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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant

4 Major In-Home Healthcare Market Drivers to Watch

by Matt Dumas, Managing Partner at Chasm Partners 04/18/2019 Leave a Comment

4 Drivers Fueling The Surge in the In-Home Care Delivery Market

We are seeing a perfect storm in the making in healthcare with trends that have combined to form tailwinds that are now poised to drive massive expansion in the home healthcare market. Even in the fast-growing healthcare sector, the home health industry stands out for its explosive growth. Home health spending is expected increase at a faster rate through 2027 than all other categories of care, according to a recent analysis from the Centers for Medicare & Medicaid Services (CMS) Office
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AllyAlign Health Raises $10M to Power Value-Based Care for Seniors

by Fred Pennic 04/17/2019 Leave a Comment

AllyAlign Health Raises $10M to Power Value-Based Care for Seniors

AllyAlign Health, a Richmond-based developer and administrator of Medicare Advantage special need plans that benefit long-term care providers has raised $10M in strategic funding led by McKesson Ventures. Existing investors Heritage Healthcare Innovation Fund, Health Enterprise Partners and the LinkAge Fund also participated in the financing. This brings the total capital raised to over $41 million.AllyAlign Health BackgroundAllyAlign Health (AAH) began reforming the health system in 2014 by
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Value-based Care in America: A Table View of State-by-State Initiatives

by Fred Pennic 04/16/2019 Leave a Comment

Value-based care programs are flourishing across the U.S., with a seven-fold increase in the number of states implementing such initiatives in the past five years, according to a new Change Healthcare report. The report, Value-Based Care in America: State-by-State is the second national study of state healthcare payment programs that reveal 48 states have now implemented value-based care or payment programs, 50% of those programs are multi-payer in scope, and just four states have little or no
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Cerner, naviHealth to Launch Medicare BPCI Advanced Offering

by Jasmine Pennic 04/12/2019 Leave a Comment

Cerner, naviHealth to Launch Medicare BPCI Advanced Offering

Cerner and naviHealth, a provider of post-acute management has announced an expanded relationship with plans to create a new offering for the Medicare’s Bundled Payments for Care Improvement Advanced program (BPCI Advanced). After working together for five years to streamline electronic workflows for post-acute discharge, Cerner and naviHealth anticipate launching the new value-based care offering to support BPCI Advanced, with an initial focus on the next CMS launch of the program in January
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UnitedHealthcare Expands Bundled Payments with Medicare Advantage Plans

by Jasmine Pennic 04/10/2019 Leave a Comment

UnitedHealthcare Expands Bundled Payments with Medicare Advantage Plans

UnitedHealthcare announced this week it is expanding its use of bundled payment offerings to care providers participating in Medicare Advantage plan networks across more than 30 states to improve quality and lower costs. The expansion builds upon UnitedHealthcare’s existing work with the Centers for Medicare & Medicaid Services’ Bundled Payments for Care Improvement Advanced (BPCI Advanced) program for fee-for-service Medicare.UnitedHealthcare Care Bundles Program OverviewThe
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U.S. Healthcare Spending Reaches $420M Per Hour, On Track to Hit $12 Trillion by 2040

by Fred Pennic 04/09/2019 Leave a Comment

The United States currently spends more than $420 million per hour on healthcare, a number that is increasing by the minute and is expected to top $12 trillion in 2040, according to HealthCostCrisis.org, a new, interactive website and crisis clock that tracks and forecasts healthcare spending in America in real time. The site, developed by West Health, a family of nonprofit and nonpartisan organizations includes tools to gauge the impact of the escalating cost of healthcare on patients and
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AHIMA, AHCA Partner to Train Skilled Nursing Facilities in ICD-10 Coding to Prepare for New Patient Driven Payment Model

by Jasmine Pennic 04/04/2019 Leave a Comment

AHIMA, AHCA Partner to Train Skilled Nursing Facilities in ICD-10 Coding to Prepare for New Patient Driven Payment Model

The American Health Information Management Association (AHIMA) has announced a collaboration with the American Health Care Association (AHCA) to provide in-depth coding and clinical documentation improvement (CDI) training programs. The goal of the collaboration is to help professionals in skilled nursing facilities (SNF) prepare for the upcoming payment reimbursement change.New, Value-based Patient Driven Payment Model (PDPM) Beginning October 1, 2019, the Centers for Medicare and Medicaid
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Blue Cross NC, Duke Health Form New Company to Offer Medicare Advantage Plan for Seniors

by Fred Pennic 04/03/2019 Leave a Comment

Blue Cross NC, Duke Health Form New Company to Offer Medicare Advantage Plan for Seniors

Blue Cross and Blue Shield of North Carolina and Duke University Health System have together formed Experience Health, a new health insurance company to offer a Medicare Advantage Plan in 2020. Jointly owned by Blue Cross NC and Duke Health, Experience Health brings together two of the most trusted and innovative names in healthcare to create a locally owned and operated non-profit health plan.Why Experience Health?Blue Cross NC and Duke Health formed Experience Health to take advantage of the
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AMA, UnitedHealthcare Develop ICD-10 Codes to Support Social Determinants of Health

by Fred Pennic 04/03/2019 Leave a Comment

Social determinants of health

UnitedHealthcare and the American Medical Association (AMA)  are teaming up to support using data for social determinants of health (SDOH) to improve and simplify how referrals are made to social services. The collaboration builds off work initiated by UnitedHealthcare to standardize how data is collected, processed and integrated regarding critical social and environmental factors that contribute to patient well-being. New ICD-10 related to Social Determinants of Health (SDOH) Today, nearly 80%
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GlobalHealth to Launch Medicare Advantage (MA) Marketplace with Evolent Health

by Jasmine Pennic 03/28/2019 Leave a Comment

GlobalHealth to Launch Medicare Advantage (MA) Marketplace with Evolent Health

GlobalHealth, an Oklahoma-based health maintenance organization, today announced it has entered into a definitive agreement to create a partnership in the Medicare Advantage (MA) plan marketplace with Evolent Health, a company providing an integrated value-based care platform to the nation's leading providers and payers. Together, both companies will launch and scale MA health plans under the True Health brand in targeted geographies. True Health Medicare Advantage (MA) Marketplace DetailsThe
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