Distributed Healthcare Intelligence by Carenodes
This environmental scan was prepared at the request of the Office of the Assistant Secretary for...
The New Jersey Health Care Quality Act (HCQA), N.J.S.A. 26:2S-1 et seq. and rules establish certain rights AND responsibilities for health care providers that contract with carriers for business that is subject to the HCQA. Whether your contract with a carrier is subject to the terms of the HCQA depends upon whether the business for which you are to deliver health care services is subject to the HCQA.
The Managed Care Legal Database is a resource identifying how state and federal statutes and regulations address many issues that may occur between private payers and physicians, such as prior authorization, credentialing, network adequacy, out-of-network payment, and contract termination. The Database also contains relevant AMA policy, issue briefs, advocacy resources, model legislation, and a State Laws Map.
Payors use a variety of reimbursement methodologies and reimbursement structures. Several reimbursement methodologies might be combined in a single arrangement with a payor, often as a means of transitioning to “value-based” payment. Reimbursement methodologies may include the following:
Patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, are eligible for CCM services
As Medicare Advantage continues to grow, a gradual but significant reshaping of the Medicare program is...
Healthcare Startups take too long to go to market hence innovations do not get to the American people in a form and fashion conducive to the aims of healthcare quality and performance in population health management.
When I left my management role at Humana to enter into the startup world, I was shocked to find that a vast majority of Health Tech organizations are founded by innovators with non-healthcare backgrounds.
The United States is going through a fundamental shift in its demographics. By 2035, there will be more seniors than children under the age of 18.
CARES Act Telehealth Expansion: Trends in Post-Discharge Follow-Up and Association with 30-Day Readmissions for Hospital Readmissions Reduction Program Health Conditions
