Physical health providers are well on their way down the path of value-based contracting. Many primary care providers receive bonus payments under pay-for-performance payment models. Medicare Accountable Care Organizations are participating in shared savings programs. Some orthopedists are being paid a single bundled payment for hip replacements. Out of this bundled payment, they must cover all care from the admission to the hospital through post-surgery rehabilitation in the community.Read More
One of the greatest stories in public health can be traced back to the use of vaccinations to prevent disease. Here’s what you need to know.Read More
Learn more about Emtiro Health’s latest partnership with Pyx Health: A Mobile Care Solution.Read More
The famous quote from former United States Surgeon General, C. Everette Coop, certainly still holds true today that “drugs don’t work in patients who don’t take them.” A vast majority of the population takes one or more medications for chronic conditions and just 50% of those medications end up being taken as prescribed (with nearly a quarter of new prescriptions never being filled at all).Read More
Forms of Artificial Intelligence (AI) have been around since the 1950s. Until recently, development has been slow, and the technology has not been altogether reliable and also very expensive. But advances in processing capability, analytics, and big data have changed much of that. We take it for granted that our smart phone can accurately hear us when we ask about a restaurant and then provide us with step-by-step driving directions to that restaurant. Soon, some predict that our “smart” car will actually drive us there with no involvement on our part at all. These abilities are all due to various systems using AI.Read More
After a long and competitive Request for Proposal (RFP) process, on Monday, February 4, 2019 the North Carolina Department of Health and Human Services (NCDHHS) announced awards to four statewide and one regional Prepaid Health Plans (PHP) that will administer the NC Medicaid and Health Choice programs.Read More
While it may sound obvious, much of medical care involves medication. In fact, medication accounts for 80% of the way in which practitioners prevent and treat disease. While medications can sometimes cause adverse reactions, the benefit of medication in improving health outcomes is overwhelming.Read More
The term ‘Medical Home’ maintains rank among buzzwords in today’s health care industry, specifically as the term relates to seeking formal, national recognition from major accrediting bodies like the National Committee for Quality Assurance (NCQA), The Joint Commission (TJC), or the Utilization Review Accreditation Committee (URAC). However, the term itself dates back to a concept first-introduced by the American Academy of Pediatrics (AAP) in 1967.Read More
We know that only a very small percent (10-20%) of our health is a by-product of what occurs when we visit our family physician or go to the hospital. We also know that chronic diseases consume a huge amount(1) of our health care budget. Why are these chronic diseases so prevalent? They are, for the most part, “lifestyle” diseases…Read More
In recent years, we have witnessed a huge shift in recognition around the importance of data as an asset. As the world undergoes a digital transformation, the seemingly small details of our lives are tracked, recorded, and leveraged as data points to make decisions. This cascade of information is growing at a rapid rate, creating innumerable opportunities for organizations to innovate and better serve customers and clients.Read More
Medicaid’s transition towards Managed Care is complex and represents a fundamental shift in how care to beneficiaries is both delivered and paid for in North Carolina (NC). However, you do not have to digest all 700+ pages of the State’s recent request for proposal to understand how this transition will affect NC primary care providers (PCP). There is a handy shortcut that provides the essential principles and parameters guiding health care delivery under Managed Care: The Advanced Medical Home (AMH).Read More
When the state of North Carolina set out to transform Medicaid over 3 years ago, many in the behavioral health world cringed.
The public behavioral health community has undergone some form of change about every five years for the last 20 years; from the days of community mental health centers, to the formation of the Local Management Entity (LME) system and the current LME/MCO structure.
Each of these major changes have required flexibility and resilience on the part of those working in the public mental health arena, particularly as they seek to help confused consumers navigate the continual system changes. However, as Medicaid Transformation has unfolded, a little ray of sunshine has emerged, symbolizing that we just might be moving toward an era of better care for patients with behavioral health needs.Read More
We each make over 200 decisions about food daily. Many of these decisions are strongly influenced by our food environment and may contribute to health status based on what is available. Limited access to nutritious foods, as well as overwhelming access to nutrient-poor foods, can be addressed by health professionals through motivational interviewing with tailored education and knowledge of community resources.Read More
When you hear the phrase integrated care, you probably think about a behavioral health clinician embedded in a primary care office. But, that’s not the only form of integrated care. Like all of health care, integration occurs on a continuum.Read More