Dan Torrens

https://lnkd.in/epcXuFNy The Centers for Medicare & Medicaid Services (CMS) approved an amendment to Vermont’s section 1115 demonstration, “Global Commitment to Health.” Approval gives the state authority to provide health-related social needs (HRSN) services and infrastructure support, close the Substance Used Disorder (SUD) Community Intervention and Treatment (CIT) coverage gap by expanding eligibility for the CIT expansion group for eligible beneficiaries up to and including 225 percent of the federal poverty level (FPL), expand Developmental Disabilities Services benefits, and support transition of most Community Rehabilitation and Treatment (CRT) and Mental Health Under 22 services currently covered under the demonstration to the Medicaid state plan.

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GASTROENTEROLOGY QUARTERLY UPDATES - 3rd Quarter - Live Webinar - July 10, 2024 - 1 hr web - 10am PT - 1 ceu from AAPC. SPECIAL DISCOUNT ADDITIONAL ATTENDEES - sign up first person at regular price - each add'l attendee(s) goes for $99 a person (includes their own connection, materials & ceu's) - limited spaces available at this rate, so signed up soon! Here's link to download registration and fax to (415)892-1271 or register online at McVey Seminars website - https://lnkd.in/g4SAuyic WANT AN AMAZING DISCOUNT? (for a short time this below discount has an extra $50 off for this week only - so take advantage of double savings for a limited time) TO GET THE NEXT 4 GI QUARTERLIES AT THE LOW PRICE OF $735.00 (BRINGS THE COST FROM $230.00 EACH TO $183.75> here's link to do all 4 sessions for 2024/2025 - https://lnkd.in/gNXFUe8 / #gastroenterology #gastroenterologist #gastrointestinal #gastro #gidoc #healthcare #medicalbilling #medicalcoding #medicalbillingandcoding #coding #billing

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In case you missed yesterday’s exciting news, Arcadia acquired CareJourney. Aaron Weitzman of Axios wrote about why this deal matters: Insufficient data analytics capabilities are one challenge in the shift to value-based care. However, the industry is moving towards a long-awaited, more open, interoperable ecosystem that requires Arcadia’s data engineering know-how and CareJourney’s strength in data science to navigate.   My colleague Aneesh Chopra (now Chief Strategy Officer for Arcadia) put it simply: “We can basically build the data platforms that organizations need to thrive as they make this transition to VBC from FFS.”   Read more: https://lnkd.in/eEbaB-cw  

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The AI revolution will be a key theme of RISE West 2024. Stop by our booth to learn how Edifecs can help unlock continuous compliance and support more effective payer-provider collaboration! #risewest2024 #healthcareAI #healthtech

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💡 Simplifying healthcare data 💡 At #HealthDatapalooza, Arcadia announced: • 🌐 Faster BCDA data sharing for providers • 📊 Improved oncology data sharing • 🏥 Improved visibility into provider networks 🔗 Learn more in this press release: https://ow.ly/NRv550TPZEX

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💡 Simplifying healthcare data 💡 At #HealthDatapalooza, Arcadia announced: • 🌐 Faster BCDA data sharing for providers • 📊 Improved oncology data sharing • 🏥 Improved visibility into provider networks 🔗 Learn more in this press release: https://ow.ly/NM0B50TMAgI

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Michael McAuliff's article, "PBM bill, telehealth extension may ride together in 'lame duck'" (Modern Healthcare), provides a great overview of the potential for #PBM reform this year! Thanks for taking the time to speak with Lloyd Fiorini and hear his perspective! "I see a possibility, a good possibility if not a probability, that something happens this year, just because there is bipartisan support to do PBM reform," said Lloyd Fiorini, general counsel at Capital Rx. It is paywalled, but check it out if you can! https://okt.to/akDI2T

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https://lnkd.in/eC-ZRZYz CMS Approved a new Pennsylvania Section 1115 demonstration to provide limited pre-release demonstration coverage to specific incarcerated individuals under Medicaid based on state-specific health-related criteria for up to 90 days before release in state prisons and county jails. In addition, through this demonstration, Pennsylvania can provide some housing and nutrition-related services to particular Medicaid beneficiaries based on a set of clinical and social risk criteria.

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A recent report from the Office of Inspector General (OIG) has sparked discussions about the effectiveness and utilization of HRAs. However, a closer look reveals that the findings may not fully capture the potential benefits these arrangements offer to both beneficiaries and health plans. HRAs can play a crucial role in enhancing care coordination and empowering members to manage their health costs effectively. They provide tailored financial support, making healthcare more accessible and improving overall member satisfaction. It's important to note that not all diagnoses identified through an HRA or chart review are considered for risk adjustment payments. For instance, if an individual has multiple diagnoses within the same Hierarchical Condition Category (HCC), only the most severe condition is counted, which can impact the financial support available for their care. As we navigate the evolving landscape of Medicare Advantage, let’s advocate for informed policies that recognize the comprehensive needs of our seniors and enhance the role of HRAs in their care journey! 💙 #MedicareAdvantage #HRAs #HealthcareInnovation #PolicyAdvocacy https://lnkd.in/erwBaK9q

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Insurance eligibility and benefits related denials continue to be the the highest ranking of all denial types. Download our ebook to see what steps you can take to avoid these types of denials.

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HEDIS aims to elevate measurement standards and enhance the quality of patient care. It is one of the most important tools in the payers' toolbox, so walking through the "what, how, and why" behind HEDIS is incredibly valuable. Read the blog for details: https://okt.to/FBkERU

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What's the key to unlocking greater efficiency in payment integrity? Check out Zelis' latest whitepaper for the details.

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Providers and health plans have been working on their Fee for Service payment processes for decades (still work to be done there), but the data flows needed to support Value Based Care arrangements are in their infancy. Organizations involved in Value Based Care (VBC) should consider using modern processes (like APIs) and standards (like HL7 FHIR) to exchange: · Rosters of members attributed to VBC populations · Financial performance on VBC contracts · VBC contract details · Patient care gaps for VBC contracts · Clinical quality performance · And the list goes on In his interview with Rick Daly from HMFA, Deepak Sadagopan talks about why his team is building the data infrastructure to support VBC and why it should matter to you. https://lnkd.in/ggKeA985

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More interesting #news today on #carecoordination and transitions of care, this time specific to bundled payments for hospitals and the #TEAM model. #CMS #Healthcare #reimbursement

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As policymakers revisit the concept of value-based payment amidst growing dissatisfaction with Medicare's pay system, the question arises: What exactly does value-based care entail, and why has it failed to meet expectations over the past two decades? https://ow.ly/Y1yz30sE5O2 #HealthcarePolicy #ValueBasedPayment #Medicare #ValueBasedCare #HealthcareReform

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CYBER MONDAY SAVINGS - Join Terry Fletcher, CPC for her Gastroenterology Updates 2025 - 1 Hr - Live Webinar on December 18, 2024 at 8:00am PT. This webinar will bring you all the new/revised/deleted updates. Cyber Monday discount of $50 off, PLUS additional participants join for $49 each, and receive their own connection, materials and AAPC ceu's. Here's link to download registration form/flyer from McVey Seminars website - https://lnkd.in/gGTa7CcG / BONUS our "pick 6" offer, so you can get more updates at a discount price is currently offering a $100 off the base price, so don't miss out on these great savings if you know you had more then one topic you need updates on. You have a year to pick all 6, so don't have to rush! Link for more information on this option - https://lnkd.in/gZAz2JTt / #gastroenterology #gastroenterologist #gastrointestinal #gastro #gidoc #healthcare #medicalbilling #medicalcoding #medicalbillingandcoding #coding #billing

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