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Category: Managed Care

Why Compliance Is Critical for Medicaid MCOs

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Direct Care Innovations provides software solutions that empower Medicaid Agencies to succeed. In an industry where compliance and training are critical, Managed Care Organizations play a vital role in delivering healthcare services to millions of low-income and vulnerable individuals through state Medicaid programs. With such a significant responsibility, strict adherence to federal and state regulations […]

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Understanding California’s Medi-Cal Budget

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Medi-Cal, California’s Medicaid program, provides health coverage to millions of low-income residents, including children, seniors, and individuals living with disabilities. As a critical part of the state’s healthcare system, Medi-Cal’s budget is a major financial consideration for policymakers, especially in the face of rising costs and economic uncertainties. Direct Care Innovations, the leading provider of […]

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Key Insights to Understanding Medicaid Managed Care

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At Direct Care Innovations, we’re committed to keeping you informed on the latest developments in Medicaid news. Medicaid plays a crucial role in providing healthcare coverage to millions of low-income Americans, and managed care has become the primary way states deliver services to enrollees. As of 2023, over 70% of Medicaid beneficiaries receive their care […]

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10 Unique Challenges of Managing an In-Home Care Business

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Given the personal and sensitive nature of the services provided, managing an in-home healthcare business involves distinct challenges. At Direct Care Innovations, we offer an integrated business management platform that enables you to run every aspect of your business or agency seamlessly, helping you navigate these difficulties. Many businesses fail within their first year, and […]

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9 Benefits of Electronic Visit Verification

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Using Electronic Visit Verification (EVV) technology offers significant benefits for home healthcare agencies, enhancing compliance, efficiency, and quality of care. Direct Care Innovations offers a mobile application to track time and ensure EVV compliance for services delivered remotely in homes or community settings. We understand the value EVV brings and its potential to transform homecare […]

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Community Reinvestment Mandates for MCOs

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State Medicaid agencies are increasingly mandating community reinvestment requirements in contracts with Medicaid managed care organizations (MCOs). These requirements necessitate that MCOs reinvest a portion of their profits back into the communities they serve to improve health outcomes. At least ten states have adopted or are implementing such requirements. Direct Care Innovations provides solutions that […]

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3 Factors Surrounding Medicaid & Managed Care Organizations

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In partnership with states nationwide, risk-based Managed Care Organizations (MCOs) coordinate essential healthcare services for Medicaid enrollees living with intellectual and developmental disabilities (IDD). Over the last decade, COVID-19 and other global and national events have greatly influenced the utilization of risk-based MCOs. Direct Care Innovations has adapted to these changes and continues to support […]

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The Medicare & Medicaid Managed Care Lifecycle

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With the ever-increasing growth of Medicaid and Medicare managed care, Direct Care Innovations is at the forefront of providing solutions that help agencies navigate these complex systems. On average, 100 million enrollees receive federal health benefits, representing a significant portion of the CMS budget. The Office of Inspector General (OIG) has released a strategic plan […]

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The Final Rule: Updated Regulations for Medicaid Managed Care

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Medicaid and Medicare have long provided access to a spectrum of healthcare services, particularly for underprivileged populations. Direct Care Innovations has been following the Centers for Medicare and Medicaid Services (CMS) as they have been updating regulations to provide efficient fiscal and operational administration without compromising quality health services. With the final CMS rule rollout […]

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3 Current Updates Regarding Medicaid & Managed Care

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Over the last few years, several updates have been made to Medicaid and managed care. With the Medicaid unwinding process taking place, the Centers for Medicare and Medicaid Services (CMS) and Managed Care Organizations (MCOs) are working together to help Medicaid-eligible members retain their current coverage. Direct Care Innovations is watching these changes closely to […]

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