Three tips to move your practice from fee-for-service Medicare to managed care only. New West Physicians, a 63-provider primary care group in Denver, has given up fee-for-service Medicare and will only see seniors enrolled in Medicare HMOs. Find out how the group made the change and in the process retained its patients.
Data File: The Center for Health Care Statistics in Hyattsville, MD, has released benchmark data on surgery visits by seniors, reporting that seniors have 3.5 times as many surgery visits as younger patients. To manage your Medicare surgery utilization, find out what the top diagnoses and procedures are for those visits.
To cut costs and boost quality of care for seniors, try a SNF rounding program. Harvard Pilgrim Health Care Inc., based in Dedham, MA, is slashing Medicare inpatient bed days per 1,000 by helping its providers set up programs designed to avoid and substitute hospitalizations with subacute stays.
Medicaid prenatal programs don't have to be 'more of the same.' The Ready Set Grow program, offered to pregnant Medicaid members by the Virginia Chartered Health Plan, provides incentives to both members and clinicians. Find out what makes this case management program for high-risk pregnancies so different that it's been hailed as a "best practice" by the American Association of Health Plans.
Also, Medicaid managed care enrollment now exceeds fee-for-service. Data recently compiled by HCFA reveal that although Medicaid managed care takes many forms, it now covers 54% of the country's total Medicaid population. Find out the latest trends in managed Medicaid enrollment.
How to do well on HEDIS measurement and boost quality of care for your Medicaid members. Neighborhood Health Plan in Boston, MA, attributes its top performance on Medicaid HEDIS measures to providers' care models, a commitment to quality, and the quest for performance data.
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