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The Letters of Intent for Next Generation Accountable Care Organization (NextGen ACO) model through the Center for Medicare and Medicaid Innovation (CMMI) are due May 2, 2016 for the program starting in 2017. Twenty-one participants nationwide will qualify for the NextGen ACO that builds upon the experience gained through the Medicare Shared Savings Program (MSSP) […]

The U.S. Health Care landscape is shifting at an unprecedented pace.  Since implementation of the Patient Protection and Affordable Care Act (ACA), reimbursement policies and methodologies have undergone significant changes alarming providers (i.e., hospitals, health systems, physicians, allied health and post-acute providers/professionals across the country). 2015 was especially remarkable due to significant policy changes in […]

Overview: California’s next Section 1115 Medicaid Waiver, Medi-Cal 2020, was approved on December 31, 2015. The Medi-Cal 2020 initiatives include a Global Payment Program, a Whole Person Care Pilot program, a Dental Transformation initiative and the introduction of the Public Hospital Redesign and Incentives in Medi-Cal program (PRIME). PRIME builds upon the successes of […]

The Texas Medicaid 1115 Waiver is going through a transformation. The sooner providers prepare, the better. As the current Texas Medicaid 1115 Waiver Demonstration nears a close in late 2016, many health care providers across the state find themselves pondering the “what ifs” of operations post-DSRIP. DSRIP, or Delivery System Reform Incentive Payment, is a […]

Background: Post-discharge phone calls are an empirically supported best practice for improving the patient experience and reducing readmissions in hospitals1. The Agency for Healthcare Research and Quality (AHRQ) recommends that follow-up calls be made to patients within 48-72 hours of discharge2. To meet industry standards and stay connected with their patients, providers are working […]

Overview:: Customer Relationship Management (CRM) platforms have exploded in popularity in the health care industry. Pharmaceutical companies, health insurers and third-party vendors use them in relatively traditional ways to manage sales, marketing and customer support. But, healthcare providers can use CRM in a novel way to streamline network development and take advantage of their […]

Stephanie King is a Senior Consultant at COPE Health Solutions. In this position, she has the opportunity to strategically partner with clients to transform the way health care is delivered. She has previous experience in ambulatory operations, project management and 1115 Waiver programs. Her previous experience working at large academic medical centers and with the […]

At approximately 2:00PM each day, the participants of the Health Scholar Program round on each patient in the Mother-Infant Unit of St. John’s Regional Medical Center to offer a light afternoon snack of cookies and refreshments. Known as “Tea at Two” within the hospital, the concept was first implemented by the unit leaders in 2010. […]

Overview: Beginning January 1, 2017, states can become a laboratory for new ideas by seeking to waive or alter certain provisions of the Affordable Care Act (ACA). Section 1332 outlining State Innovation Waivers under the ACA allows states to request alternative provisions to enhance state health markets if coverage and cost would remain the […]

Our current health care system has become financially unsustainable with gaps in care, silos and duplication in care delivery, and lacks bridges to critical support services necessary for improving health outcomes. One challenge is that overall population health is determined by factors and social determinants outside the health care delivery system. Per the Healthy People […]