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Posts tagged with "Medicaid programs"

CMS Rules

CMS Unveils HCBS Quality Metrics for Patient Outcomes

The Centers for Medicare and Medicaid Services (CMS) published a set of quality metrics for home and community-based services (HCBS) to assess patient health outcomes. According to CMS, the ratings will provide insight into HCBS programs and will enable states to determine the success of long-term services and support programs offered...
Arizona News

Navajo Nation to Launch MCO with Molina Healthcare

The Navajo Nation announced plans to create a "one-of-a-kind" managed care organization (MCO) under New Mexico's Medicaid program with Molina Healthcare. The tribe, spanning portions of northern Arizona, southern Utah and northern New Mexico, would be the first to launch a managed healthcare entity. According to a September white...
Arizona News

CMS Invites States to Submit IMD Exclusion Waivers to Expand Coverage for SMI Populations

Originally created to ensure Medicaid beneficiaries with a serious mental illness (SMI) weren't warehoused in facilities by the government, the IMD exclusion means state Medicaid agencies can't pay for mental healthcare services received in a residential treatment center with more than 16 beds. This week, (November 13) Medicaid...
Arizona News

Alternative Payment Models in Medicaid Emphasize Value

An Alternative Payment Model (APM) is one way of delivering value-based care, as the shift from traditional fee-for-service to a value-based payment model continues, programs are continuously looking to serve as a catalyst in offering cost-effective, higher-quality care. APMs incentivize this goal and can apply to an episode, condition,...
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