Insights from the minds at Cognosante

Effective Medicaid Consumer Engagement: Thinking Outside the Box

Person-centered approach Many individuals enrolled in Medicaid also access services from other state human services agencies and community-based providers. Deploying a “whole person” approach for enrollees—supported by modern tools and one-to-one support—can increase beneficiary engagement while lowering a state’s overall costs and administrative burden. The Medicaid landscape is changing Since implementation of the Affordable Care […]
State health and human services

Advancing payment reform with effective state health information exchange

Throughout the healthcare system, payers are shifting away from payment models that incentivize volume of services to models that incentivize quality, outcomes, and savings. Efforts to transform healthcare through value-based payment reform can be seen in state Medicaid managed care contracts that incentivize outcomes, delivery system reform efforts under Medicaid demonstration projects, State Innovation Model (SIM) efforts […]
State health and human services

National provider call center delivers exceptional customer support to provider community

Healthcare providers have been required to enroll in many disparate programs to provide and be reimbursed for services under Federal, state, and commercial healthcare plans. The move to a National Provider Identifier (NPI) and the enactment of legislation like the Health Information Technology for Economic and Clinical Health (HITECH) Act have increased the need for […]
Federal health programs, State health and human services

Modernizing Medicaid managed care

The “mega” Medicaid managed care rule released this spring by the Centers for Medicare and Medicaid Services (CMS) set in motion a long-overdue overhaul of managed care programs in Medicaid and the Children’s Health Insurance Program. As managed care plans oversee larger percentages of enrollees and benefits, the pressure on state Medicaid agencies to ensure […]
Federal health programs, State health and human services

Investing in Medicaid IT

As the nation’s largest public insurance program, Medicaid provides health insurance to 1 out of every 5 Americans. The program supports individuals from birth to end-of-life, paying for approximately 45 percent of births nationwide and more than 50 percent of long-term care services and support, including nursing home care and home and community based services. […]
Federal health programs, State health and human services

What makes Medicaid important?

The U.S. healthcare system is undergoing a rapid transformation, the goal of which is to maximize value of the dollars spent on providing higher quality care with better outcomes to improve overall population health. While the trends associated with this transformation impact all payers and providers, it is Medicaid – the nation’s largest source of […]
Federal health programs, State health and human services