What You Should Know: - Aledade is continuing its strong momentum today, announcing that Cigna Healthcare Medicare Advantage customers can now receive value-based care from Aledade’s network of independent primary care practices. - Participating practices can access Aledade’s cutting-edge data analytics, user-friendly guided workflows, and health care policy expertise, as well as integrated care services supported by AledadeCare Solutions. - This news comes shortly after Aledade
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Medicare Advantage | Payers | News, Analysis, Insights
PointClickCare Acquires Value-Based Care EHR Patient Pattern
What You Should Know: - PointClickCare Technologies, a healthcare technology platform enabling meaningful collaboration and access to real‐time insights at every stage of the patient healthcare journey, today announced the acquisition of Patient Pattern. Financial terms of the transaction were not disclosed. - The combination of PointClickCare and Patient Pattern will further the companies’ shared vision of enabling better care and outcomes for high-needs populations and provide
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Signify Health, Cardinal Health Partner to Offer In-Home Medication Therapy Management
What You Should Know: - Signify Health announced a partnership with Cardinal Health, a medical device and pharmaceuticals supplier, to provide in-home medication therapy management to Medicare members. - In order to provide a more coordinated care experience and help members with their often-complex medication regimens, Signify’s mobile network of 11,000 credentialed clinicians will be able to offer medication management services for health plan members through in-home health evaluations
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Apixio Launches EHR-Integrated Post-Visit Solution
What You Should Know: - Apixio, a leading AI platform that powers value-based care launches its new Apicare Post-Visit™ offering, an EHR-integrated intelligent workflow solution for health plans and providers. With the Centers for Medicare & Medicaid Services' recent Medicare Advantage Risk Adjustment Data Validation Final Rule, healthcare organizations need to have complete diagnosis capture and accurate documentation for reimbursement to ensure compliance. - The new Post-Visit
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It’s Time to Stop Accepting the Payer-Provider Dynamic as ‘Adversarial’ and Work Toward Alignment
Today’s relationship between payers and providers is more fraught than ever. With a history of transactional, often adversarial, fee-for-service contract negotiations, it’s no wonder that the healthcare industry has grown too comfortable pitting payers and providers against each other. The lack of trust and transparency between the two groups has led to a perceived misalignment of vision. Across the board, the administrative staff has shouldered the brunt of this friction, which in the end
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Aledade Acquires Curia, Adds More Than 450 New Practices
What You Should Know: - Aledade today announced the acquisition of Curia, a leader in value-based care analytics using practical applications of artificial intelligence (AI) to optimize the targeting of patient care and engagement programs. The acquisition will enhance Aledade’s ability to extract valuable insights from disparate data sources, provide more accurate predictions using past data, and optimize primary care workflows through cutting-edge AI algorithms. - In addition, the
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Why It’s Time for Intelligent Prior Authorization
The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients. Specifically, the rule stipulates that health plans adopt electronic prior authorization processes, adhere to shorter turnaround times, clearly communicate denial reasons, publish key metrics annually, and implement the Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface
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Mighty Health Raises $7.6M for Daily Health Program for Medicare-Aged Adults
What You Should Know: Mighty Health, the first all-in-one daily health program designed for adults ages 50 and up, today announced $7.6M in new financing co-led by Will Ventures and GFT Ventures. - Mighty Health has built the modern home for healthy living for 50 on up, offering aging adults access to personalized and holistic health guidance through joint-friendly workouts, chronic condition-specific programs, custom nutrition plans, and 1-on-1 health coaching.
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Study: Increased Transparency Between Payers and Providers at the Point-of-Care Improves Risk Capture and Quality Measures
What You Should Know: - IllumiCare, a pioneer in point-of-care healthcare information technology, today released a new report detailing how increased data transparency between health plans and providers on care and coding gaps results in higher compliance, process improvement, and positive behavior changes among network providers. - The report demonstrates, across multiple plans, that placing previously unavailable yet actionable information on quality gaps, HCC (Hierarchical
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9 Executive Revenue Cycle Predictions/Trends to Watch in 2023
Nate Maslak, the co-founder/CEO of Ribbon Health Price Transparency: In 2022, we saw CMS’s Transparency in Coverage rule go into effect, requiring non-hospital entities like health plans and providers to publish publicly available rates for care. In 2023, we’ll see this price transparency data become more mainstream as it finally makes its way into the hands of patients, empowering them to find the best care for them, reevaluate their care choices, and shop around for the best possible care
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