a missing link of sidewalk between Brookside Lane and an existing sidewalk further along Clarks Crossing Road. Work included installing sidewalk, curb ramps, drainage improvements, and milling and overlaying asphalt. The project was substantially completed in March 2022 and provides approximately 200 feet of new pedestrian access along Clarks Crossing Road.
Tysons West Wastewater Conveyance Systems Modifications Project 05-22.pptxFairfax County
Future wastewater flows in northern Fairfax County exceed existing system capacity
Treatment capacity is available in Noman M. Cole Jr. Pollution Control Plant in Lorton, VA
New pipes and pumps are needed to move future flows to treatment plant
NEXT STEPS
Field investigations / surveys
Finalize alignments and pump station layout
Use of open cut excavation
Use of trenchless methods
Easement acquisition needed
Develop traffic control plans
Description:
The project consists of a new, 23,000 square feet, two-story, four-bay fire station facility and associated improvements to the 3.3-acre site including storm water detention, landscaping and parking. The scope also included the demolition of the existing fire station, and a temporary fire station to house the Fire and Rescue Department during construction of the new facility. The key elements of the overall project include:
Scotts Run at Old Meadow Road Park Phase I and Phase II Stream RestorationFairfax County
Scotts Run @ Old Meadow Road Stream Restoration was substantially completed on March 30, 2022. The Scotts Run project consisted of restoring, enhancement, and stabilizing of approximately 2,930 linear feet of eroding stream using Natural Channel Design criteria. This project included two phases: Phase I was funded by proffers from a private development and Phase II was County funded. Also included was the removal of invasive non-native plants and the installation of new plantings to stabilize the stream and floodplain.
Sully Community Center Construction ProgressFairfax County
This document provides construction progress photos of the Sully Community Center in Fairfax County, Virginia. The photos show the ongoing construction of the building's exterior, interior spaces like the lobby, corridors, multi-purpose rooms, game room, gym, exercise room, and healthcare suite. The document was published by the Fairfax County Department of Public Works and Environmental Services to share updates on the construction of the new community center, which is scheduled to open in summer 2022.
Riverwood Community Meeting - 04-14-2022- Presentation.pptxFairfax County
The new 4-inch ductile iron force main will serve the surrounding community for the foreseeable future. Replacement of the force main will:
Reduce the level and frequency of maintenance required to keep the force main operating.
Prevent costly emergency repairs.
Provide residents with safe, reliable utility infrastructure.
Enhance the quality of life for residents.
Reduce risks to public health and the environment.
Burke Centre VRE Connector Phase IV project was substantially completed on March 7, 2022. This project enhanced the access to mass transit by creating a more direct connection from the VRE Station to the residential areas west of Premier Court. This project also connects the Oak Bluff community to the Virginia Rail Express (VRE) Burke Station and provides a multi-use shared pedestrian and bicycle trail for outdoor recreation.
Long Branch Public Meeting - FINAL - 04-11-2022Fairfax County
Overarching Project Goals:
-Achieve Long Branch Central TMDL waste load reduction requirements.
-Provide long-term stability and have low maintenance.
-Improve water quality within the Long Branch Central Watershed.
-Improve habitat and environmental health (ecological lift).
Objectives: Share our project understanding with the council and seek input on the unique opportunities and housing goals for this site that could help guide
our master planning process.
Rabbit Branch at Collingham Drive Stream Restoration - March 28, 2022.pptxFairfax County
4,800 linear feet of stream will be restored using Natural Channel Design methodologies
Pollutant reduction
1,439 lbs/total phosphorus
3,400 lbs/total nitrogen
462.1 tons of total suspended sediment
Protection of private property and public infrastructure
Increased ecological diversity with native vegetation
DEQ has awarded a SLAF grant to this project for these environmental benefits
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The Lake Barton Dredging, Restoration, and Riser Modification project was substantially completed on December 29, 2021. The project is located within the Pohick Creek watershed. The project consisted of dredging and removal of approximately 19,100 cubic yards of sediment to restore the sediment trapping capacity and improve water quality. The project also included construction of new sediment forebays, in-lake haul roads, and riser modifications (new mid-level sluice gate and cold-water intake) to facilitate future maintenance, stabilize the shoreline, and improve downstream water quality. Fish habitat was also added within the lake.
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This document summarizes a meeting about a proposed arts center in Reston, Virginia that would result from a proffer from Boston Properties for development of an area known as Block J. The meeting covered the background and objectives of community outreach efforts to understand needs for the arts venue. Feedback was shared from previous focus group meetings on performing arts, visual arts, and other topics. Key spaces discussed included a 500-seat theater, art studios, galleries, and support spaces. Next steps include further programming, cost estimating, and community input before potential design and construction.
Stormwater Wastewater Facility Virtual Community Meeting, March 29, 2022Fairfax County
Benefits of Consolidated Facility
Building and Site Efficiencies
Operational Efficiencies
Addresses Space Deficiencies
Addresses Renovations and Capital Renewal Requirements
for WCD
Provides for a Centrally Located Site that Accommodates Program
Consolidates Integrated Services on One Centrally Located Site
Reston Arts Center Feasibility Study Focus Group - March 28, 2022Fairfax County
This is the 4th of 5 engagement meetings. We are excited to hear from you – your preferences, priorities, questions, hopes, concerns. The information we receive today will be used to inform the space allocations and cost estimating for discussion of the proffer by Fairfax County.
Oak Marr Pump Station Rehabilitation – Construction ProjectFairfax County
Neighborhood was built in the 1980s, and the sewer infrastructure has been in operation since.
Aged pump station equipment – pumps, valves, fans, concrete, etc.
This aging equipment has the potential of causing:
Sanitary Sewer Overflows (SSO)
Sewer back-ups into homes
Environmental damages
Maintenance problems
Tucker Avenue Neighborhood Community Meeting, 03-15-2022Fairfax County
Identify and evaluate house flooding and public safety concerns
Improve drainage conditions to convey 100-year storm if feasible
Reduce and treat stormwater runoff at the source
Improve water quality and stream protection
Use resilient & functional designs
Make improvements compatible with characteristics of neighborhood
Partner with community to develop sound, cost effective solutions that can be collaboratively implemented and maintained
Build on lessons learned to help improve site development process for infill development
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This document summarizes a focus group meeting to discuss needs and ideas for a proposed new arts center in Reston, Virginia. The meeting covered background on the proposed project, which would result from a development proffer. Attendees provided input through polls and discussion on desired visual arts programming, spaces, and amenities. Key priorities identified included studio space, galleries, classrooms, digital media facilities, and ensuring the center is diverse, equitable and accessible. The project team will take this community feedback into account as they continue planning.
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Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
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Federal Authorities Urge Vigilance Amid Bird Flu Outbreak | The Lifesciences ...The Lifesciences Magazine
Federal authorities have advised the public to remain vigilant but calm in response to the ongoing bird flu outbreak of highly pathogenic avian influenza, commonly known as bird flu.
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Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
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केरल उच्च न्यायालय ने 11 जून, 2024 को मंडला पूजा में भाग लेने की अनुमति मांगने वाली 10 वर्षीय लड़की की रिट याचिका को खारिज कर दिया, जिसमें सर्वोच्च न्यायालय की एक बड़ी पीठ के समक्ष इस मुद्दे की लंबित प्रकृति पर जोर दिया गया। यह आदेश न्यायमूर्ति अनिल के. नरेंद्रन और न्यायमूर्ति हरिशंकर वी. मेनन की खंडपीठ द्वारा पारित किया गया
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https://ecspe.org/the-rise-of-christian-persecution-in-islamic-countries/
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Re-Shaping Virginia Public and Private Health and Human Services Delivery System
1. Re-shaping Virginia Public and Private Health
and Human Services Delivery System
Presentation to Fairfax County Human Services
Council
Secretary of Health and Human Resources
Dr. Bill Hazel
May 18, 2013
2. 2
Health and Human Resources
Jobs and
Economic
Development
Homelessness
Adoption
Children’s
Services
Community
Integration
DOJ
Veteran’s and
Active Duty
Military
Services
Coordination
Prisoner
Reentry
eHHR
Effective and
Efficient
Government
Health
Health System
Reform
Mental Health
State Managed
Shelters
3. 3
1. Requires Most U.S. Citizens and Legal Residents to Have Health Insurance;
– Offers enhanced federal dollars for states that choose to Expand Medicaid (at
state option) for all individuals with income under 133 percent of poverty. (plus
a 5% income disregard).
– Reconfigures insurance industry requiring a larger pool of insured individuals to
cover the cost of eliminating insurance underwriting (i.e., pre-existing
conditions) while standardizing insurance benefits and pricing.
2. Creates Health Benefits Exchanges for Individuals and Small Businesses to
compare and purchase health insurance;
– Offers subsidies to low-income individuals with income between 100 and 400
percent of poverty to purchase insurance
3. Encourages Innovation
The Patient Protection and Affordable Care Act
3 Major Components
4. 4
The Supreme Court’s decision leaves it to state policymakers to
decide whether or not to expand Medicaid’s income
eligibility levels to cover all individuals up to 138% of the
poverty level
What does Medicaid Expansion Include?
5. MandatoryProvisions
($142m)
OptionalExpansion
$280m
Estimated Costs of the Affordable Care Act for Virginia: 2014-2022
These costs
and savings
are already
reflected in
the
Governor’s
Introduced
Budget
These costs
and savings are
identified in
the Fiscal
Impact
Statement for
the ACA
Expansion
Annual Impact of Mandatory Provisions
Annual Impact of Optional Expansion (only)
5
SFY 14:
($36,673,715)
SFY 14:
($52,050,282)
6. 6
Federal Match for Expansion Population
The big question…will it remain?
* Per the PPACA, federal financial participation will continue at a 90% rate beyond 2022.
• Expansion must include individuals up to 133% (plus a 5%
income disregard) of the Federal Poverty Level (FPL).
• Savings highlights:
– Community Behavioral Health Services (shift from local and state funds to
enhanced federal funds)
– Inmate Inpatient Hospital Savings (shift from local and state funds to
enhanced federal funds)
– Indigent Care Savings (shift from state funds to enhanced federal funds)
Estimated Cost of Expansion in Virginia
8. —No consideration of expansion until significant
reforms are underway within the Medicaid
program.
—2013 Legislative Session
—concluded with budget language authorizing
three phases of Medicaid Reform
—created the Medicaid Innovation and Reform
Commission
8
Virginia’s Legislative Approach to Medicaid Expansion
9. 9
Improve
Service Delivery:
Improve Quality, Predict
Costs, and Innovate when
Needed
Improve
Administration:
Streamline Administration
and Minimize Waste,
Fraud, and Abuse.
Increase
Beneficiary
Engagement:
Showcase Wellness and
Cost Sharing
Objectives of Medicaid Reform
10. All Medicaid Populations
Including LTC in
Coordinated System
Continued Stakeholder
Engagement
(Phase III)
Value Based Purchasing in
Managed Care for Medical
Services, Administrative
Simplification and
Flexibility and Innovation
(Phase II)
Ongoing Reforms
(Phase I)
Three Phases of Medicaid Reform
10
11. 11
Phase II: Improvements in Current Managed
Care and Fee For Service programs
– Commercial like benefit packages and service limits
– Cost sharing and wellness
– Coordinate Behavioral Health Services
– Limited Provider Networks and Medical Homes
– Quality Payment Incentives
– Data Improvements
– Standardization of Administrative Processes
– Health Information Exchange
– Agency Administration Simplification
– Parameters to Test Pilots
Three Phases of Medicaid Reform
12. Phase II (Process)
New Medallion II (Managed Care) Contracts
– Total reformat based on review of 13 state contracts – focus on
life cycle
– Technical manual – reporting, automation, encounter data, scoring
– Quality incentive
– Medallion Care System Partnership – focus on models
– All Payer Claims Database (APCD)
– Program Integrity collaborative incentives
– Improved chronic care section
– Maternity care
– Foster care language
– Wellness
Three Phases of Medicaid Reform
12
13. Phase II (Process)
Three Phases of Medicaid Reform
Medicaid Managed Care “Breakfast Club”
–Six Targeted Conversations
–What You Get For The [Medicaid Managed Care] Dollar
–Early Periodic Screening, Diagnosis, and Treatment
(EPSDT)
–Emergency Room Utilization
–Personal Responsibility and Co-pays
–Administrative Simplification
–Innovation Models
13
14. 14
Phase III: Coordinated Long Term Care
– Move remaining populations and waiver
recipients into cost effective and coordinated
delivery models
– Report due to 2014 General Assembly on
design and implementation plans
Three Phases of Medicaid Reform
15. Savings accrued during the first five years of
the expansion should be protected and
reinvested to improve the health delivery
system.
—Reinvestment and Savings Strategies Include:
– The flexibility to invest in high quality, cost saving health
care innovation models
– Improved analytical and oversight capability at DMAS
• Requirement of timely and accurate encounter data from
contracted Medicaid managed care plans
• Creation of Data and Analytics Unit at DMAS
– Need to identify structure to protect savings and ensure
reinvestment
Reinvestment of Medicaid Funding
15
16. Cost and Value Problems in the Healthcare Arena can’t be
Solved without Significant Innovation
―Innovation opportunities within PPACA are lost in the
uncertainties associated with the law.
―Virginia is already making progress in key innovation areas
―Virginia has created the Virginia Center for Health Innovation
(501 (c)3) housed out of the Chamber of Commerce
System Wide Innovation
16
17. Virginia Health
Innovation Plan
Improving
Transparency and
Availability of Data
Improving Early
Childhood
Outcomes
Payment and Delivery
Reform: Improving
Care Integration
for Physical and
Mental Health
Educating and
Engaging
Consumers to
Purchase Value
Improving the
Effectiveness,
Efficiency, and
Appropriate Mix of
the Health Care
Workforce
Payment and Delivery
Reform: Improving
Chronic Disease
Care
Each priority has a
dedicated workgroup
assigned to explore
pilot programs and to
reach consensus on
a recommended
three-year
implementation plan.
Workgroups include
members of the
VHRI Advisory
Council, the VCHI
Board of Directors,
as well as key
thought leaders in
each particular
priority area.
Virginia Center for Health Innovation Priorities
17
18. MIRC
Purpose: To review, recommend and approve innovation and
reform proposals affecting the Virginia Medicaid and Family
Access to Medical Insurance Security (FAMIS) programs, including
eligibility and financing for proposals set out in Item 307 (Virginia
Budget) in the Department of Medical Assistance Services.
Specifically, the Commission shall review:
(i) the development of reform proposals;
(ii) progress in obtaining federal approval for reforms such as
benefit design, service delivery, payment reform, and quality
and cost containment outcomes; and
(iii) implementation of reform measures.
The Medicaid Innovation and Reform Commission
18
19. Chair of Senate Finance, or his
designee & 4 members of
Senate Finance
Chair of House Committee on
Appropriations, or his
designee, & 4 members of
House Appropriations
—Walter A. Stosch
—Janet D. Howell
—Emmett W. Hanger, Jr.
—John C. Watkins
—L. Louise Lucas
—R. Steven Landes
—James P. Massie, III
—John M. O'Bannon, II
—Beverly J. Sherwood
—Johnny S. Joannou
MIRC Membership
Ex Officio Members:
Secretary of Health and Human Resources
Secretary of Finance 19
20. • Evolve Analytics Discipline across agencies
• eHHR Modernization of Eligibility Services
– Comply with PPACA
– HHR services integrated across agencies
– Build operational efficiency into social services
– Fight Fraud and Abuse
eHHR Effort
21. —CommonHelp Portal
—Case Management System
—Enterprise Data Management (EDM)
—Business Rules Engine
—Document Management System
—Enterprise Service Bus (ESB)
21
eHHR Core Elements
22. Some call it the “new Medicaid” because of all the changes.
Affordable Care Act requires:
• Complete replacement of Medicaid eligibility criteria
• Eligibility criteria must be checked real-time with Social Security
Administration, IRS, Homeland Security
• Income must be computed using IRS Modified Adjustable Gross Income
methodology
• Applications must be accepted on paper, on-line, by phone and by fax
• New coverage for Foster Children
• Changes to Notifications (letters), Appeals and Complaints processing
• New Presumptive Eligibility workflow for hospitals
• Cases must be coordinated real-time with the Federal Exchange;
electronic transfer between Medicaid and subsidized coverage
Preparing to comply with ACA
23. eHHR Core Elements
• CommonHelp Portal
• Enterprise Service Bus (ESB)
• Enterprise Data Management (EDM)
• Business Rules Engine
• Case Management System
• Document Management System
• Connection to the Federal Facilitated
Exchange (FFE)
24. Department of Social Services
• Leader on Eligibility System
modernization
• Interface with Local DSS network
Department of Medical Assistance
• MAGI Call Center Operations
• Interface with Center for Medicare
and Medicaid Services
• Affordable Care Act policy experts
• Federal Exchange experts
eHHR Team
VITA
• IT Hosting
• Enterprise Data Management
• Enterprise Service Bus
mentorship
Department of Motor Vehicles
• National leadership with on-line
citizen authentication
Virginia Department of Health
• Birth/death registry services
25. eHHR - progress to date
• 11 projects on schedule (Initiation or Execution phase)
• Launched the statewide CommonHelp Eligibility Services portal.
• Reached agreement with the OAG on Citizen Consent language
needed to empower the modernized eligibility system
• IT system infrastructure to support Development and Testing secured
and deployed on-schedule by VITA; includes new Service Oriented
Architecture/Enterprise Service Bus (SOA/ESB) modularized
architecture
• DSS Enterprise Delivery System Program Contract solicited and
awarded, signed with Deloitte Consulting on 12/19/12 25
26. Making Government work smarter
VDSS winning the “Innovation in
Utilization Award” at RichTech this month
This award recognizes “the company or
organization whose creative use of
technology enhances processes,
methodologies, and /or services for theirs
or others’ benefit.”
27. • The capacity to collect and analyze client-specific
expenditure data for the significant fund sources and
to integrate that data with demographic and
assessment data will enable the Commonwealth to
answer critical questions such as:
– Are services available to the children who need them?
– Are services being provided in accordance with each
child’s needs?
– Are funds for services being spent wisely?
– To what extent is each program meeting the measurable
goals for that program based on the availability of services,
each child’s needs, and the funds for those services?
CSA Opportunities
28. Transparency
• OCS can identify the unique children
served by localities requesting those
funds.
• OCS can review individual charges that
constitute the aggregate reimbursement
requests.
29. Accountability
• Data are being integrated across programs to
identify the total funding per child over time.
• Database under development now includes
historical child-level data from:
OCS CANS score data on child need
CSA claim level payment data
Title IV-E funding at the claim level
VDSS case data on foster care status
VDSS VEMAT data on child need
Medicaid claim data for child services procedure
codes
31. Even With CSA to Coordinate payments, Services for
Children Remain Fragmented
32. Local service provider data, e.g., specific costs for specific services, are not
currently reported to the Commonwealth. We have shown through a
brief, privately funded, proof of value project that these data can be
efficiently collected and can be matched to other data sources to enable
powerful analysis. We have documented things such as:
1. There is significant variability in the cost of services available to a child
receiving CSA services at the local level, even adjusting for child need.
2. A risk-adjusted payment model can be produced to allow for comparable
per diem per client estimates which will highlight outliers.
3. A linear model of payment per client per day allows us to account for the
effects of the multiple variables simultaneously, e.g., gender, ethnicity,
locality, assessment scores (initial and final), age, number of placements,
etc. to ensure that differences are statistically significant and indicative of
“risk,” i.e., potentially indicative of fraud, waste or abuse.
CSA Opportunities
33. Lessons Learned
• Some localities cannot distinguish CSA from Title IV-E
funding
– Informally being stored in comment fields
• Some localities using non-standard accounting
practices
– methods for recording ongoing monthly payments
(ex., “Payment for June, July…” recorded only in
comment fields)
– Inconsistent process for recording re-payments or
cancelled payments.
34. • Recent payment of $48,446 was made to a
CSA vendor in error.
• Recent CSA payment for 25 shirts @
Burlington for the same child.
• New analytics process identified both of these
anomalies. Funds were recovered.
Results
35. Virginia’s Movement Towards Community-
Based Services
Prior to
1960
Late
1960s–
1970s
Early-
mid
1970s
19911972 Today
Large training
centers (TCs)
primary service
source
TC
Census is
5,240
Growth of community
services starts with
arrival of community
services boards
TC Census = 839;
Those on Waiver =
9943; Waiver Waiting
List = 7864
First group homes
appear, community
vocational
services begin
Medicaid Waiver for Home
and Community-Based
services and Medicaid State
Plan Option developed
36. Community Integration/DOJ
DOJ Settlement Agreement Timeframe
• February 2011 – Findings
• Jan. 26, 2012 - Negotiation completed and
settlement agreement signed
• Aug. 23. 2012 - Judge signs agreement as
consent decree
36
37. Community Integration/DOJ
Virginia will create 4,170 waiver slots by June 30, 2021:
37
State
Fiscal
Year
Individuals in Training
Centers to Transition
to the Community
ID Waiver Slots
for Individuals on
Urgent Wait List
DD Waiver Slots
for Individuals
on Wait List
20121 60 275 150
2013 160 225* 25**
2014 160 225* 25**
2015 90 250* 25**
2016 85 275 25
2017 90 300 25
2018 90 325 25
2019 35 325 25
2020 35 355 50
2021 0 360 75
Total 805 2915 450
These FY2012 slots have already been funded and assigned to individuals.
*25 slots each year are prioritized for individuals less than 22 years who reside in nursing homes or large
ICFs.
**15 slots each year are prioritized for individuals less than 22 years who reside in homes or large ICFs.
38. 38
DOJ
Summary of Total Cost of the
Settlement Agreement
Total 10-Year Cost $2.4 Billion
Total GF cost of services $1.2 Billion
Total GF savings and offsets $ 826.9 Million
Total estimated new
GF required
$ 387.7 Million
39. Improve Waivers to
Resolve Current Challenges
Virginia must evaluate methods to move toward a more
flexible array of services that support system values and
resolves challenges with current waivers:
• Flexibility to address the most complex medical and
behavioral needs
• Expand the array of residential supports to include
smaller, more integrated environments
• Expand group and individual supported employment
options
40. Children’s Services
Virginia’s behavioral health services for children faces multiple challenges including an
incomplete, inconsistent array of services, inadequate early intervention services, a need for
workforce development and inadequate oversight and quality assurance.
0
5
10
15
20
25
30
35
40
Crisis Stabilization
Unit for Children
Emergency Respite
Care
In Home Crisis
Stabilization
Mobile Child Crisis
Response
Psychiatric Services Case Management Intensive Care
Coordination
Intensive In-Home
Services
Availability of Base Services by Number of CSBs
Adequate Capacity Inadequate Capacity Services Not Provided
41. Children’s Services
• Priority needs in most Virginia communities:
– Access to child psychiatry
– Crisis stabilization services
– Mobile crisis teams
• In 2012 and 2013, the Governor and General Assembly provided
funding to provide child psychiatry, crisis stabilization, and mobile
crisis services to children with behavioral health disorders.
Fiscal Year GF Dollars
FY 2013 $1.5M
FY 2014 $3.65M
TOTAL $5.15M ($3.65M ongoing)