Medicare

Hawaii Health System Launches Population Health Analytics Collaboration

August 1, 2022 - Hawaii Health Network (HHN) and COPE Health Solutions (CHS) have announced a population health analytics partnership focused on providing value-based payment insights to enhance performance under a new Medicare risk arrangement for the clinically integrated network (CIN). A CIN is defined as “a formal group of healthcare providers working...

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Medicare Data Inaccuracies Hinder Health Disparity Assessment

by Shania Kennedy

A new report published by the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has found that race and ethnicity data gathered as part of Medicare enrollment are...

NCCN Guideline Adherence Lowers Total Cost of Care for Cancer Patients

by Shania Kennedy

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...

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...

Medicare Beneficiaries’ Race and Ethnicity Data Inaccurate

by Jessica Kent

Significant inaccuracies exist in Medicare beneficiaries’ race and ethnicity data, which could exacerbate disparities in healthcare access and quality, according to a study published in Medical...

Toolkits Use Prescription Drug Claims Data to Combat Opioid Misuse

by Jessica Kent

The Department of Health and Human Services Office of the Inspector General (HHS OIG) has developed two toolkits to identify certain patients at risk of opioid misuse or overdose using prescription...

Medicare Beneficiaries at High Risk in COVID-19-Prevalent Counties

by Jessica Kent

In the top 25 US counties with the highest prevalence of COVID-19, the majority of adults over age 65 are at high risk for severe illness if they contract the virus, according to an analysis from...

Geisinger Advances in CMS Artificial Intelligence Challenge

by Jessica Kent

CMS has selected Geisinger and EarlySign, a machine learning company, for their joint proposal in the agency’s Artificial Intelligence Health Outcomes Challenge. The partnering organizations are...

CMS Requests Comments on Effective Use of Artificial Intelligence

by Jessica Kent

The Centers for Medicare and Medicaid Services issued a request for information seeking information on how to leverage artificial intelligence and other tools to ensure proper claims payment, reduce...

New Clinical Model Aims to Scale Chronic Disease Management

by Emily Sokol, MPH

A new study from Chronic Care Management, Inc. (CCMI) suggests evidence-based practices for managing multiple chronic conditions in Medicare-aged populations, including in-between visit care...

Dozens of Orgs Urge CMS to Keep Next-Gen Genetic Testing in Medicare

by Jessica Kent

More than 60 leading healthcare organizations representing patients, providers, and academic medical centers have called on CMS to revise its interpretation of the National Coverage Determination (NCD)...

CMS Aims to Address Senior Poverty, Social Determinants of Health

by Jessica Kent

To drive down healthcare costs for Medicare beneficiaries, CMS is expanding policies to reduce prescription drug prices, increase community partnerships, and foster technological innovations that will...

CMS Adds Hospitals to Medicare Disparities Data Visualization Tool

by Jessica Kent

CMS has expanded the Mapping Medicare Disparities (MMD) Tool to include a Hospital View, which enables users to compare healthcare quality and outcomes at the hospital level and identify care...

Data Analytics Support $62M in Next Generation ACO Savings

by Jessica Kent

Data analytics and other health IT tools played an integral role in helping Next Generation Accountable Care Organization (NGACO) Model generate net savings of approximately $62 million for the...

GAO: CMS Lacks Adequate Data to Monitor Opioid Prescribing

by Jessica Kent

CMS should gather more comprehensive data on Medicare patients and providers to sufficiently monitor and prevent opioid overprescribing, according to a report from the US Government Accountability...

Medicare Diabetes Prevention Program Model Expands Nationwide

by Jessica Kent

The Centers for Medicare and Medicaid (CMS) has expanded its Medicare Diabetes Prevention Program (MDPP) nationwide.  The program will now enroll both traditional healthcare providers and...

Humana Targets Social Determinants to Improve Population Health

by Jessica Kent

Humana’s Bold Goal program, a comprehensive strategy aiming to improve population health, focuses on identifying and addressing social determinants of health to boost outcomes for Medicare...

UnitedHealth Supports Bundled Payments with Health Data Analytics

by Jessica Kent

UnitedHealth Group recently announced its collaboration with healthcare providers, health systems, and government that will include offering health data analytics coordination tied to the growing use...

CMS Recognizes Kaiser Permanente for Reducing Care Disparities

by Jessica Kent

CMS has named Kaiser Permanente as the first recipient of the Health Equity Award, which recognizes Kaiser Permanente’s commitment to reduce care disparities for Medicare...

In Medicare, Mental Health Disparities Impact Ethnic Minorities

by Jessica Kent

Multiracial and other minority Medicare beneficiaries generally reported worse mental health functioning and more symptoms of depression compared to white individuals, according to a CMS data highlight...

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