Payer & Financing Models Archives

Minnesota HealthPartners To Revise Processes & Pay Fine For Mental Health Parity Violations

Article July 20, 2023

On May 4, 2023, the Minnesota Department of Commerce announced a consent order with HealthPartners that requires the company to revise its processes to ensure that coverage for behavioral health… Read More

Mental Health Conditions Rose Nationally In Share Of Telehealth Claim Lines In March 2023

Article July 3, 2023

National telehealth utilization increased 1.8% in March 2023, from a decrease to 5.5% of medical claim lines in February to 5.6% in March. Telehealth utilization also increased in two of the… Read More

Arizona Medicaid Cuts Payments To More Than 100 Behavioral Health Provider Organizations Due To Fraud Allegations

Article July 3, 2023

On May 17, 2023, the Arizona Health Care Cost Containment System (AHCCCS), which oversees the state’s Medicaid program, announced actions against over 100 Medicaid behavioral health residential and outpatient treatment… Read More

Reducing Psychiatric Boarding – What Will Work?

Article July 3, 2023

Last week, the American College of Emergency Physicians, Emergency Nurses Association, and National Alliance on Mental Illness held a congressional briefing to persuade lawmakers to adopt their proposed solutions to… Read More

Clinical Consistency, It Matters

Article June 12, 2023

Clinical “consistency” is a key quality issue. Defined as “treating similar conditions in a similar manner,” organizations with clinical consistency reduce variability, are more likely to improve consumer health, produce… Read More

Medicare Home Health Value-Based Purchasing Model Improved Quality of Care & Reduced Spending By 1.9%

Article June 12, 2023

The Medicare Home Health Value-Based Purchasing (HHVBP) Model increased home health provider organization performance on quality-of-care measures by 51% compared to their performance prior to participating. The model also reduced… Read More

Nevada To Expand Medicaid Managed Care To Rural Areas By 2026

Article June 12, 2023

Nevada is planning to expand Medicaid managed care to rural areas of the state by January 2026. The Division of Health Care Financing and Policy (DHCFP), within the Nevada Department… Read More

Between 2020 & 2021, The Death Rate Rose 4% Among Adults Ages 65 To 74

Article June 12, 2023

Among older adults in the United States, the death rate among those ages 65 to 74 increased by 4% between 2020 and 2021 (during COVID-19). The 2021 death rate (2,150… Read More

New York Budget Includes $1 Billion To Expand The State’s Continuum Of Mental Health Care

Article June 12, 2023

On May 3, 2023, New York Governor Kathy Hochul signed the state’s $229 billion budget for fiscal year 2024—which includes $1 billion for a long-term investment to transform the state’s… Read More

CBO Projects 15.5 Million Will Lose Medicaid & 6.2 Million Will Become Uninsured During PHE Unwinding

Article June 12, 2023

Over the next 1.5 years, the U.S. Congressional Budget Office (CBO) projects that approximately 15.5 million current Medicaid beneficiaries under the age of 65 years will lose their Medicaid coverage… Read More

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