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Medicare Advantage | Payers | News, Analysis, Insights

3 Strategies to Up-Level Medicare Advantage Enrollment Before it is Too Late

by Trey Keller, VP of Product Management & Aaron Fulner, Sr. Director at Edifecs 04/19/2021 Leave a Comment

3 Strategies to Up-Level Medicare Advantage Enrollment Before it is Too Late

With a new administration looking to reshape healthcare policy and additional special enrollment periods already underway, now is the time to ensure Medicare enrollment systems are ready for the unpredictability, and potential opportunities, ahead. While Medicare is the fastest growing segment of the healthcare industry, it is also highly competitive, expensive to operate in, and riddled with complexities and regulations to navigate. Health plans don’t have room to make a misstep when it comes
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Payers Struggle with Provider Data Management Too

by Eric Demers, CEO of Madaket Health 03/04/2021 Leave a Comment

Payers Struggle with Provider Data Management Too

Provider data management is usually discussed from the provider perspective: the busy staff, the needless paperwork amid a pandemic, the faxing, emailing and uploading of data. In these scenarios, the health plans are often painted as the villains for their bureaucratic processes and unique requirements. But the reality is that health plans aren’t totally to blame. Payers and providers share a common goal: to provide the best quality care for their patients. The amount of data, including
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DispatchHealth Reaches $1.7B Valuation, Raises $200M for In-Home Care Model

by Fred Pennic 03/03/2021 Leave a Comment

DispatchHealth Raises $135.8M to Expand On-Demand In-Home Care Model

What You Should Know: - DispatchHealth has secured an additional $200 million in a Series D round of funding led by Tiger Global. The additional financing brings DispatchHealth into the “unicorn” category and solidifies its valuation at more than $1.7 billion.  - DispatchHealth’s new round of financing will allow the company to bring it’s model of in-home medical care to more than 100 markets across the country
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Signify Health Shares Soar More Than 33% in IPO, Valuing Company at Over $7.12B

by Fred Pennic 02/11/2021 Leave a Comment

Signify Health Shares Soar More Than 33% in IPO, Valuing Company at Over $7.12B

What You Should Know: - Shares of Signify Health, a value-based care billing platform for in-home and bundled health services jumped more than 33% in its initial public offering (IPO), valuing the company at over $7.12B. - Today, Signify Health’s CEO Kyle Armbrester will also join the ranks among the youngest CEOs to ever take a company public – notably alongside Bumble’s CEO who also began trading on the NASDAQ today.  - The company raised 564 million by offering 23.5 million
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Anthem Acquires Puerto Rico’s Largest Medicare Advantage Plan

by Fred Pennic 02/04/2021 Leave a Comment

Anthem Acquires Puerto Rico’s Largest Medicare Advantage Plan

What You Should Know: - Anthem, Inc. has entered into an agreement with InnovaCare Health, L.P., to acquire its Puerto Rico-based subsidiaries, including MMM Holdings, LLC (“MMM”) and its Medicare Advantage (MA) plan MMM Healthcare, LLC as well as affiliated companies and Medicaid plan.   - MMM is Puerto Rico’s largest MA plan and one of the fastest-growing vertically integrated healthcare organizations in the United States. - With more than 267,000 MA members and over 305,000
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Aledade Secures $100M for Value-Based Primary Care, Reaching $2.1B Valuation

by Jasmine Pennic 01/19/2021 Leave a Comment

Aledade ACO

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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CVS Health Launches Senior Medical Alert System, Symphony

by Jasmine Pennic 01/14/2021 Leave a Comment

CVS Health Launches Senior Medical Alert System, Symphony

What You Should Know: - Today, CVS Health announced Symphony, a medical alert system designed to keep seniors safe and connected at home. - Symphony consists of a collection of in-home and wearable devices that offer a new at-home experience by connecting a suite of sensors that can monitor for falls, motion, and room temperature while also providing a 24/7 personal emergency response platform for use when needed. CVS Health, today announced the release of Symphony medical alert
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Net Health Acquires Post-Acute Analytics Platform PointRight – M&A

by Fred Pennic 01/12/2021 Leave a Comment

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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12 Telehealth & Virtual Care Predictions and Trends for 2021 Roundup

by Fred Pennic 01/04/2021 Leave a Comment

12 Telehealth & Virtual Care Predictions and Trends for 2021

Dr. Paul Hain, Chief Medical Officer of GoHealth Telehealth is Here to Stay in 2021 Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows
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As Telehealth Surges, Are Seniors Being Left Behind?

by Anne Davis, Director of Quality Programs & Medicare Strategy at HMS 12/11/2020 Leave a Comment

As Telehealth Surges, Are Seniors Being Left Behind?

A global health crisis has thrust us into a scenario in which lives quite literally depend on the ability to virtually connect. Telehealth has rapidly emerged as a vital tool, enabling continuity of care, allowing vulnerable individuals to access their physician from home, and freeing up resources for providers to treat the most critical patients. The acceptance of telehealth and expansion of covered services for the senior population demonstrate that this technology will endure long after
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