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By 2010, the company was the third largest Medicaid HMO in the country, with $2.5 billion in revenue and 800,000 members across Ohio and Michigan. [12] In 2010, CareSource announced expansion of its provider network in Southeastern Ohio through a partnership with Quality Care Partners (QCP), a physician-hospital organization (PHO). [13]
CareStar, Inc. (CareStar) is a private, Ohio-based healthcare corporation which provides home and community-based case management services in government, agency and residential operations. [1] CareStar is one of the contracted case management agencies for the Ohio Home Care Waiver Program and HOME Choice through the Ohio Department of Medicaid ...
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
Nearly 40% of Ohio's budget is spent on Medicaid, insuring low-income residents, but is that investment reflected in how healthy its residents are?
Five factors that can be used to assess the advancement level of a particular IDN include provider alignment, continuum of care, regional presence, clinical integration, and reimbursement. [ 5 ] Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies.
1997 - Medical Mutual expanded beyond health insurance and created Antares Management Solutions to leverage the company's computer systems. 2001 - Medical Mutual's Preferred Provider Organization (PPO), SuperMed Plus, is recognized as the first PPO in the United States to earn Full Accreditation from the National Committee for Quality Assurance.
The two broad types of architecture, centralized and federated, correspond to the data warehouse and federated database system models of data integration. In the centralized configuration (e.g., The Santa Cruz Community and the Michigan UP Network), all providers send their data to the RHIO's central repository on a periodic basis (daily).
53 million Medicaid patients rely on Deloitte software—but the technology has generated notices with errors, sent paperwork to the wrong addresses, and been frozen for hours at a time, according ...