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Category: Industry News

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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4 Expected Changes to New York’s Consumer-Directed Program

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Fiscal intermediaries (FIs) play an essential role in providing high-quality care for self-directed individuals living with intellectual and developmental disabilities (IDDs). Recent changes to the Consumer Directed Personal Assistance Program (CDPAP) will have an impact on how FIs can conduct business in the state of New York, potentially compromising the health and safety of children […]

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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 Surprising Benefits of EVV in Home Health Care

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Since the introduction of EVV across the home health industry, several other benefits have been discovered beyond verifying home health care visits and preventing Medicaid fraud. For this reason, EVV compliance is a crucial tool that many of Direct Care Innovations‘ clients find significantly beneficial. Let’s examine three surprising benefits of EVV and how they […]

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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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National Strategies to Overcome Direct Care Workforce Challenges

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In recent years, hiring and retaining direct care workers has become a growing challenge. To discover the various reasons behind this challenge, a deeper look into the current state of the direct care workforce is a must. As a company that supports home- and community-based service programs (HCBS) and agencies, Direct Care Innovations understands the […]

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Why Direct Care May Be Experiencing Staffing Shortages

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The direct care workforce is at an all-time low, and there are currently no effective solutions for this challenge. The increasing demand for direct care workers continues to grow, and elderly populations and individuals with disabilities are relying more and more on home-based care. With such a high need for direct care workers, why are […]

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How Self-Direction Services Have Changed in Recent Years

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Direct Care Innovations specializes in collaborating nationwide with self-directed agencies, also known as consumer-directed agencies. As part of a broader spectrum of long-term services aiding aging adults, individuals with physical disabilities, and those with intellectual and developmental disabilities (I/DD), self-direction services have witnessed substantial growth in recent years. The National Inventory of Self-Directed Long-Term Services […]

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