Medicare/Medicaid | Wellness Platform

Using a Health Risk Assessment to Improve Your Medicaid Quality Measures

5

Mar

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Medicaid and CHIP Health Care Quality Measures

In April 2016 CMS published a final rule requiring that all states implement a quality rating system for Medicaid managed care plans over a period of three years. The goal is to increase transparency in Medicaid and CHIP, allow States to compare plan performance, and empower consumers to consider health plan quality when selecting a...

Health Risk Assessment for Medicare Annual Wellness Visit

2

Mar

Posted by pdhiadmin

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The Centers for Medicare and Medicaid Services (CMS) requires a health risk assessment to be included in the Annual Wellness Visit. The purpose of the Medicare health assessment is to identify heath needs and risk factors so beneficiaries can be directed to appropriate care, ultimately improving outcomes and reducing costs. The Center for Disease Control and...

Health Risk Assessment for Medicaid

3

Feb

Posted by pdhiadmin

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Starting July 1, 2017 Medicaid and Children’s Health Insurance Program (CHIP) plans are required to make their best effort to conduct a health risk assessment within 90 days of enrollment for all new enrollees. Many health plan clients already use ConXus Profile Health Assessment for Medicaid in both adult and pediatric populations. We deliver secure,...

Medicare Chronic Care Management Reimbursement

29

Dec

Posted by pdhiadmin

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Starting in January 2015, Medicare will pay a monthly chronic care management (CCM) fee of $40.39 for providing care management services to seniors with two or more chronic conditions. These care management services may be delivered by physicians or other healthcare providers, such as clinical nurse specialists, and may include non-face-to-face services. The target population is...

NCQA MEM Standards Required for Medicaid and Medicare Plans

10

Jul

Posted by pdhiadmin

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NCQA MEM Standards Required for Medicaid and Medicare Plans

From July 1, 2014 the National Committee for Quality Assurance (NCQA) Member Connection Standards for Health Plans (MEM Standards) require health plans to be scored for all product lines, including Commercial, Medicare, Medicaid, and Exchange products. For the first year, the health plan may present a plan for implementing required functions by July...

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Category Archives: Medicare/Medicaid

Using a Health Risk Assessment to Improve Your Medicaid Quality Measures

Health Risk Assessment for Medicare Annual Wellness Visit

Health Risk Assessment for Medicaid

Medicare Chronic Care Management Reimbursement

NCQA MEM Standards Required for Medicaid and Medicare Plans