August 2015
In the August 2015 edition of the COPE Monthly Digest, we examine the Centers for Medicare and Medicaid Services’ proposed managed care rules—the first major update in more than a decade. We also delve into New York State’s proposed alignment strategy between Medicare and Medicaid beneficiaries and offer insights into care coordination.
COPE Health Solutions
  How COPE Health Solutions is Transforming Health Care
Five Key Considerations on CMS’Proposed Managed Care Rule
  Author: Cindy Ehnes, Esq., Executive Vice President
The Centers for Medicare and Medicaid Services (CMS) recently released its proposed Medicaid and CHIP Managed Care Proposed Rule—the first major update to regulations in more than a decade. Public comments were due on July 27, 2015. As the former Director of the California Department of Managed Health Care (DMHC) with oversight of the state’s health insurance regulatory...
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New York State’s New Role in Aligning the Goals of State and Federal Health Reforms
  Author: Anush Gevorgyan, Senior Consultant
New York State (NYS) has one of the nation’s largest populations of Medicaid and Medicare beneficiaries, each around 3 million members. As health care reform continues to lead states away from volume-based payments to value-based reimbursements, NYS has proposed a unique alignment strategy between the two largest federal health care coverage programs. ...
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Key Takeaways from the Care Coordination Summit
  Author: Cindy Ehnes, Esq., Executive Vice President
COPE Health Solutions has enjoyed success with some of our health system partners in deploying Care Navigators to better link high-cost patients to care within the system to enhance success under at-risk contracts, readmission penalties and value-based payments. Such compassionate touch and high quality patient care has become a critical success factor for today’s hospitals...
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  Team Member Spotlight
Wells Shoemaker, MD, Medical Director
and Executive Vice President
Wells Shoemaker, MD, recently joined the COPE Health Solutions team as medical director and executive vice president. He brings a wealth of knowledge from a career that has been dedicated to community health. Shoemaker began his medical career as a pediatrician and spent 25 years providing primary care services to the farm worker communities of Watsonville and Salinas in California. During that time, he opened a lactation program and a Level II neonatal intensive...
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COPE Health Solutions provides our clients with the tools, services and advice they need to be leaders in the health care industry. Focusing on all aspects of strategy, population health management, Medicaid waivers, and workforce development, we help drive our clients' success every step of the way.
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