There are many systems and services that contribute to children’s health, development, and well-being. However, many of our health systems are complicated, difficult to use, and have strict eligibility requirements; and many health services exist in silos and are not well coordinated. As a result, access for families is difficult. Many children who are not given a chance to thrive and get a healthy start in life grow up to be unhealthy adults with chronic and costly health conditions.
Reviewing applications for disability retirement benefits is a complex and time-sensitive process. Getting it right protects plan members and the financial soundness of the plan itself. Commonwealth Medicine empowers its team of licensed and credentialed case reviewers with secure, cloud-based technology to maintain operational continuity—even during a pandemic. The result is accurate, fair and timely disability recommendations.
A study, led by Soumya Vishwanath and other policy experts, from Commonwealth Medicine, assessed the effectiveness of a three-part, proactive intervention in prompting new prior authorization (PA) submissions and/or provider response prior to PA expiration in a Medicaid population.The intervention group had PAs submitted an average of 2.7 days before the expiration date vs.13 days after expiration in the comparison group.
Pharmacy experts from the University of Massachusetts Medical School and Commonwealth Medicine completed a study on whether the overall benefit of sacubitril/valsartan outweighed the cost of the drug within a Medicaid population. Previous studies have shown that patients treated with sacubitril/valsartan had lower rates of hospitalizations, but before now, the data on the economic impact of the drug on a Medicaid population was limited.
A policy brief co-authored by Commonwealth Medicine’s Robert Seifert, MPA, & Hilary Deignan, JD, MEd, and the Child Health and Development Institute of Connecticut, Inc's Lisa Honigfeld, PhD & Eminet Garganus, MPH explains why having all insurers involved in pediatric primary care redesign is vital for creating more positive health outcomes for children in families in communities at large
The Director of the Charitable Trusts Unit, within the New Hampshire Attorney General’s office, is charged with reviewing transactions involving health care charitable trusts, including non-profit hospitals, to determine whether these transactions are in the best interest of the community. The Charitable Trusts Unit retained the Health Law & Policy team at Commonwealth Medicine, UMass Medical School, to perform a thorough, impartial review of the Hospital Corporation of America’s (HCA) proposed acquisition of Frisbie Memorial Hospital.
Commonwealth Medicine’s Health Law & Policy expert Carol Gyurina explains why the federal parity law, which requires health plans to apply the same coverage limits to both behavioral health and medical benefits, is a good first step but not enough on its own to guarantee substance abuse services for Medicaid enrollees
Discover the comprehensive and customized approach Commonwealth Medicine's Disability Evaluations Team takes toward reviewing the 40,000+ disability evaluations it screens every year.
Our Health Law & Policy expert Katharine London joined several other policy and program experts to explore the role, impact, and system supports for community health workers in the United States, and Navajo Nation.
Find keys to success, policy recommendations, and implementation tools for starting a Recovery Coach program in your community. Commonwealth Medicine’s Health Law & Policy experts Katharine London, MS, and Jeremy Tourish, MPH, share research on the impact Recovery Coaches had in the battle against opioid use disorder in six states.
Check out our Health Law & Policy team’s brief updating information on the MassHealth Accountable Care Organization program as it enters its second year. Released by Blue Cross Blue Shield, the primer explores enhancements including the expanded Community Partners Program and the new Flexible Services Program. Learn more on our website about the way nearly 900,000 residents of The Commonwealth are receiving health care services
Our Medicare Buy-In Quality Review Initiative, which our TPL expert Jenifer Hartman presented on during the 2019 Medicaid Enterprise Systems Conference, digs deep to find gaps in quality control and has returned $25 million in Part A premium overpayments since 2009 for MassHealth.
Take a look at results from The Massachusetts Medicare Enrollment Support Initiative, coordinated with guidance from our third party liability expert Jenifer Hartman of Health Care Finance Solutions.
Learn how cost avoidance activities made possible by our Health Care Finance Solution's Enhanced Coordination of Benefits led to a savings of $66.4 million for MassHealth in 2019.
Learn the Third Party Liability integration strategies implemented by MassHealth, the Massachusetts Medicaid program, to optimize identification of and access to TPL sources for all Medicaid members and at all points within the Medicaid experience.
Accountable Care Organizations (ACOs) can improve oral health for Medicaid members and also reduce costs through emergency department (ED) diversion, our Health Law & Policy experts highlight in a report for the Southern New England Practice Transformation Network (SNE-PTN).
This overview of the Massachusetts Medicaid program, MassHealth,
provides details on recent enrollment and spending, as well as updates on delivery system innovations and reforms.
On behalf of the Minnesota Department of Health Services, experts from Health Law & Policy within Public and Private Health Solutions conducted a literature search of successful interventions across the country that improve the health of previously incarcerated individuals and five focus groups to gain feedback from professionals who work with previously incarcerated individuals.
In June 2019, NESCSO and Commonwealth Medicine jointly released a white paper titled The Effective Medicaid Pharmacy Program. Through information compiled from stakeholder interviews and an environmental scan, this brief paper reviews components of an effective Medicaid pharmacy program and provides practical information for Medicaid programs and state leadership.
By creating stronger connections and nurturing communications with their members, Accountable Care Organizations (ACOs) and Community Partners (CPs) improve compliance with care plans and prescriptions, reduce medical costs, and increase member satisfaction.
Discover the best practices for improving member engagement and understanding in this white paper.
Infants born at times of unstable housing are significantly more likely to need medical care in a hospital during their first year of life and had higher medical spending in their first six years of life, says a new study in Health Affairs. Our Robert Seifert, executive director, Health Law & Policy, collaborated with research colleagues from UMass Medical School to analyze the health outcomes of infants born into homelessness.