Tag: Toolkit

ROI Calculator for Partnerships to Address Social Determinants of Health

The ROI Calculator for Partnerships to Address Social Determinants of Health is a tool designed to help CBOs and their health care partners explore, structure, and plan financial arrangements to fund social services for people with complex needs. The tool allows health systems, payers, medical providers, social service providers, and CBOs to determine the overall return on investment from integrating social services with medical care under different payment models.

Healthcare organizations are increasingly partnering with community-based organizations (CBOs) to address patients’ health-related social needs such as nutrition, housing, and transportation. These partnerships can help integrate services for people with complex needs, but health care and social service organizations often struggle to establish partnerships and contracts given their different structures and financial resources.

Access the ROI Calculator for Partnerships to Address Social Determinants of Health (ROI Calculator) — designed to assist CBOs and their health care partners to explore, structure, and plan financial arrangements to fund social services for people with complex needs.

The ROI Calculator for Partnerships to Address Social Determinants of Health is a tool designed to help CBOs and their health care partners explore, structure, and plan financial arrangements to fund social services for people with complex needs. The tool allows health systems, payers, medical providers, social service providers, and CBOs to determine the overall return on investment from integrating social services with medical care under different payment models.

This Better Care Playbook webinar describes the application of the ROI Calculator to health care organizations and CBOs. It features a case example of a Washington State CBO that used the tool to quantify the value of their services when developing a partnership with a Medicare Advantage plan.

Medi-Cal Managed Care Enrollment Report

This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

Medi-Cal Managed Care Enrollment Report

The Medi-Cal Managed Care Enrollment Report is a dataset that contains information about the number of people enrolled in Medi-Cal Managed Care plans based on reported month, plan type, county, and health plan. This report is an important tool for policymakers and researchers who want to better understand the state of healthcare in California.

The dataset provides valuable insights into the number of people enrolled in Medi-Cal Managed Care plans, which are designed to provide affordable healthcare to low-income Californians. By analyzing the data in the report, policymakers and researchers can identify trends in enrollment, plan type, and county-level differences in enrollment rates.

One important trend that the report highlights is the increasing popularity of Medi-Cal Managed Care plans. As of the latest reported month, the total number of people enrolled in these plans was higher than ever before, indicating that more Californians are taking advantage of these affordable healthcare options.

Another important trend is the differences in enrollment rates across different counties in California. The report shows that some counties have higher enrollment rates than others, indicating that there may be disparities in access to healthcare across the state.

Overall, the Medi-Cal Managed Care Enrollment Report is an essential resource for anyone interested in understanding the state of healthcare in California. By providing detailed information about enrollment in Medi-Cal Managed Care plans, this report can help policymakers and researchers identify areas where improvements can be made, and ensure that all Californians have access to affordable, high-quality healthcare.

Medi-Cal Managed Care Enrollment Report

Toolkit Managed Care Resource

The Managed Care Legal Database is a resource identifying how state and federal statutes and regulations address many issues that may occur between private payers and physicians, such as prior authorization, credentialing, network adequacy, out-of-network payment, and contract termination. The Database also contains relevant AMA policy, issue briefs, advocacy resources, model legislation, and a State Laws Map.

2023 Managed Care Resource Kit

The Managed Care Legal Database is a resource identifying how state and federal statutes and regulations address many issues that may occur between private payers and physicians, such as prior authorization, credentialing, network adequacy, out-of-network payment, and contract termination. The Database also contains relevant AMA policy, issue briefs, advocacy resources, model legislation, and a State Laws Map.

Payment Issues

Network Issues

Contract Changes / Disputes

Coverage / Utilization Review

Claims Processing