Medicaid

NCCN Guideline Adherence Lowers Total Cost of Care for Cancer Patients

June 7, 2022 - Adherence to National Comprehensive Cancer Network (NCCN) guidelines during treatment correlates to lower total costs of care (TCOC) for breast and colon cancer patients, according to findings presented at ASCO 2022 by CVS Health. The NCCN’s clinical guidelines aim to enhance the safety of cancer treatments by incorporating the latest...

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Machine Learning May Help Predict Opioid Overdoses in Medicaid Patients

by Shania Kennedy

Researchers have developed and validated a machine-learning (ML) model that can accurately predict opioid overdose risk in Medicaid beneficiaries in Pennsylvania and Arizona, indicating that the model...

CMS Announces Winner of Artificial Intelligence Challenge

by Jessica Kent

CMS has announced ClosedLoop.ai as the winner and Geisinger as the runner-up in its Artificial Intelligence Health Outcomes Challenge, a multi-stage competition that began in 2019. The AI Health...

How an ACO, FQHC Model Leveraged Social Determinants of Health

by Emily Sokol, MPH

Community Care Cooperative’s (C3’s) unique accountable care organization (ACO) model enables population health management to overcome the social determinants of health needs of their...

Artificial Intelligence Identifies High-Risk COVID-19 Patients

by Jessica Kent

Medical Home Network, an organization serving patients in the Chicago area, is using artificial intelligence to identify individuals who have a heightened vulnerability to severe complications from...

Population Health Management Reduces Pediatric Hospital Stays

by Jessica Kent

Children enrolled in Medicaid who are exposed to a population health management program could experience 50 fewer hospital admissions each month and 3,600 fewer bed-days in a year, according to a study...

NC Medicaid Data Reveals Need for Increased Opioid Misuse Treatment

by Jessica Kent

North Carolina has implemented several measures that have combated the opioid epidemic across the state, but more work could be done to increase the rate at which people with opioid use disorder (OUD)...

Social Determinants Screenings Cut Hospital Admissions by Nearly 30%

by Jessica Kent

Medicaid members who receive community-based services, particularly those that emphasize screening for and addressing the social determinants of health, experienced a 26.3 percent drop in inpatient...

Social Determinants of Health, Value-Based Care Key for Medicaid Success

by Jessica Kent

Value-based care incentives and broader collaborations to address the social determinants of health will be required to reduce spending and improve outcomes for Medicaid beneficiaries, according...

CMS: Better Data Analytics, Quality Measures will Modernize Medicaid

by Jennifer Bresnick

Modernizing the Medicaid program environment will require investments in data analytics and a greater reliance on meaningful quality measures, says CMS Administrator Seema Verma in a new blog post. As...

CMS: Data Analytics will Strengthen Medicaid Program Integrity

by Jessica Kent

New CMS initiatives will utilize advanced data analytics tools, quality data, and increased transparency to strengthen Medicaid program integrity and ensure the sustainability of the program for all...

Eight States Partner for Medicaid Transformation, Data Analytics

by Jennifer Bresnick

The National Governors Association (NGA) has selected eight states from across the nation to participate in a health data exchange and data analytics collaborative intended to foster innovation in...

CMS: Use Health IT, Medicaid Coverage Options to Combat Opioids

by Jessica Kent

CMS has released two documents describing how states can leverage Medicaid services and health IT tools to support beneficiaries battling opioid addiction. The organization released an Informational...

Using Health IT to Meet Medicaid Population Health, Socioeconomic Needs

by Jennifer Bresnick

Despite the fact that one out of every five members of the United States population is covered under Medicaid, providers dedicated to serving this segment of the market can often feel as if they are operating in a slightly separate...

IoT, Machine Learning Integration Boosts Medicaid Patient Care

by Jessica Kent

Applying smart technology like the Internet of Things (IoT) and machine learning to Medicaid systems can drive better care for patients, according to a recent Deloitte report. Medicaid agencies could...

CMS Eases Medicaid Barriers to Substance Abuse, Opioid Treatment

by Jennifer Bresnick

State Medicaid programs will have more opportunities to design programs to meet their residents’ substance abuse and opioid addiction treatment needs, CMS announced this week. Following the...

CMS Requests Input on “New Direction” in Patient-Centered Care

by Jennifer Bresnick

CMS officials have opened up an informal survey designed to collect public input on how the agency can take an innovative approach to fostering affordable, effective patient-centered care. With a...

Seema Verma Receives Confirmation as New CMS Administrator

by Jennifer Bresnick

Seema Verma, the former head of Indiana’s Medicaid agency, will lead the Centers for Medicare and Medicaid Services as Republican lawmakers seek to make significant changes to both public...

AMA, Intermountain Form Real-Time Data Partnership for Diabetes

by Jennifer Bresnick

The American Medical Association, Intermountain Healthcare, and Omada Health have announced a new data-driven chronic disease management and prevention program aimed at reducing the incidence of Type 2...

Medicaid Gets a Big Data Boost with Funding, Analytics Tools

by Jennifer Bresnick

While much of the industry’s attention over the past few years has been focused on Medicare and the massive funding opportunities involved in its half of the EHR Incentive Programs, the Medicaid...

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