CalAIM, California, ECM, Medi-Cal, Managed Care, Medicaid, Provider Resource Alex Yarijanian CalAIM, California, ECM, Medi-Cal, Managed Care, Medicaid, Provider Resource Alex Yarijanian

DHCS Quarterly Enhanced Care Management and Community Supports Report: Insights and Future Directions

The Department of Health Care Services' Q3 2023 Enhanced Care Management (ECM) and Community Supports (CS) Quarterly Implementation Report illuminates the progressive rollout of these crucial healthcare initiatives under CalAIM. Notably, the report highlights the expansion of provider participation and the diversification of services offered, reflecting a positive growth trend in state-wide healthcare enhancements.

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Vermont, New Hampshire, Tennessee, Medicaid, Value Based Care Payments, Provider Resource, Behavioral Health, Reimbursement Alex Yarijanian Vermont, New Hampshire, Tennessee, Medicaid, Value Based Care Payments, Provider Resource, Behavioral Health, Reimbursement Alex Yarijanian

Value-Based Payment Models in Behavioral Health: State Innovations and Outcomes

Discover how states are revolutionizing mental health care with Value-Based Payment (VBP) models tailored for behavioral health providers. Learn about the innovative approaches, including capitated payments, care coordination programs, and quality-focused incentives in states like New Hampshire, Tennessee, Vermont, and through the Certified Community Behavioral Health Clinics initiative. These models aim to improve patient outcomes, enhance care efficiency, and ensure sustainable financing for mental health and substance use disorder services.

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Medicaid, California, Reimbursement Alex Yarijanian Medicaid, California, Reimbursement Alex Yarijanian

Historic Pay Raise for Medi-Cal Providers (California Medicaid)

What makes these increases noteworthy is their scale. For each eligible code, rates are set to be at least 87.5% of the lowest Medicare rates in California. This significant financial boost is aimed at encouraging more providers to participate in the Medi-Cal program, thereby expanding access to healthcare services for enrollees.

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HCA & Dignity Health: Advanced Bundled Payment and Risk Sharing Program Management

Carenodes’ expert management and careful coordination led to successes at Dignity Health and HCA Hospitals. Carenodes’ strategy led to over $1.1 million in shared savings in just one quarter at a single hospital, resulting in significant shared savings and elevated financial performance across 14 hospitals and 50+ SNFs. The achievements underscore Carenodes' unwavering commitment to advancing financial performance in healthcare while upholding the highest standards of patient care.

Kaiser – Partnership in Substance Abuse Treatment Services with Carenodes

Discover how Kaiser forged a remarkable partnership to enhance substance abuse treatment. Focusing on methadone and outpatient SUD services, we bridged a critical gap in Kaiser's healthcare offerings. Our strategic collaboration, rooted in relationship building and outcome tracking, led to increased business and stronger professional ties with Kaiser.

Humana – Comprehensive Contracting and Network Management

Collaborating with Humana, mastered the art of healthcare contracting and network management across Nevada and Hawaii. Overseeing a network of 4,000+ providers, we set a new standard in healthcare excellence. Learn more about this innovative journey.

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Introducing the Care MAP Tool: A Comprehensive Guide

Introducing the Care MAP Tool, designed to support healthcare providers in managing complex care needs. This user-friendly, Excel-based tool offers a structured framework for effective care coordination, resource allocation, and patient management. With modules for an overview and practical scenarios, plus a comprehensive resource library and FAQ section, the Care MAP Tool enhances care strategies and improves patient outcomes. Download it today and elevate your care management practices.

Dashboards: Breastfeeding Intention and Duration Indicators

The Breastfeeding Intention and Duration Indicators are key measures used to track breastfeeding practices and intentions among new mothers. These indicators include plans to breastfeed exclusively or in combination with formula, actual breastfeeding activities, and breastfeeding duration up to three months. They exclude mothers whose infants were not living with them at the survey time, ensuring data accuracy. These indicators help shape effective breastfeeding support programs, inform policy decisions.

CalAIM Budget Estimator Tool: A Budget Template for CBOs Considering CalAIM Contracting

The CalAIM budget estimator tool is an Excel-based template that helps community-based organizations estimate costs and potential revenue for providing Medi-Cal Enhanced Care Management and Community Support Services. It includes built-in assumptions, customizable revenue inputs, and a summary tab to project program margins, supporting informed financial decisions and contract negotiations with managed care organizations.