Approximately 42% of Medicare beneficiaries are enrolled in Medicare Advantage plans—a segment projected to reach 46% by 2025. Due to rapid growth of the 65-and-older portion of the population, Medicare expenditures are forecast to reach $1,559.4 billion in 2028, with spending per enrollee reaching $20,751.
Key trends are influencing this growth, including:
- An aging population
- Continued increase in overall Medicare costs
- Government support and benefit flexibility (e.g.,
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ACOs
Analysis: Is Oracle Cerner Planning to Build A National EHR?
Earlier this month Oracle closed its $28.3B acquisition of Cerner and shortly after Oracle founder and CTO, Larry Ellison, outlined Oracle’s vision for Healthcare IT post-acquisition. The key elements of this vision included:
- Developing a solution for a national EHR database.
- Leveraging this solution, and similar smaller-scale connected EHR initiatives, to provide life science, pharma and other users with a rich environment for research, clinical trials and drug
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The No Surprises Act: How Payers Can Stay Compliant
As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a topic discussed by consumers and policymakers. Surprise billing can occur when a patient unknowingly receives care from providers that are outside their network. This can result in balance billing, the practice of billing a patient the difference between what their health plan covers and what the provider charges. Unfortunately, these bills are often the result of care provided in
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Interoperability: A Powerful Solution to Staffing Challenges Continues to be Overlooked
In our ever-changing world, clinicians nowadays must find more efficient ways to operate with fewer resources. Increased patient loads, reimbursement changes, rule and regulation adjustments and thin margins, all while being short-staffed can be compared to a smoldering bonfire that reignites every time the wind blows. As if that weren't enough, post-acute providers will begin to feel even more heat if they don’t embrace interoperability. Our global demographics simply will not be able to
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Forge Health Secures $11M for Value-Based Behavioral Health Model
What You Should Know:
– Forge Health, a White Plains, NY-based behavioral healthcare provider with a proven, national-payer-validated ability to drive clinical outcomes that span all areas of health, today announced an $11M growth funding round led by HC9 Ventures.
- Innovative behavioral health company works with payers and health systems to enable value-based care for mental health and substance use populations.
Transforming Addiction and Mental Health Treatment
Founded in 2016,
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Bamboo Health ACOs Generate $1B+ in Medicare Shared Savings Program
What You Should Know:
- Following the National Association of Accountable Care Organizations (ACOs) announcement of 2020 data detailing the Medicare Shared Savings Program (MSSP), Medicare's largest alternative payment model, Bamboo Health, formerly Appriss Health and PatientPing, announced its national network of ACOs generated over $1 billion in total shared savings.
- Bamboo Health’s ACO partners succeed under value-based care programs like the MSSP by utilizing their Pings
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Apriss Health Acquires Care Coordination Platform PatientPing
What You Should Know:
PatientPing, a comprehensive care collaboration platform focused on behavioral health and substance use disorder., today announced that it has entered into a definitive agreement to acquire care coordination platform Appriss Health.
- Together, PatientPing and Appriss, backed by Clearlake Capital Group, L.P., and Insight Partners, will represent the largest and most diverse care collaboration network connecting nearly 1 million healthcare providers to one another and
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Aledade Secures $100M for Value-Based Primary Care, Reaching $2.1B Valuation
What You Should Know:
- Aledade raises $100 Million in Series D funding to help
more primary care practices thrive in value-based care.
- The new funding will power the growth of a nationwide network of more than one million patients by further expanding into Medicare Advantage Contracts.
Aledade,
a Bethesda, MD-based provider of value-based primary care, today announced it
has closed a $100 million Series D funding round following a year of
significant growth for its national
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Net Health Acquires Post-Acute Analytics Platform PointRight – M&A
What You Should Know:
- Net Health acquires post-acute market analytics platform PointRight to deepen the company’s analytics capabilities, post-acute presence, and support for SNF networks.
Net
Health, a provider of cloud-based software for specialty medical providers
across the continuum of care, today announced that it has acquired
PointRight Inc., a leading provider of
analytics and data-driven tools for the post-acute market. The acquisition adds
to Net Health’s expanding
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PointClickCare Acquires Collective Medical for $650M to Create to Largest Combined Acute and Post-Acute Care Network
What
You Should Know:
-
PointClickCare announces its intent to acquire Collective Medical to create the
largest combined acute and post-acute care network in North America for $650M.
-
Collective Medical’s platform connects more than 1,300 hospitals, thousands of
ambulatory practices and long-term post-acute care (LTPAC) providers, as well
as accountable care organizations (ACOs) and every national health plan in the
country, across a 39-state network.
- With the acquisition of
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