Though doubts about the benefits of the “payvider” model certainly exist, the success of recent payer-provider partnerships showcases the potential of these programs to improve the patient and provider experience. A study of Aetna’s integrated program, for example, found that plan members could realize significant savings for high-cost chronic conditions and experience fewer hospital admissions. A similar report from Cigna echoed these conclusions, finding that integrated benefit plans resulted
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Aetna
Aetna Taps Emcara Health to Deliver Home-Based Primary Care to 240k Medicaid Patients
What You Should Know:
- Emcara Health and Aetna Better Health, which announced that the two companies will be partnering to deliver primary care in the home to more than 240,000 Medicaid patients in the Miami/Dade and Tampa, Florida regions.
- The relationship extends Emcara Heath’s comprehensive primary care model – which includes behavioral health and social determinants of health assessments – to adult Aetna Medicaid members.
Partnership
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Why Health Systems Need a New Transition Strategy to APMs
There is an adage that change in healthcare moves at the speed of tectonic plates. The slow adoption of Alternative Payment Models (APMs), the central feature of value-based care, is a good example of constraint despite immense pressure to control costs.
Data from 2020 demonstrate almost zero change from 2018 in the proportion of straight Fee-for-Service (FFS) reimbursement. Other results show a slight uptick in APMs with or without downside risk at 34.6 percent. However,
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CVS Health in Talks to Acquire Signify Health
What You Should Know:
- Signify Health is exploring strategic alternatives including a sale, according to a Wall Street Journal report. Initial bids are due this coming week. Additional companies are also in acquisition discussions with Signfiy Health, and CVS could face competition from other managed-care providers and private-equity firms.
- The potential Signify acquisition has a market value of around $4.7 B after its shares rose on the news of a potential sale.
Leveraging
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Impact of Applying Law of Small Numbers to the Telehealth Industry & Why Its Unsustainable
Driven by headlines and incomplete, misleading data that favor a telehealth narrative, health systems and healthcare investors must start asking "who" is actually supporting waning demand.
The healthcare industry is no stranger to the 80/20 rule. The principle says 80% of an effect is driven by 20% of a cause, and in healthcare, it usually refers to there being a specific cohort of the population (e.g., the chronically ill) driving the majority of care utilization and costs.
More recently,
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Wysa Secures $20M for AI-Powered Mental Health Chatbot
What You Should Know:
- Wysa, a Boston, MA-based AI digital platform for mental health, today announces it has secured $20M in financing led by HealthQuad, who along with British International Investment (BII), the UK’s development finance institution, joins earlier investors W Health Ventures, Kae Capital, Google Assistant Investments, and pi Ventures amongst others.
- Funds will enable access to clinically evidenced digital therapeutics (DTx) in the US, UK, India and other global
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Sharecare Appoints Harsha Panyadahundi as Chief Technology Officer
What You Should Know:
- Sharecare appoints Harsha Panyadahundi as Chief Technology Officer (CTO) to further the company’s goals to accelerate growth and create greater value for customers and shareholders. Harsha brings a purpose- and results-driven approach to his new role overseeing all engineering and technology development and operations across Sharecare.
- Harsha joins Sharecare from Wolters Kluwer, where he led technology for its Health, Governance Risk and Compliance, and
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3 Ways Health Plans Can Improve Sleep Health for their Members
Getting a good night’s sleep should have nothing to do with having a great health plan — but it often does.
While some individuals can improve their sleep by making small changes, many who suffer from serious, chronic sleep disorders need a higher level of care and ongoing treatments, and many health plans offer insufficient benefits.
For example, Medicare covers sleep diagnostic tests under strict conditions, if patients are referred by a physician. Other health plans have denied
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CVS Health Launches New Virtual Primary Care Platform
What You Should Know:
- CVS Health launches of its new Virtual Primary Care solution on a single digital platform for a more coordinated and consumer-centric health care experience.
- The new offering, which is being sold to Aetna fully-insured, self-insured plan sponsors, and CVS Caremark clients now, will become effective for eligible Aetna members starting January 1, 2023, and for eligible CVS Caremark members during the second quarter of 2023. It
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Brightside Health Raises $50M for Personalized Anxiety & Depression Care
What You Should Know:
- Today, Brightside Health announced it raised a $50M Series B, led by ACME Capital and Mousse Partners, bringing its total funding to $75M to date.
- The funding will help Brightside expand access to high-quality mental healthcare to more people across the country, enhance the platform, forge new partnerships, and grow as a team, from about 57 now to an expected 175 later this year.
Brightside Health, a telemedicine platform that offers fast access to
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