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The Centers for Medicare & Medicaid Services (CMS) and Congress will be under significant political pressure to roll back the maintenance of effort (MOE) requirements included in the Patient Protection and Affordable Care Act (PPACA), according to Michael Miller, director of policy at Community Catalyst in Boston, "either wholesale, or via individual waiver applications such as that filed by Arizona."
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The states with the largest expected Medicaid enrollment growth are the very ones that have the fewest number of primary care physicians, according to a March 2011 report.1 Temporary increases in Medicaid reimbursement are unlikely to make much of a difference in states facing the biggest enrollment increases, says study author Peter Cunningham, PhD, a senior fellow and director of quantitative research at the Center for Studying Health System Change in Washington, DC.
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The Medicaid expansion will pose a major challenge in terms of where the newly insured will be able to receive care in 2014, according to Daniel R. Hawkins, senior vice president for public policy and research at the National Association of Community Health Centers in Washington, DC.
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"This was a new patient who had a severe hand injury and was seeing a microsurgeon for an evaluation.
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Technology can make a huge difference in the practice of case management, but you should choose carefully and deliberately to avoid pitfalls in the future, cautions Marcia Diane Ward, RN, CCM, PMP, a case management consultant based in Columbus, Ohio.
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As part of a program targeting at-risk Medicaid fee-for service members, case managers at Hudson Health Plan are using a software tool that helps them focus in on the needs of their clients they should address first.
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When the Centers for Medicare and Medicaid Services (CMS) begins its Medicare Shared Savings Program for Accountable Care Organizations (ACOs) providing care for fee-for service Medicare patients in January, 2012, it's likely to mean new opportunities for case managers, says Bruce Merlin Fried, JD, senior member of SNR Denton's Health Care group and former director of the Center for Health Plans and Providers at CMS.
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Hip fractures are among the most debilitating and expensive diagnoses to treat, but hospitals can significantly improve outcomes and lower costs if they move hip-fracture patients into surgery quickly, explains Anthony Balsamo, MD, an orthopedic surgeon and head of the Geriatric Fracture Care Program (GFCP) at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, PA.
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