Blog

II have been asked why, as a regulatory law attorney, I have taken a detour from that career to provide executive leadership for the COPE Health Scholars programs of COPE Health Solutions. I joined Health Scholars to address the time-worn question, “Where will the next generation of health leadership come from?” How will the best […]

COPE Health Solutions engages health systems to design innovative educational experiences for aspiring health care professionals. These programs are an ideal avenue for providers to build meaningful relationships with community members and position their health system as the provider of choice within their service area. Students engage with their program facility through on-site training and […]

Transitioning from Planning to Execution Well on its way into implementation, the New York Delivery System Reform Incentive Payment (DSRIP) Program is nearly halfway through the first performance year. While many of the planning activities continue to carry over from demonstration year zero, Performing Provider System (PPS) leads are pivoting to execute on plans to […]

The Washington State 1115 Waiver application and concept paper is a system transformation initiative that will significantly change the way care is delivered to low-income patients. Medicaid patients are entitled to accessible, coordinated and quality health care that is supported by robust community support services. This multi-faceted approach to patient care and wellness lays the […]

Overview: Delivery System Reform Incentive Payment (DSRIP) providers in Texas have been closely following the proposed extension to the Texas State Section 1115 Waiver as HHSC prepares to submit an extension application to the Centers for Medicaid and Medicare Services (CMS). A main goal of the extension is to align the waiver with Medicaid […]

The Centers for Medicare and Medicaid Services (CMS) recently released its proposed Medicaid and CHIP Managed Care Proposed Rule—the first major update to regulations in more than a decade—with public comments due on July 27, 2015. As the former Director of the California Department of Managed Health Care (DMHC) with oversight of the state’s health […]

COPE Health Solutions has enjoyed success with some of our health system partners in deploying Care Navigators to better link high-cost patients to care within the system to enhance success under at-risk contracts, readmission penalties and value-based payments.  Such compassionate touch and high quality patient care has become a critical success factor for today’s hospitals […]

New York State (NYS) has one of the nation’s largest populations of Medicaid and Medicare beneficiaries, each around 3 million members. As health care reform continues to lead states away from volume-based payments to value-based reimbursements, NYS has proposed a unique alignment strategy between the two largest federal health care coverage programs. The “Draft Medicare […]

The state of Texas has published a draft extension application requesting an additional five years of its 1115 Medicaid Waiver, which began in 2012 and will expire in September 2016 without an extension.  Providers implementing projects under the current waiver will need to understand how programmatic changes in this extension may impact their operations and […]

Nationally, the drive to improve health outcomes, enhance patient/member satisfaction and reduce total annual cost per member is requiring both providers and health plans to re-evaluate their contracts and the structure of their financial relationships.  The health care industry and its payers, both government and commercial, are rapidly shifting from fee-for-service to a value-based payment […]