Category: CMS

The accountable care organization (ACO) is a staple of healthcare reform. CMS will launch its Shared Savings Program — an ACO for Medicare patients — in January 2012. John Harris, principal with the consulting firm of DGA Partners, advises potentia…

Who’s using health risk assessments (HRAs), and how are they administered? What are the top incentives driving HRA completion, and what are the top three uses for HRA data? What completion rates can be expected? In this month’s healthcare benchmarks podcast, Healthcare Intelligence Network executive VP and COO Melanie Matthews shares the latest market research…

To provide immediate feedback to participants in Colorado’s accountable care organization (ACO) for Medicaid beneficiaries, program developers have chosen a handful of performance measures that will focus on program quality and cost containment, explai…

To create a virtual medical home — also called a virtual healthcare home — primary care providers partner with community organizations to deliver a full continuum of healthcare services in a manner that is transparent to patients and health plan members. Sarah Dixon-Gale, lead contract manager for the Iowa/Nebraska Primary Care Association, explains how Iowa’s…

Three key factors influence consumers’ use of the hospital emergency room today, according to Dr. Barsam Kasravi, managing medical director for state-sponsored programs for WellPoint. In this podcast, Dr. Kasravi discusses how WellPoint is trying to close critical care gaps and encourage its members to utilize healthcare services more effectively. Dr. Kasravi and Dr. Karen…

Medicaid patients present their own unique set of needs during home visits, explain Dr. Larry Greenblatt, medical director, Chronic Care Program, Durham Community Health Network, Duke University Medical Center, and Jessica Simo, program manager, Durham Community Health Network for the Duke Division of Community Health. The duo explains the two types of patients that benefit…

In the first of several conversations with Metcare of Florida chief executives on its continuing medical home pilot with Humana, CEO Mike Earley and President and COO Dr. Jose Guethon describe Metcare’s longstanding commitment to the management of care transitions for its Medicare patients, how its 10 medical home practices keep a handle on patient…

The patient-centered medical home is at the heart of Mesa County, Colorado’s shared savings model, explains David West, M.D., a hospitalist, family physician and healthcare consultant from Grand Junction, Colorado. Dr. West describes how the shared savings model can be adapted across markets, including the conditions and factors that must be present for this approach…

Even though more than a third of the elderly are online, they’re not necessarily using the Internet to seek health assistance, explains Marcia Wade, M.D., F.C.C.P., M.M.M., senior medical director at Aetna Medicare. That’s why Aetna delivers its health risk assessment for the elderly in an alternate format while making available other Web-based tools to…

The dismal economy of 2009 has been a bright spot for health coaching and other health improvement programs, notes Dr. Jim Reynolds, chief medical officer for Health Fitness Corporation. Dr. Reynolds also compares early results from a Massachusetts’ smoking cessation program for Medicaid beneficiaries with outcomes in commercial populations, and describes what Year 1 of…