MEDICAID MANAGED CARE
Disaster Preparedness for Members with Chronic Conditions
August 19 | NOON - 1 p.m.
Please join us for the last webinar in this series focused on disaster preparedness for members with chronic conditions. This webinar will cover the following:
Register by clicking the button below. We look forward to connecting with you!
A new toolkit from NCDHHS offers a variety of resources to support healthcare providers with giving vaccines. The information and tools address the challenges involved in providing vaccines, including conversation guides, communication tools, and population-specific guidance.
Save the Date!
Fifth Annual Virtual Statewide Quality Forum
October 8, 2025 | noon - 1 p.m.
The North Carolina Department of Health and Human Services Division of Health Benefits and North Carolina AHEC, in conjunction with the five Medicaid managed care standard plans, will host the Fifth Annual Virtual Statewide Quality Forum on October 8 from noon-1 p.m. Topics will include:
The forum is designed to help providers, practice managers, and quality managers succeed with Medicaid Managed Care quality initiatives. Look for additional details, including how to register, soon.
We hope you can join us!
Today we bring you updates from the latest CMS QPP Newsletter for Small Practices:
CMS Proposes Policy Changes for Quality Payment Program
The Centers for Medicare & Medicaid Services (CMS) has issued its Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule, which includes proposed policies for the Quality Payment Program (QPP).
The Notice of Proposed Rulemaking (NPRM) includes proposals for the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), as well as several Requests for Information (RFIs).
Specifically, we’re proposing policies that:
Key QPP policies that we are proposing in the CY 2026 PFS Proposed Rule include:
We are also seeking feedback on RFIs about the following topics:
Medicaid Managed Care Back Porch Chat
Key Updates: Children and Families Specialty Plan (CFSP) Launch, HOP
Thursday, July 31 | noon-1p.m.
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NC Medicaid published the 2025 NC Medicaid Standard Plan Performance Comparison Tool and accompanying Technical Guide. The new tool allows Medicaid beneficiaries to compare the performance of the five NC Medicaid Standard Plans.
The tool enables beneficiaries to make informed decisions about which Standard Plan works best for them. It provides easy-to-read comparisons of how the Standard Plans perform across different domains of health care, including: getting care, care experience, experience with providers, reproductive and sexual health, and children’s health. The complementary technical guide provides details on how NC Medicaid conducted the comparison, and where the data came from.
Here's one excerpt from the tool:
A Full Star means the health plan performed better than the average of all the Standard Plans
A Half-Filled Star means the health plan performed within the average of all the Standard Plans
An Empty Star means the health plan performed worse than the average of all the Standard Plans
Sources:
NC Medicaid Standard Plan Performance Comparison Tool 2025
NC Medicaid 2025 Standard Plan Performance Comparison Tool Technical Guide
The AHEC Standardized Onboarding and Credentialing program aims to improve the process of placing health science students in clinical placements through partnerships as well as onboarding and credentialing tools.
These tools help reduce the time and resources needed to onboard and credential students to clinical rotations. These tools, as well as support and guidance from AHEC and other partners, can make it easier for small practices to host students, helping to increase opportunities for training, and ultimately increasing clinical capacity. To get started or for more information, please contact Aubrey Delaney, Associate Director Onboarding and Credentialing at Audelaney@wakeahec.org.
Learn more: Standardized Student Onboarding and Credentialing.
From CMS:
CMS is committed to crushing fraud, waste, and abuse. The WISeR Model, which stands for Wasteful and Inappropriate Service Reduction, will help meet this goal, while supporting people with Original Medicare to receive safe and appropriate care and protecting federal taxpayers.
Through WISeR, CMS will partner with companies specializing in enhanced technologies to test ways to provide an improved and expedited process for reviewing the medical necessity of select items and services shown to have little to no clinical benefit and that are particularly vulnerable to fraud, waste, and abuse.
With this announcement, CMS has issued a Request for Applications (RFA) for companies interested in participating in the model.
Find more information on the WISeR Model webpage, as well as the model press release and factsheet.
Send questions about the model to WISeR@cms.hhs.gov.
WEBINAR OPPORTUNITY
Remote Patient Monitoring Optimization for FQHCs
June 25, 2025 | noon-1 p.m.
Join us for an exclusive training webinar hosted by NC AHEC Practice Support in collaboration with the NC Community Health Center Association. The training is designed specifically for federally qualified health center staff interested in optimizing or starting remote patient monitoring (RPM) as a solution for improved patient care. RPM is a new healthcare practice that uses digital devices to collect and transmit patient health data to healthcare providers. It allows for continuous monitoring and management of patient’s conditions from a distance. This healthcare practice can work successfully if implemented correctly.
This session will provide an overview of the latest trends, how to implement in your workflows, and appropriate Medicare/Medicaid billing codes to ensure financial sustainability and accuracy. Register now and take the first step in learning more.
Register for the RPM Webinar
