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Wednesday, July 29, 2020 | History

3 edition of Evaluating Coordination of Care in Medicaid: Improving Quality and Clinical Outcomes found in the catalog.

Evaluating Coordination of Care in Medicaid: Improving Quality and Clinical Outcomes

United States

Evaluating Coordination of Care in Medicaid: Improving Quality and Clinical Outcomes

Hearing Before the Subcommittee on Health of the Committee on En

by United States

  • 17 Want to read
  • 32 Currently reading

Published by Government Printing Office .
Written in English


The Physical Object
FormatHardcover
Number of Pages72
ID Numbers
Open LibraryOL10116127M
ISBN 100160713587
ISBN 109780160713583

Improving Patient Safety and Health Care Quality through Health Information Technology AMERICAN HOSPITAL ASSOCIATION ANNUAL SURVEY IT SUPPLEMENT BRIEF #3 JULY 1 The potential to improve patient safety and quality through better information sharing and guidance around best practices is a critical component of the. the same time as improving quality of care and patient outcomes. Is there research using prospective, controlled study designs which shows what happens to quality, access and costs as a result of investments to enhance and improve primary care? Have recent evaluations documented the outcomes of interventions in the U.S. promoting primary.

  As part of that health care delivery system, states are increasingly using value-based payment models in Medicaid, which pay providers a set amount for all or most of a patient’s care — rather than paying for each service they provide — while requiring that providers meet specific quality and outcomes standards. CHAPTER 1 CARE COORDINATION CLINICAL REASONING: CONTEMPORARY COMPETENCY EXPECTATIONS The contributions of nurses are vital in meeting 21st-century health care challenges (Institute of Medicine [IOM], ). In spite of advancements in disease prevention and health promotion, a need exists to educate people about healthy lifestyles and provide care for and counsel people if.

In primary care settings, patient-centered communication is associated with faster recovery, improved clinical outcomes, a better care experience, and fewer diagnostic tests and referrals. ABD Care Coordination Program •All members will have access to: –Member Care Coordination Call Center –24/7 Nurse Call line –Outreach and Education relevant to patient’s healthcare and disease state(s) •Providers will be able to refer issues and opportunities for better coordination to Vendor for follow up and intervention.


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Evaluating Coordination of Care in Medicaid: Improving Quality and Clinical Outcomes by United States Download PDF EPUB FB2

Get this from a library. Evaluating coordination of care in Medicaid: improving quality and clinical outcomes: hearing before the Subcommittee on Health of the Committee on Energy and Commerce, House of Representatives, One Hundred Eighth Congress, first session, Octo [United States.

Congress. House. Committee on Energy and Commerce. EVALUATING COORDINATION OF CARE IN MEDICAID: IMPROVING QUALITY AND CLINICAL OUTCOMES.

Date(s) Held: th Congress, 1st Session. GPO Document Source: CHRGhhrg Superintendents of Documents ID: Y 4.C 73/8.

Related Items: United States Senate Bill (th Congress) United States House Bill (th Congress). Full text of "EVALUATING COORDINATION OF CARE IN MEDICAID: IMPROVING QUALITY AND CLINICAL OUTCOMES" See other formats.

Background. Care coordination services that link pregnant women to health-promoting resources, avoid duplication of effort, and improve communication between families and providers have been endorsed as a strategy for reducing disparities in adverse pregnancy outcomes, however empirical evidence regarding the effects of these services is contradictory and by:   Overview.

Care coordination is considered a hallmark of patient-centered treatment and has been shown to improve health outcomes and patient satisfaction as well as reduce d as organizing patient care activities and sharing information among all participants concerned with an individual’s treatment plan in order to achieve safer and more effective results, care coordination is.

The Centers for Medicare & Medicaid Services is committed to helping states and their providers undertake efforts to improve transitions and improve medical and LTSS coordination by providing technical assistance, resources, and facilitating the exchange of information about promising practices of high quality, high impact, and effective care.

The Center for Medicaid and CHIP Services (CMCS) partners with states to share best practices and provide technical assistance to improve the quality of care. CMCS’s efforts are guided by the overarching aims of the Centers for Medicare & Medicaid Services (CMS) Quality Strategy: better health, better care, lower cost through improvement.

Quality Measure and Quality Improvement The vision of the CMS Quality Strategy is to optimize health outcomes by improving quality and transforming the health care system [1]. CMS serves the public as a trusted partner with steadfast focus on improving outcomes, beneficiary/consumer experience of care, population health, and reducing health care costs through.

The benefits of care coordination across clinicians, specialties, and settings have been a central focus of health care payment and delivery system reforms. Better care coordination, it has been argued, is a remedy for a fragmented health system and could lead to improved health outcomes, superior patient experiences, and lower costs.

Effectiveness of care outcome measures evaluate two things: Compliance with best practice care guidelines. Achieved outcomes (e.g., lower readmission rates for heart failure patients). Given the rapid changes that occur within healthcare, making sure best practice care guidelines are current is critical for achieving the best care outcomes.

Background. In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare & Medicaid Services (CMS) and Hospital Quality Alliance (HQA) began publicly reporting day mortality measures for acute myocardial infarction (AMI) and heart failure (HF) in June and for pneumonia (PN) in June Care coordination is identified by the Institute of Medicine as a key strategy that has the potential to improve the effectiveness, safety, and efficiency of the American health care system.

Well-designed, targeted care coordination that is delivered to the right people can improve outcomes for everyone: patients, providers, and payers.

can improve health outcomes and quality of life as well as reduce health care costs. Many states have initiated efforts to pursue clinical integration, especially for vulnerable populations of high- need Medicaid enrollees. One barrier states face in advancing clinical integration for Medicaid enrollees is separate financing.

Key Findings. The Collaborative Care Model has the most evidence among integration models to demonstrate its effective and efficient integration in terms of controlling costs, improving access, improving clinical outcomes, and increasing patient satisfaction in a variety of primary care settings – rural, urban, and among veterans.

The benchmark forces an annual evaluation of health care cost growth and may contribute to pressure to adopt additional reforms. to improve the coordination of care in Medicaid. Care management is driven by quality-based outcomes such as: improved/maintained functional status, improved/maintained clinical status, enhanced quality of life, enrollee satisfaction, adherence to the care plan, improved enrollee safety, cost savings, and enrollee autonomy.

include improving care coordination and access to care for Medicare beneficiaries receiving chemotherapy for cancer. OCM leverages a two-pronged approach to incentivize the provision of high-quality care. It includes a $ Monthly Enhanced Oncology Services (MEOS) per-beneficiary per-month.

During care transitions, critical information aimed to improve the patient’s condition and health outcomes needs to be accurately communicated and coordinated between health professionals, the patient, and the family to ensure that safe, high-quality care is provided and care.

Stage 2 criteria encouraged the use of CEHRT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible. In OctoberCMS released a final rule that established Stage 3 in and beyond, which focused on using CEHRT to improve health outcomes.

ABSTRACT: Discussions of hospital quality, efficiency, and nursing care often taken place independent of one another. Activities to assure the adequacy and performance of hospital nursing, improve.

There are several reasons why it is difficult to evaluate the effect of managed care on quality of care. Quality is a somewhat subjective concept and can be evaluated using both process measures (e.g., if certain protocols were correctly followed) or outcomes (e.g., if treatments resulted in positive results).The evolution of medical care, its financing, and the expectations of the American population for high-quality care and rational use of public funds have linked, irreversibly, CMS to clinical medicine.

1 CMS finances health care for more Americans than any other single entity; the agency has a responsibility to its beneficiaries to ensure that. The Need for Better, Improved Care Coordination As medical practices and technologies have advanced, the delivery of sophisticated, high-quality medical care has come to require teams of health care providers—primary care physicians, specialists, nurses, technicians, and other clinicians.