January 19, 2021
On the day before the inauguration of a new president, the country marks a once unthinkable milestone of 400,000 deaths. The winter surge of the pandemic claimed 100,000 Americans in just five weeks.
January 19, 2021
The report sheds light on the U.S. health disadvantage and the role business leaders can play in improving community health through engagement and investment.
January 15, 2021
Engagys and RISE have collaborated once again to release our 5th annual State of Healthcare Engagement Survey. Here’s a sneak peak on what the 2020 findings revealed. Engagys Managing Director Kathleen Ellmore will review the full survey findings during the RISE 2021 Medicare Marketing & Sales Summit, a live-streaming virtual event, Feb. 22-23.
January 14, 2021
The American Health Information Management Association (AHIMA) has released the results from its 2020 social determinants of health (SDoH) survey.
January 13, 2021
The Centers for Medicare & Medicaid Services (CMS) issued a final rule Tuesday that will speed Medicare beneficiaries’ access to the latest advanced devices.
January 13, 2021
RISE looks at recent headlines concerning social determinants of health (SDoH).
January 12, 2021
RISE reviews the latest from the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS).
January 11, 2021
Dr. Emanuel, a member of President-elect Joe Biden’s transition COVID-19 advisory board, will kick off the first day of RISE National on Monday, March 29, with a keynote address on the future direction of the American health care system. Also slated to speak at the virtual conference: infection disease expert Dr. Luciana Borio, who warned the public in January 2020 about the pending COVID-19 pandemic; Dr. Wendy Sue Swanson, M.D., a leading innovator in digital health, innovation and prevention; and health care futurist Ian Morrison.
January 08, 2021
What’s in store for the RISE Association communities in 2021? We asked experts in Medicare Advantage, quality and revenue, consumer engagement, and social determinants of health for their predictions on trends that will impact the industry in the upcoming year. Spoiler alert: COVID-19 will continue to play a big role.
January 08, 2021
The Centers for Medicare & Medicaid Services (CMS) on Thursday issued new guidance for states to address social determinants of health (SDoH) in Medicaid and the Children’s Health Insurance Program (CHIP).
December 30, 2020
The new bill includes $3 million in funding to establish a social determinants of health (SDoH) pilot program.
December 22, 2020
Within just a few days, the logistical barriers of the vaccine made by Pfizer and BioNTech were laid bare. Many officials now hang their hopes on Moderna, whose vaccine comes in containers of 100 doses, doesn’t require deep freezing and is good for 30 days from the time it’s shipped.
December 17, 2020
Persuading vulnerable low-income and ethnic communities hit hard by the coronavirus to take a new vaccine may be challenging. But established local health leaders, like a group in Rochester, Minnesota, home of the Mayo Clinic, may be one answer.
December 11, 2020
High stakes and big challenges await as the U.S. prepares to roll out vaccines against COVID-19, with front-line health care workers and vulnerable nursing home residents recommended as the top priority.
December 09, 2020
Manatt Health, in collaboration with the Robert Wood Johnson Foundation and the Nemours Children’s Health System, released a report outlining how organizations can drive social determinants of health (SDoH) investments for children through a Children’s Health and Wellness Fund.
December 07, 2020
President-elect Joe Biden today announced his nominations and appointments of his health team and the names will be familiar to those in the health care industry.
December 04, 2020
Identifying risk attributes — social determinants of health (SDOH) — for populations can enhance an organization’s ability to develop sound, data-driven interventions that can influence change, enrich wellness, and improve profitability.
December 03, 2020
RISE looks at the latest news regarding social determinants of health (SDoH), including recent approaches from Medicaid programs.
November 25, 2020
RISE rounds up recent headlines concerning social determinants of health (SDoH).
November 23, 2020
Research indicates a concerning increase in relapse, fatal and non-fatal overdose, anxiety and depression, and other mental health conditions due to the pandemic.
November 23, 2020
Morrison will address the future of the health care marketplace, trends, and implications during RISE National 2021, which will take place March 28-30, 2021.
November 19, 2020
A new data brief finds that in 2021 more and more Medicare Advantage (MA) plans will offer supplemental benefits like adult day care services, home-based palliative care, in-home support services, and career support.
November 19, 2020
In a new interview with Kaiser Health News, the nation's top infectious disease expert breaks down how to survive the coming months and describes how hard it is when people still insist the coronavirus outbreak is “fake news.”
November 16, 2020
The Republican-led states are trying to prove they were harmed by the 2010 health law—and thus have “legal standing”—because their Medicaid costs increased, even though Congress eliminated the penalty for not having health coverage in 2019. At least one justice was skeptical.
November 16, 2020
While there is not a one-size-fits-all answer to social determinants or social needs, there is some basic information that can help you address the unmet needs of your member population.
November 13, 2020
The rule puts an end to overly prescriptive regulations that stakeholders have complained about since 2016, according to CMS Administrator Seema Verma.
November 11, 2020
The survey explored physicians’ perspectives on the COVID-19 pandemic and the future of the health care system. A key factor: social determinants of health (SDoH).
November 10, 2020
The U.S. Supreme Court will hear arguments today in a case that could overturn the Affordable Care Act. California Attorney General Xavier Becerra, who is defending the law with the backing of more than 20 other states, told California Healthline that he predicts the justices will uphold it.
November 09, 2020
The United States on Monday became the first country to surpass 10 million cases and public health experts warn numbers may continue to climb unless the Trump administration takes steps now to stop the spread of the deadly virus.
November 09, 2020
The Supreme Court on Tuesday will hear oral arguments in a case that, for the third time in eight years, could result in the justices striking down the Affordable Care Act (ACA).
November 06, 2020
The RISE team is looking forward to seeing conference attendees live and in person when the time is right. Here are the measures RISE has taken to create a healthier and safer conference experience− let us know when you’re ready.
November 05, 2020
The American Diabetes Association (ADA) conducted a scientific review of previous research and literature on the association of social determinants of health (SDoH) and diabetes risk and outcomes as well as the impact of targeted interventions.
November 04, 2020
As the votes continue to be counted in the tight battle between President Donald Trump and former Vice President Joe Biden, the federal role in health care is at stake.
October 30, 2020
Addressing social determinants of health (SDoH) has enabled one special needs plan to improve health outcomes for members and has led to a decrease in emergency room visits, inpatient admissions, and inpatient lengths of stay.
October 21, 2020
RISE is now accepting nominations for its annual Martin L. Block Award that recognizes excellence and clinical leaders’ passion to improve patient care. For 2021, RISE has broadened the criteria beyond risk adjustment and Stars to ensure the spirit of excellence and innovation lives on.
October 21, 2020
For the first time, the National Academy of Medicine recommended vaccine prioritization be given to individuals who struggle with social determinants of health (SDoH).
October 21, 2020
RISE reviews the latest headlines that impact Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act marketplace.
October 21, 2020
In this video interview recorded prior to his retirement as executive director of the RISE Association, Kevin Mowll, discusses his work with RISE over the past seven years and what the future holds for the association and its related communities.
October 16, 2020
RISE looks at recent headlines in the news that impact the health care industry.
October 16, 2020
During the second day of RISE’s live-streamed virtual conference, Gillette will share his firsthand experiences and perspective on health care accessibility.
October 14, 2020
Learn more about one of the exciting benefits of joining the RISE Association.
October 14, 2020
The health system’s model will enable primary care practices to effectively screen for social determinants of health (SDoH) to improve health equity in vulnerable communities.
October 12, 2020
The COVID pandemic changed the landscape of the social needs that drive health overnight. Millions of people lost their jobs; millions of people were ordered to stay home. People lost access to food for themselves and their families because they couldn’t afford it, or they couldn’t get to a grocery store. Miles of cars waiting at drive-through food pantries dominated the headlines. People became more isolated and depressed. People’s ability to pay for their housing was jeopardized.
October 09, 2020
The new network seeks to break down barriers between clinical and social care to better address member’s socioeconomic needs in the Philadelphia area.
October 08, 2020
COVID-19 continues to dominate headlines in the wake of President Trump’s diagnosis and hospitalization. Here’s a roundup of the latest news.
October 07, 2020
Under normal circumstances, an older adult is treated every 11 seconds in an emergency department (ED) because of a fall.
October 02, 2020
RISE looks at the latest headlines that impact Medicare and Medicaid.
October 02, 2020
After downplaying the seriousness of the virus for months, President Donald Trump and the First Lady Melania Trump tested positive for the coronavirus. He is now under quarantine.
October 01, 2020
The principal of EFS Supervision Strategies, LLC, will work with the RISE Association to help guide our Social Determinants of Health (SDoH) Community.
September 29, 2020
Mark your calendars! We are excited to return to Nashville, Tenn. in March for RISE National 2021. Get a first look at the new tracks we’ve already planned for you.
September 29, 2020
RISE looks at recent headlines concerning social determinants of health (SDoH), including the impact of COVID-19 on Latino, Black, and Native American communities.
September 29, 2020
President Donald Trump’s executive order says that people with preexisting conditions can get affordable insurance. But it doesn’t explain how.
September 25, 2020
RISE summarizes the latest headlines that impact Medicare, Medicare Advantage, and Medicaid.
September 22, 2020
The innovative model of care saves money, improves patient satisfaction, and may boost Medicare Advantage plan enrollment.
September 21, 2020
With the death of Justice Ruth Bader Ginsburg, a lawsuit brought by Republican state officials has become the latest existential threat against the federal health law, scheduled for oral arguments at the Supreme Court a week after the general election in November.
September 15, 2020
Learn best practices to improve outcomes for hard to reach and at-risk populations during a live-streamed virtual event on Oct. 27-28.
September 15, 2020
The live-streaming virtual event will feature two days filled with timely discussion on how to best pivot to the new landscape of population health in a post-pandemic world. The 2nd annual summit will take place November 17-18. Here’s an inside look at some of the speakers and hot topics included in this year’s event.
September 11, 2020
RISE Managing Director Ellen Wofford made the following announcement during RISE West on Friday:
September 10, 2020
A new study released by Better Medicare Alliance (BMA), a leading research and advocacy organization supporting Medicare Advantage, finds that MA beneficiaries have lower incomes, speak English as a second language, are more likely to rent their home, and are reliant on public transit. The findings, BMA said, show MA’s value to underserved populations.
September 04, 2020
The RISE Association’s webinar series recently featured a case study on a community-based, multi-hospital system medical respite program in Pittsburgh, Pa. that aims to provide care to people experiencing homelessness.
September 03, 2020
Learn more about the interactive virtual sessions and activities we’ve planned for RISE West 2020, which will take place Sept. 9-11.
September 03, 2020
Older Blacks are perishing quietly, out of sight, victims of the pandemic and a lifetime of racism and its attendant adverse health effects.
September 01, 2020
The Commonwealth Fund recently explored the quality of health coverage for U.S. working-age adults in the first half of 2020. Among the findings: Two in five adults do not have stable health coverage.
September 01, 2020
In this 10-minute video with RISE, Stephen Klasko, M.D., MBA, president and chief executive officer, Thomas Jefferson University and Jefferson Health, provides a glimpse into what a global pandemic would look like in 2030 based on what we’ve learned during the COVID-19 public health emergency of 2020.
August 27, 2020
RISE has once again teamed up with Engagys to find out how communications tactics have changed throughout the COVID-19 pandemic. Here are five findings from our most recent survey. Learn more when we discuss the complete results during a one-hour webinar at 1:30 p.m. EST, Wednesday, Sept. 16. The webinar is free to RISE Association members.
August 26, 2020
COVID-19 has made member engagement more important than ever before. In this article, RISE talks to three of the facilitators of RISE West’s upcoming preconference workshop that tackles the need for Medicare Advantage (MA) plans to double down on member engagement in the second half of 2020.
August 25, 2020
The agency’s most recent 10-year plan aims to prioritize critical public health issues including the COVID-19 pandemic and social determinants of health (SDoH).
August 21, 2020
A recent international survey found people in the United States are struggling more than people in other wealthy nations amid the global pandemic.
August 20, 2020
Part 2 of our interview with John E. McDonough, DrPH, MPA, professor of public health practice, Harvard T.H. Chan School of Public Health, who will be a featured speaker at RISE’s upcoming virtual event, RISE West 2020, Sept. 9-11.
August 19, 2020
RISE rounds up the latest news concerning COVID-19.
August 18, 2020
A New York federal judge on Monday stopped the Trump administration from enforcing a new rule that rolls back nondiscrimination protections for transgender patients.
August 14, 2020
As COVID-19 cases and deaths surge in several hot spots across the United States, many individuals and organizations continue to ask, “What else can we do to help protect ourselves, our families, our communities, and our nation?”
August 11, 2020
Consider the following framework to effectively assess the ROI of SDoH interventions.
August 11, 2020
The findings indicate that adults who experience one or more social determinant of health (SDoH) have an increased risk of stroke.
August 07, 2020
The death toll in the United States may reach nearly 300,000 by December 1, according to new data released Thursday from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine.
August 06, 2020
Researchers caution that a COVID-19 vaccine is likely to be less effective in obese adults.
August 04, 2020
Chief Derek Bergsten of the Rockford, Ill. Fire Department talks to RISE ahead of the RISE West virtual summit, where he will share the success of a collaborative social determinants of health (SDoH) program that has reduced emergency department visits, ambulance runs, and hospital admissions.
August 03, 2020
Experts say adults 60 and up must continue to limit exposure in the years to come—even after there is a vaccine for COVID-19.
July 31, 2020
A recent study found racial and ethnic disparities beyond underlying health conditions play a significant role in the disproportionate impact of COVID-19 on communities of color.
July 29, 2020
The live-streamed virtual event will take place Sept. 9-11 and features presentations from leading experts in risk adjustment, quality performance, documentation, HCC coding practices, member engagement, payer-provider collaboration, and social determinants of health. Take a look at the sessions we’ve planned.
July 28, 2020
The Centers for Medicare & Medicaid Services (CMS) on Tuesday released its first monthly update of data that reveals the impact of the coronavirus on the Medicare population, including American Indian/Alaskan Native Medicare beneficiaries.
July 24, 2020
Recent research indicates a hotspotting approach to meet physical, behavioral, and social needs of high-cost patients is too narrow to have a lasting impact.
July 24, 2020
RISE rounds up the latest news on COVID-19.
July 21, 2020
The pandemic has given the National Institutes of Health an opportunity to show the value of its $1.5 billion “All of Us” research program. A major effort to make the platform’s database representative of America resulted in minorities making up more than half of its more than 270,000 volunteers.
July 20, 2020
Here are five actionable steps that organizations can take to support communities of color hit especially hard by the global pandemic.
July 16, 2020
A study from Sutter Health underscores the role race and ethnicity play in how individuals access care and the health outcomes caused by existing inequities.
July 14, 2020
A new study by EmblemHealth, one of the largest nonprofit health insurers in the United States, reveals ownership of electronic devices, access to internet services, and overall lack of technology impinge on access to telehealth.
June 26, 2020
Learn about the actions BlueCross BlueShield of North Carolina (Blue Cross NC) took as part of a payer-based strategy to improve behavioral health access, quality, and efficiency.
June 25, 2020
The U.S. Department of Health & Human Services (HHS) Office of Minority Health (OMH) will partner with Morehouse School of Medicine to help the communities hit hardest by the global pandemic.
June 25, 2020
The Administration for Community Living (ACL) and the Office of the Assistant Secretary for Health created the challenge to find an online tool to help isolated Americans connect with others and engage in the community.
June 18, 2020
Client perspectives call for more action from plans and providers, community-based organizations (CBOs) thrive in cross-sector collaboration, and loneliness and mental wellness remain areas of concern.
June 16, 2020
The ABC news veteran shared his inspiring story during a keynote fireside chat at last week’s virtual RISE National Summit on Social Determinants of Health.
June 12, 2020
The benchmarking survey focused on how health plans and community-based organizations define success for programs that address social determinants of health (SDoH) and measure their outcomes and impact.
June 11, 2020
The survey examined the occurrence of loneliness among Americans and the link between factors such as age, social media use, income, and occupation.
June 03, 2020
RISE looks at recent news regarding social determinants of health (SDoH), including the different impacts the global pandemic presents to children and adults.
May 28, 2020
The guidance to stay sheltered as society slowly reopens wears on older Americans, who have a growing sense of isolation and depression.
May 28, 2020
The global pandemic has exacerbated existing inequities for the black and Latino populations, putting them at heightened risk for physical and mental health issues.
May 21, 2020
The virtual event on June 4 and June 5. will bring together industry experts to examine the impacts of COVID-19 on vulnerable population and strategies for adaptation in this uncertain time.
May 20, 2020
Leading experts from cross-sector health care organizations will share insights to address challenges related to social determinants of health (SDoH). If you’re a professional involved with community-based organizations (CBOs), payers, hospitals/health systems, funders, manufacturers or government entities, you’ll want to be a part of this drive for social good.
May 18, 2020
While people across the country continue to experience different impacts from the global pandemic, they all have one thing in common: Stress. Here are some tips to build resiliency in these uncertain times.
May 05, 2020
A recent report from the Centers for Disease Control and Prevention (CDC) confirms homelessness is a significant contributor to virus spread.
April 20, 2020
Social isolation due to COVID-19 has friends and families left to their own devices…literally. So much so, that grandparents are trying to learn new communication technologies to stay in touch.
April 15, 2020
The findings indicate that older adults, males, black Americans, and those with underlying health conditions are at a higher risk for hospitalization due to the virus.
April 13, 2020
The launch of the interactive mapping website, which curates publicly available data at the census tract level, provides an added resource to California-based researchers amidst the COVID pandemic.
April 01, 2020
Several proposals to expand the Medicare program are under consideration. Here’s a breakdown of each approach and what they could mean for those at risk of racial and ethnic health disparities.
March 27, 2020
While it’s vital that Americans hunker down at home to avoid spreading COVID-19, doing so may amplify another public health threat: loneliness. Research has shown that loneliness is as damaging to a person’s health as smoking 15 cigarettes per day.
March 26, 2020
The Department of Health and Human Services (HHS) has implemented efforts to better address social determinants of health (SDoH) for certain programs and groups of people, but others face worsened conditions, according to a Health Affairs blog post.
March 25, 2020
Gaps in the social safety net have become apparent as public health leaders try to halt the spread of the virus.
March 19, 2020
Mortality rates for low-income older adults who are dually enrolled in Medicare and Medicaid are twice as high compared to those more affluent and solely enrolled in Medicare.
March 18, 2020
RISE looks at recent headlines concerning social determinants of health (SDoH), including the impact social distancing has on those already most vulnerable.
March 17, 2020
A new blog post from Deft Research looks at the link between non-medical circumstances and the use of the emergency room for non-emergency and routine medical care.
March 10, 2020
RISE reschedules national conferences due to concerns over COVID-19.
February 25, 2020
Speaker update: Calder Lynch from the Center for Medicare & Medicaid Services has been added to a roster of more than 50 speakers at the annual event, March 15-17, 2020 at the Omni Nashville Hotel.
February 13, 2020
Leading experts in the community-based organization (CBO) space will join together for an open panel discussion about firsthand experiences, strength and constraint areas, and bridging the gap between health care partners-a necessity for continued improvement in social determinants of health (SDoH), according to Denise Harlow, chief executive officer, National Community Action Partnership. Harlow will moderate the panel on June 10, the first full day of this year’s virtual summit.
February 06, 2020
The Centers for Medicare & Medicaid Services (CMS) recently released its first report on the use of diagnostic codes for social determinants of health (SDoH) in Medicare claims since the Z codes were implemented in 2016. The main finding: It’s difficult for the government to capture consistent data because providers aren’t assigning Z codes even when patients reveal their SDoH concerns.
January 24, 2020
Gov. Gavin Newsom has earmarked nearly $600 million in his 2020-21 state budget plan to provide intensive care management to high-needs, high-risk patients around the state. The programs are similar to an initiative in Camden, New Jersey, that was called into question by a recent study finding hospital readmissions dropped, but at only about the same rate as patients who didn’t receive the same kind of intensive services.
January 15, 2020
RISE Association partners with Mossavar-Rahmani Center for Business and Government at Harvard Kennedy School senior fellow to identify the drivers of successful social determinants of health programs.
January 13, 2020
Jacob Reider, M.D., chief executive officer, Alliance for Better Health, former deputy national coordinator for health information technology at the U.S. Department of Health and Human Services (HHS), will moderate a fireside chat on the federal government’s plans to address social determinants of health at The RISE National Summit on Social Determinants of Health, which will be held virtually on June 9-11. In this article, Reider shares his thoughts on the value of cross-sector collaboration.
December 09, 2019
Cross-sector health care organizations will come together in Nashville March 15-17 to address challenges related to social determinants of health (SDoH). If you’re a professional involved with community-based organizations (CBOs), payers, hospitals/health systems, funders, manufacturers or government entities, you’ll want to be a part of this drive for social good.
November 25, 2019
Well-intentioned, payer philanthropy is the wrong approach to solving the social determinants of health (SDoH) needs in American communities, writes Jacob Reider, M.D., CEO of Alliance for Better Health, and the former deputy director of the Office of the National Coordinator Health Information Technology, in a piece published by Health Payer Intelligence.
November 19, 2019
The annual event will take place March 15-17, 2020 at the Omni Nashville Hotel and will feature cross-sectional collaboration as thought leaders discuss actionable, tactical, and scalable solutions to social determinants of health (SDoH). Virtual attendance option is also available for those unable to travel.
October 11, 2019
For the latest installment of our semi-regular series that recommends articles, white papers, or issue briefs of importance to RISE members, we turn to a recent blog post by Deft Research’s Richard Hamer, Steve Runfeldt, and Adam Johnson about some of the conclusions from the firm’s survey to measure social determinants of health (SDoH) and intervening factors. These factors, known as “frames of reference” are defined as “internalized concepts and experiences that predict health behavior” and may depend on the person’s upbringing, circle of friends, education, and experiences with health care.
October 04, 2019
With 70 percent of a person’s health attributed to environmental factors and lifestyle choices, it’s crucial to understand what social determinants are and how to apply them to support your population at an individual level.
August 28, 2019
For the fifth installment of our semi-regular series that recommends articles, white papers, or issue briefs of importance to RISE members, we suggest United Hospital Fund of New York’s white paper Complex Construction: A Framework for Building Clinical-Community Partnerships to Address Social Determinants of Health. The paper provides an insightful look into the hurdles that organizations face when they try to leverage the resources of community-based organizations to meet the social determinants of health needs of their patients in a medical setting.
August 15, 2019
Jason Helgerson, chief solutions officer of Helgerson Solutions Group and former Medicaid director for the states of New York and Wisconsin, will be a featured speaker at the National Population Health Summit, Nov. 12-13, in Orlando. In this article, RISE talks to Helgerson and his co-presenter, Juliette Price, solutions architect for the social determinants of health, Helgerson Solutions Group, on trends in value-based payment (VBP), population health, and social determinants of health (SDoH).
August 02, 2019
The two-day, dual-tracked event on Nov. 12-13 in Orlando will address the most pressing issues associated with population health, addiction treatment, and disease management.
July 03, 2019
WASHINGTON, D.C.—Don’t wait for lawmakers on Capitol Hill to solve problems related to health care. They aren’t going to do it, according to Rich McKeown, the keynote speaker at RISE’s National Summit on Social Determinants of Health. Instead of lawmakers, solutions will come from the 250 attendees of the conference who represent community-based agencies, health plan providers, service providers, and consultants who will drive necessary changes.
June 27, 2019
Speaker Kathleen Stillo, president and chief operating officer of the clinical redesign direct care delivery unit in UnitedHealthcare’s Community & State division, talks to RISE ahead of the September conference about the organization’s mission to provide its most medically and socially complex members with better care at lower cost.
June 07, 2019
One-third of Americans say they have trouble meeting their basic human needs, such as stable housing, adequate food, and reliable transportation, and they want health care providers to help identify and address these non-medical social needs, according to the results of a new national survey from Kaiser Permanente. Those who experienced unmet social needs were twice as likely to rate their health as fair or poor compared to those who did not.
June 03, 2019
The health care industry is focusing more attention to the impact that living conditions, lifestyle, and employment have on people’s quality of life and health outcomes. Information collected about these social, economic, and physical conditions, known as the social determinants of health (SDoH), are among the most difficult to share through health information exchanges (HIEs), according to a recent report from eHealth Initiative and Foundation and Orion Health.
May 15, 2019
Many health care organizations are establishing programs to address the social needs of their patients and members in response to the growing recognition that personal, social, economic and environmental factors have a greater influence on health status than medical care. RISE looks at some of these efforts, including the Centers for Medicare & Medicaid Services’ data-collection initiatives, and Kaiser Permanente’s rollout of a social health network to address needs on a broad scale.
April 11, 2019
Medicare Advantage (MA) plans have another new benefit to offer their members in 2020: telehealth services. The Centers for Medicare & Medicaid Services (CMS) recently announced it has finalized changes that would allow MA beneficiaries to access health care services from places like their homes, rather than require them to go to a health care facility for treatment.
April 11, 2019
As the health care industry turns its attention to models that address social barriers that prevent people’s access to better health, two big-name organizations have joined forces to push providers to use data for social determinants of health to improve and simplify how referrals are made to social services.
April 03, 2019
The Centers for Medicare & Medicaid Services (CMS) on Monday released its final policy and payment updates to Medicare Advantage (MA) and Part D programs for 2020. In addition to updated payment rates, the agency outlined policy changes to address the opioid crisis, star ratings enhancements, and social determinants of health. Here ‘s what you need to know about the Call Letter and payment updates:
March 26, 2019
NASHVILLE, Tenn.— More than 1,400 executives and senior leaders from hundreds of health plans, provider groups, integrated health systems and service providers across the country came together last week in Nashville to share strategies to address regulatory challenges, the latest trends and developments in the industry, member engagement strategies, and care outcomes.
February 05, 2019
The health care industry’s shift in focus to truly address the social determinants of health is a make it or break it opportunity, according to Jamo Rubin, M.D., founder and CEO of TAVHealth, who served as the chair of last month’s RISE Symposium on Partnering to Address the Social Determinants of Health in Fort Lauderdale. Social determinants left unaddressed or unresolved flow into the health care system as unintended consequences and become health care claims, he said. The two-day symposium highlighted the challenges and successes of organizations that have made progress tackling social determinants, including behavioral health, opioid addiction, housing, and transportation. Here are five takeaways from the conference:
January 16, 2019
Health plan leaders began the year 2019 just as they did in 2018 with uncertainty over the future of the Affordable Care Act (ACA). RISE turned to industry experts for their thoughts on the ACA and what other challenges the industry may face this year. Here are five predictions from Sean Creighton, managing director of the healthcare consulting firm Avalere; John Criswell, CEO of health care data analytics and technology company Pulse8; and John Broderick, M.D., FACEP, CPE, chief clinical officer-East for the risk-based provider group Landmark Health.
December 03, 2018
Alex Azar, secretary of the Department of Health & Human Services, made a surprising announcement earlier this month during a speech at the Hatch Foundation for Civility and Solutions when he said the agency wants to pay for services that address social determinants of health, the root cause of a large portion of U.S. health spending. Azar says social determinants are tied to the agency’s move toward a value-based healthcare system that delivers better outcomes at a lower cost. But will health plans be a part of the equation?
September 17, 2018
Social determinants of health was the hottest topic at RISE West 2018, an indication that in the upcoming year health plans will likely pursue models of care that aim to improve the health and quality of life of their members. Speaker Aaron Horsfield, administrative fellow, UPMC Health Plan, predicted that the industry will see rapid change in this area as more plans collaborate with community partners to address the housing and food needs of their patient populations.