CHESS Health Solutions

10/24/2025

CMS is launching a $50 billion program to modernize rural health, expand access, and close disparities over the next five years.

For rural providers, this is a rare opportunity. Get involved by:

+ Reviewing the Notice of Funding Opportunity and aligning your practice's strengths with the program goals
+ Engaging state agencies and stakeholder groups
+ Contributing local data, challenges, and ideas to influence proposals
+ Exploring pilot initiatives in anticipation of implementation

10/23/2025

Managed Medicaid isn't just for large systems.

Small, rural hospitals like Northern Regional are proving that with the right partnerships and a focus on care coordination, they can improve outcomes and expand access too.

Hear how Emily Volk and her team are meeting patients where they are and building stronger relationships across their community on the Move to Value Podcast.

Emily Volk of Northern Regional shares how her team tackles documentation, continuity of care, and data challenges in Medicaid managed care.

10/22/2025

CHESS Health Solutions officially launched its Medicaid CIN earlier this year -- making value-based care more achievable for every provider, not just large systems.

Our CIN is built specifically to support independent practices navigating the complexities of Managed Medicaid. From care management to quality improvement resources, CHESS is equipping providers with what they need to thrive in Medicaid value-based contracts.

We believe in better care for all, regardless of insurance type.

📢 Ready to learn more or partner with us? Send us a message!

10/20/2025

Advanced Primary Care = Better Outcomes

Stronger care coordination. Smarter use of data. More engaged patients.

Advanced Primary Care Management is transforming how providers deliver care and how communities stay healthy. The focus is simple: close gaps, build trust, and improve outcomes.

https://www.chesshealthsolutions.com/2025/09/25/advanced-primary-care-management/

10/16/2025

Prior authorizations don't have to overwhelm providers.

Pharmacists can ease the burden by:
✔️ Recommending alternatives that avoid prior auths
✔️ Supporting documentation to reduce denials
✔️ Flagging high-cost meds early
✔️ Guiding patients through the process

Collaboration with pharmacists streamlines care and gets patients the treatment they need faster.

10/15/2025

Did you know that Medicare costs are not the same for every beneficiary?

The exact amount a patient pays depends on:
+ Their chosen coverage
+ The medical services and items they use yearly
+ Whether they receive financial assistance

10/14/2025

Pharmacists are essential players in value-based care!

In the shift towards value-based care, pharmacists are doing more than just dispensing medications. Their expertise helps:

💊 Optimize Treatment Plans
💊 Ensure Patients Adhere to their Medications
💊 Reduce Unnecessary Costs by Preventing Complications

How do you see pharmacists shaping the future of healthcare?

10/13/2025

By proactively addressing breast cancer screening, practices not only improve quality scores but, more importantly, save lives through early detection.

https://youtu.be/zT2y7IIKoKA

10/09/2025

Collaboration is the foundation of better care.

In the latest episode of the Move to Value Podcast, Debi Hueter of WakeMed Key Community Care and Rebecca Grandy from CHESS share how CINs empower physicians, specialists, and pharmacy partners to deliver patient-centered care.

They discuss how building trust and aligning goals across teams allows providers to work at the top of their license -- supporting independent practices and improving outcomes for patients.

🎧 Listen in to learn how collaboration turns a network into a community of care:

Discover how pharmacy partnerships within clinically integrated networks enhance collaboration, improve outcomes, and advance value-based care

10/08/2025

Happy American Pharmacist Month! 💊👏

Join us in celebrating the unwavering dedication of over 700,000 pharmacy professionals. From managing complex medication therapies to providing personalized patient care, pharmacists are essential to improving health outcomes.

A special shoutout to the CHESS Pharmacy team for all the incredible work they do to ensure patients receive the best care possible!

10/07/2025

🚨 Attention Healthcare Professionals: The CMS-HCC Risk Adjustment Model is transitioning from Version 24 to Version 28.

This update brings significant changes:
✅An increase in HCC disease groups, reflecting more detailed condition categories
✅ More detailed and focused condition grouping, emphasizing the need for precise coding
✅Recalibrated RAF scores

Providers, coders, and care teams must adapt to these changes to ensure accurate documentation and optimal reimbursement.

10/06/2025

Medicare Open Enrollment is Here!

Medicare open enrollment is the perfect time for patients to review their coverage, explore new plan options, and ensure they have access to the care they need.

Tips for supporting your patients:

✅Encourage patients to check their eligibility and renewal deadlines.

✅ Provide educational resources about plan benefits.

✅ Help patients understand preventive care and services covered under their plan.

Taking a few minutes to discuss enrollment during visits can make a big difference—ensuring patients stay covered and connected to the care that matters most.