CMS Posted New Study for Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease (AD)

July 7, 2023

CMS Posted New Study for Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease (AD)

The Centers for Medicare & Medicaid Services (CMS) has posted a new study for treatment of Alzheimer’s Disease (AD).

Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease (AD)

New Alzheimer’s Drug Fact Sheets for Providers and Patients – Please scroll to bottom of page

Keeping Patients covered in Medicaid and CHIP

June 21, 2023

Keeping Patients covered in Medicaid and CHIP

The unwinding of the continuous enrollment condition authorized by the Families First Coronavirus Response Act (FFCRA) presents the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act. As a condition of receiving a temporary .2 percentage point Federal Medical Assistance Percentage (FMAP) increase under the FFCRA, states were required to maintain enrollment of nearly all Medicaid enrollees during the COVID-19 Public Health Emergency.

The end of the public health emergency has resulted in states resuming normal operations, including restarting full Medicaid and CHIP eligibility renewals and terminations of coverage for individuals who are no longer eligible.

The Centers for Medicare & Medicaid Services (CMS) has developed communication tools to help patients keep their Medicaid and CHIP coverage as states restart full eligibility reviews.

What you can do:

  • Spread the word
  • Get the word out about Medicaid renewals
  • Help patients with the renewal process
  • Partner with your State Medicaid/CHIP agency to provide direct assistance to individuals and families with completing the renewal form

Don’t risk a gap in your patients Medicaid or CHIP Coverage. Help them to take action by sharing these steps with patients:

  • Visit Medicaid.gov/renewals or call your state Medicaid Office for help or to update your contact information today;
  • Make sure contact information is up to date;
  • Watch their mail for a letter
  • Complete their renewal form if they get one.

Health care providers should take every opportunity to get the word out to patients that Medicaid renewals have restarted and to assist patients in completing renewal forms or directly connecting them to health plans, navigators, or state agencies that can help do so.

Communications Toolkit

CMS Announces Multi-State Initiative to Strengthen Primary Care

June 12, 2023

CMS Announces Multi-State Initiative to Strengthen Primary Care

New Model Aims to Enhance Access and Quality of Primary Care, Improve Health System

Today, the Centers for Medicare & Medicaid Services (CMS) announced a new primary care model – the Making Care Primary (MCP) Model – that will be tested under the Center for Medicare and Medicaid Innovation in eight states. Access to high-quality primary care is associated with better health outcomes and equity for people and communities. MCP is an important step in strengthening the primary care infrastructure in the country, especially for safety net and smaller or independent primary care organizations. The model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and leveraging community-based connections to address patients’ health needs as well as their health-related social needs. 

The goals of MCP are to 1) ensure patients receive primary care that is integrated, coordinated, person-centered and accountable; 2) create a pathway for primary care organizations and practices – especially small, independent, rural, and safety net organizations – to enter into value-based care arrangements; and 3) to improve the quality of care and health outcomes of patients while reducing program expenditures.

The MCP Model will provide participants with additional revenue to build infrastructure, make primary care services more accessible, as well as better coordinate care with specialists. CMS expects this work to lead to downstream savings over time through better preventive care and reducing potentially avoidable costs, such as repeat hospitalizations. MCP will run for 10.5 years, from July 1, 2024, to December 31, 2034. The model will build upon previous primary care models, such as the Comprehensive Primary Care (CPC), CPC+, Primary Care First models, and the Maryland Primary Care Program (MDPCP).

CMS will test this advanced primary care model in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. CMS will work with model participants to address priorities specific to their communities, including care management for chronic conditions, behavioral health services, and health care access for rural residents. CMS is working with State Medicaid Agencies in the eight states to engage in full care transformation across public programs, with plans to engage private payers in the coming months. The model’s flexible multi-payer alignment strategy allows CMS to build on existing state innovations and for all patients served by participating primary care clinicians to benefit from improvements in care delivery, financial investments in primary care, and learning tools and supports under the model.

“The goal of the Making Care Primary Model is to improve care for people with Medicaid and Medicare,” said CMS Administrator Chiquita Brooks-LaSure. “This model is one more pathway CMS is taking to improve access to care and quality of care, especially to those in rural areas and other underserved populations. This model focuses on improving care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and partnering with community-based organizations, which will help the people we serve with better managing their health conditions and reaching their health goals.”

Strong relationships with primary care teams are essential for patients’ overall health. Primary care clinicians provide preventive services, help manage chronic conditions, and coordinate care with other clinicians. By investing in care integration and care management capabilities, primary care teams will be better equipped to address chronic disease and lessen the likelihood of emergency department visits and acute care stays, ultimately lowering costs of care. This model will support participants with varying levels of experience with value-based care, including Federally Qualified Health Centers (FQHCs) and physician practices with limited experience in value-based care, as CMS continues to work to reduce disparities in care and drive better patient experience and outcomes.

“Ensuring stability, resiliency, and access to primary care will only improve the health care system,” said CMS Deputy Administrator and Center for Medicare and Medicaid Innovation Director Liz Fowler. “The Making Care Primary Model represents an unprecedented investment in our nation’s primary care network and brings us closer to our goal of reaching 100% of Traditional Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care arrangements, including advanced primary care, by 2030.”

The model includes a progressive three-track approach based on participants’ experience level with value-based care and alternative payment models. Participants, which include FQHCs, Indian Health Service facilities, and Tribal clinics, among others, in all three tracks will receive enhanced payments, with participants in Track One focusing on building infrastructure to support care transformation. In Tracks Two and Three, the model will include certain advance payments and will offer more opportunities for bonus payments based on participant performance. This approach will support clinicians across the readiness continuum in their transition to value-based care, furthering CMS’s goal to ensure 100% of traditional Medicare beneficiaries are in a care relationship with accountability for quality and total cost of care.

Primary care organizations within participating states may apply when the application opens in late summer 2023. The model will launch on July 1, 2024.

To view the MCP webpage, visit: https://innovation.cms.gov/innovation-models/making-care-primary

To view a model key highlights video, visit: https://youtu.be/8vy3PHHlCe4

Webinar – Missouri Ending the HIV Epidemic Quarterly Community Forum- June 13 – Re-engagement in HIV Care

June 5, 2023

Webinar – Missouri Ending the HIV Epidemic Quarterly Community Forum- June 13 – Re-engagement in HIV Care

The Missouri Department of Health and Senior Services invites you to attend the upcoming quarterly Community Engagement Forum focused on Ending the HIV Epidemic (EHE) in Missouri.

These virtual sessions are designed for YOU!

The Bureau of HIV, STD, and Hepatitis wants to hear your thoughts on how to end the HIV epidemic in Missouri and how best to serve people living with HIV.

Registration is open and can be accessed by clicking the event time:

  • Tuesday, June 13, 2023, Noon
  • Tuesday, June 13, 2023 6 p.m

Upcoming Webinars:

  • HIV and Tuberculosis, September 12, 2023, noon and 6 p.m.
  • A year in Review, December 12, 2023, noon and 6 p.m.

Watch for updates on specific event information and RSVP details. To stay up to date on all things Ending the HIV Epidemic in Missouri, visit the dedicated webpage speakuphiv.com/ehe.

Please share this information!

We want to hear from:

  • persons living with HIV
  • community members impacted by HIV
  • local care and prevention planning bodies
  • stakeholders from organizations currently implementing HIV prevention and care programs
  • faith-based organizations
  • community-based organizations
  • local public health departments
  • federally qualified health centers

Highlighting Disparities During National Men’s Health Month

June 5, 2023

Highlighting Disparities During National Men’s Health Month

During June, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is recognizing National Men’s Health Month by encouraging men from populations that are underserved to prioritize their health and well-being.

Heart disease is the number one cause of death for men of most racial and ethnic groups in the United States, accounting for 1 in every 4 male deaths. Among Medicare fee-for-service (FFS) beneficiaries, men had a higher prevalence of ischemic heart disease (32.3%) than women (22.2%) in 2018. Men from minority populations are often disproportionately affected by heart disease and many of its risk factors, including high blood pressure. According to the CDC, hypertension was more common in Black (58.4%), Asian (51.9%), Hispanic and Latino (50.4%) men from 2015-2018 compared to White men (49.8%). Racial disparities are prevalent not only in heart disease, but also in prostate cancer, which is the second-leading cause of cancer death among males. In 2019, Black men had the highest rate of new cancer diagnoses, followed by White, Hispanic, American Indian and Alaska Native, and Asian and Pacific Islander men.

In addition to promoting men’s physical health this month, CMS OMH is highlighting the importance of men’s mental health. Since men are far less likely to seek mental health treatment than women due to stigma, their mental health concerns often go untreated. In 2021, the suicide rate among males was approximately four times higher than the rate among females. Though men make up 50% of the U.S. population, they represent nearly 80% of suicides.

National Men’s Health Month allows CMS OMH an opportunity to highlight racial and ethnic disparities in men’s health as well as the importance of physical and mental well-being for men of all backgrounds. We encourage you to share the below resources with the men in your community to help them take control of their health this month and all year.

Resources:

Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility for a Low-Income Subsidy and Disability Stratified Report

May 23, 2023

Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility for a Low-Income Subsidy and Disability Stratified Report

The Centers for Medicaid Services” Office of Minority Health (CMS OMH) released a report detailing the quality of care received by people enrolled in Medicare Advantage (MA).

The Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability report presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability.

Overall, the report showed that people who were dually eligible for Medicare and Medicaid or eligible for the Low-Income Subsidy received worse clinical care than those who were not. The largest differences between the two groups were in the areas of Follow-up After Hospital Stay for Mental Illness (within 30 days of discharge), Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with Dementia, and Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with a History of Falls. Disparities by dual eligibility status/Low-Income Subsidy eligibility status were least common among Hispanic individuals and most common among White individuals. The report also shows more pronounced disparities in clinical care for dually eligible/Low-Income Subsidy eligible individuals in urban areas as compared to rural areas.

This report is based on an analysis of data from the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on the technical quality of care that Medicare Advantage enrollees receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease.

Health care professionals, organizations, researchers, and hospital leaders can utilize this report along with other CMS tools and resources to help raise awareness of health disparities, develop health care interventions for Medicare Advantage enrollees who are dually eligible for Medicare and Medicaid/Low- Income Subsidy eligible and those with disabilities, and implement quality improvement efforts that improve health equity.

Help CMS to advance equity by sharing this report and our resources on prevention and health equity initiatives. Also, sign up for CMS’ listserv or visit https://go.cms.gov/omh for more information.

Missouri Telehealth Network

March 21, 2023

The Missouri Telehealth Network’s Show-Me ECHO program builds learning communities of health care professionals who serve patients across Missouri. Show-Me ECHO facilitates multidisciplinary collaboration on topics various topics in adult and child clinical care, behavioral/mental health, community efforts, and education. Project ECHO fundamentally changes the way knowledge is shared to ensure the latest research and best practices reach every citizen in every corner of the state, especially rural and underserved populations.

Through videoconferencing technology, each month, professionals discuss participants’ cases and collaborate to share strategies and solutions. More than 7,500 healthcare professionals have participated over the years in more than 67,000 hours free instruction. There are over 40 different ECHO programs to choose from at no cost to participating sites or individuals. Many ECHOS also provide free continuing education credit for qualifying professionals.

       

         

Register to join the next ECHO session by visiting showmeecho.org.

Health Equity and Childhood Oral Health: Improving Access to Care with Medicaid and CHIP

February 14, 2023

Health Equity and Childhood Oral Health: Improving Access to Care with Medicaid and CHIP

This February, the Connecting Kids to Coverage National Campaign, an outreach and enrollment initiative that reaches out to families with children and teens eligible for Medicaid and the Children’s Health Insurance Program (CHIP), is recognizing National Children’s Dental Health Month.

This is an opportune time remind families that Medicaid and CHIP cover children’s dental services, such as teeth cleanings, check-ups, X-rays, fluoride treatments, dental sealants and fillings.

 

CDC Science Brief – Mpox Brief

February 3, 2023

CDC Science Brief – Mpox Brief

Today, CDC released an updated Science Brief: Detection and Transmission of Mpox Virus. These updates incorporate findings from a growing body of scientific evidence that now show some people can spread mpox virus to others from one to four days before symptoms of mpox appear. This is known as presymptomatic spread. There is currently no evidence showing that people who never develop symptoms have spread mpox virus to someone else.

During the current outbreak, the most common way mpox has spread from person to person is through direct contact with the infectious rash, scabs, or body fluids, especially during sexual contact. People infected with mpox virus may be able to spread mpox virus to others for up to two weeks after becoming ill.

In the United States, mpox cases have declined, but it’s still important for people who are eligible to get vaccinated to prevent future cases, especially people in communities disproportionally affected by mpox. Vaccination is an important tool to protect people from mpox and stop the spread of mpox. People who are eligible for mpox vaccination should get two doses for the best protection. The second dose should be given four weeks after the first dose.

Science Brief

How mpox spreads