Luke Hansen

A new #EBHC scoping review explores how health service and delivery systems in high-income countries define and operationalise #HealthEquity. 👉 https://ow.ly/ZxaY50ShGWU

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Loper and #Medicare #Reimbursement: What Does the Future Hold? Ganny A Belloni from Bloomberg News wades in (in a terrific article) on the implications of #Chevron and the rise of #Loper on Medicare reimbursement issues. I'm quoted. My take? I think, as I say in the article, Loper will have less impact than people think. Loper eliminates Chevron “deference” by a court to an agency’s interpretation of a federal statute, where that law is “ambiguous”, meaning it can reasonably be read in different ways. Congress can (and will) significantly reduce the risk of litigation challenges in a Looer world by, as Ganny summarizes the point, defining statutory terms more precisely and "more clearly and explicitly giv[ing] the agency the discretion to decide issues". Further, many potential challenges can be avoided by CMS, as I say in the article, by framing "more ... [agency] decisions as ‘factual determinations’ or ‘adjudicative’ questions, where it still is entitled to deference, even after Loper.” To those of you who are fans of the administrative state, take heart. The sky, truth be told, is not falling. #healthcare Centers for Medicare & Medicaid ServicesU.S. Department of Health and Human Services (HHS) #CMS #HHS #APA #administrativestate #agencydiscretion #rulemaking #agencies #administrativelaw

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The Association of Healthcare Value Analysis Professionals (AHVAP) celebrates Elizabeth Eisenberg, MSN, RN, CVAHP from Scripps Health for commitment to excellence in the specialty of healthcare value analysis! Liz has signified this commitment by signing the official Association of Healthcare Value Analysis Professionals (AHVAP) healthcare value analysis pledge. To learn more about the Association of Healthcare Value Analysis Professionals (AHVAP) Commitment pledge: https://lnkd.in/gqEWPBue. #AHVAP #valuebasedcare #excellenceincare #valueanalysis

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New study in #HSR from Yevgeniy Feyman PhD et al  measure specialty provider networks in Medicare Advantage (MA) and examine associations with market factors. WHAT IS KNOWN There is limited evidence on the relationship between MA network breadth among specialists and plan or market factors. WHAT THIS STUDY ADDS Using a recently developed algorithm for measuring the restrictiveness of primary care providers, this study measures the network restrictiveness of nine high-prescribing specialties among MA contracts. CONCLUSION Findings suggest that rural beneficiaries may face disproportionately reduced access in these networks and that efforts to improve access should vary by specialty. FULL ARTICLE: https://lnkd.in/gnn6Uwmk Wiley AcademyHealth #HSR 

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Introduction of Medicaid APM options for federally qualified health center (FQHCs) was associated with modest, statistically significant increases in quality concentrated among FQHCs with APM models that explicitly incentivized quality. https://ja.ma/4daDw8H

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Most viewed in the last 7 days from JAMA Health Forum: This JAMA Forum discusses the current data collection mechanisms used for Medicare and proposes ways to improve nationwide data collection efforts for Medicaid. https://ja.ma/4dJuqzJ

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Economic forces and political rhetoric mean that uncertainty will continue to plague key hospital revenue streams. These conditions may not be surprising but are certainly exhausting for clinicians, #HTM teams, and #CapitalPlanning committees. Looking inward for strategies to increase the availability and output of equipment resources can help health systems build stability in clinical operations. Becker's Healthcare https://hubs.ly/Q030ljJl0 

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🎙 On Tuesday, December 10, HC3 hosted a LIVE Podcast Event exploring the future of health care! 🎙 In collaboration with Health Care Council of Chicago (HC3)’s parent organization, Third Horizon, and partner 4sight Health, the event featured a thought-provoking panel discussion on 2024 health care trends, covering topics like workforce development, payment reform, artificial intelligence, and health equity. Our incredible panelists included Dave Gomel, CEO, Rosecrance Behavioral Health; Carolyn Metnick, Partner at Sheppard Mullin Richter & Hampton LLP; Esther Macchione, Co-founder and Principal of Prestige Health; and Jordan Powell, Senior Vice President, Illinois Health and Hospital Association with Ryan Voyles, Reporter at Health News Illinois as the moderato of the discussion. Following the panel, attendees were treated to an inspiring fireside chat with David Johnson, CEO of 4sight Health and author of the recently released "The Coming Healthcare Revolution," and David Smith, Founder and CEO of Third Horizon and Co-Founder of Health Care Council of Chicago (HC3). The event delivered valuable insights and actionable strategies from seasoned industry visionaries dedicated to reimagining health care for a brighter future. ✨ Missed the event?✨ Catch the full recap, video highlights, and podcast episodes now available: https://lnkd.in/dBGSV2T7 HC3 Podcast episodes are available to download and stream wherever you listen: https://lnkd.in/gX9XAfSh Don’t miss these impactful takeaways as we reflect on 2024 and anticipate what lies ahead! #HealthcareInnovation #FutureOfHealthcare #HealthEquity #ArtificialIntelligence #WorkforceDevelopment #PaymentReform #HealthcareLeadership #HealthCareTrends #PodcastEvent #HC3Podcast #HealthcareRevolution #HealthNews #ThoughtLeadership #IndustryInsights #HealthcareTransformation

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Managing prior authorizations across all lines of business is easier when you have a single source of truth. PA Checkpoint becomes that source of truth for our clients - listen to BCBS of Minnesota share their experience: #PriorAuthorization #AIinHealthcare #ItilitiHealth

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Prior authorizations create a significant administrative burden for providers. An average practice completes 45 prior authorizations a week per physician. Physicians and their staff spend an average of 14 hours a week completing those requests. Rebecca Grandy - Director of Pharmacy at CHESS - shares how pharmacists can help reduce this burden, letting providers get back to practicing medicine. Learn more on the latest episode of the Move to Value Podcast. Available to stream wherever you get podcasts. #podcast #healthcarepodcast #valuebasedcare #priorauthorizations

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SURVEY RESULTS | USAging Aging and Disability Business Institute’s 2023 CBO-Health Care Contracting Survey results are in! Check out the latest data brief from their research partner Scripps Gerontology Center and the infographic and toolkit slides to learn more about how CBOs and networks are contracting with health care entities. https://bit.ly/4dF0LYr

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The Kaiser Family Foundation report linked below examines the extent of physician networks in the Affordable Care Act (ACA) Marketplaces and how the breadth of these networks impacts enrollee costs. The study analyzes the share of doctors participating in the provider networks of Qualified Health Plans offered in the individual market in 2021 while focusing on the challenges enrollees face when selecting plans with little information on network breadth. #PrivateInsurance #AffordableCareAct #Healthcare

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Through an independent review organization and patient feedback, the Ohio Department of Medicaid provides a managed care plan report card each year. The 2024 report card was just released rating each of the seven Medicaid managed care plans. See how Ohio Medicaid’s health insurance plans compare in key performance areas: https://lnkd.in/gXRtKKMn #OhioMedicine #Physicians #Ohio

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I’ve been given advice that the fastest way to monetize HER Heard without charging the end user (woman) is trackers and selling data. Instead, I’d like to build something more trustworthy. I don’t want to be in a headline like this. If you are not paying, then you are the product (you/your data are being sold). There are newer ways to deindentify data or even to aggregate things women search for that can be of interest to various stakeholders. In theory that could be okay to sell, but in a post-Roe world with laws encouraging bounty hunting, I am vetting the choices ahead. I am all for moving fast, without breaking things.

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The 2024 Final Rule on § 1557 of the ACA brings a crucial protection against "discriminatory patient care decision support tools." This broader definition encompasses various automated decision-making tools, from flowcharts to complex AI algorithms. NHeLP's advocacy played a role in expanding this definition to address the diverse harms of automated systems. Learn more about this significant step towards equitable healthcare access. By Cassandra LaRose, JD, MPH and Elizabeth Edwards #HealthEquity #PatientProtection https://lnkd.in/gN6HQWhf

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Ohio is now “live” in CMI-Connect! The Medicaid payment system transition in Ohio is extra complex due to the following reasons: 1. The State used the OSA, but only for providers that did not “freeze” their case-mix. Most providers froze their CMI.  2. We don’t know the exact quarter that our PDPM performance will begin to count towards CMI. 3. We don’t know the exact construction of the PDPM system that will be used (Nursing, Nursing + NTA). This is what we do know: 1. The Nursing component will be predominantly featured in the Ohio calculation, regardless of whether it is Nursing only or Nursing + NTA. 2. Providers that are more bullish on an early conversion to PDPM will focus on the Nursing component for PDPM Medicaid beginning today (10/1/24) for the Q4 collection. CMI-Connect is configured for the Ohio case-mix calculation for providers that wish to focus on CMI now while the State irons out all of the details. Reach out to learn more about our EMR based clinical alerts that can aid in accurate compliant capture of reimbursement sensitive acuity in Ohio!  

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