As if 2020 couldn’t be any more challenging for healthcare providers, new federal rules on interoperability and patient access, granting patients direct access to their healthcare data, begin taking effect in 2021 and will continue into 2022. These rules, while ultimately beneficial to patients, bring an additional level of operational complexity to many revenue-stressed healthcare organizations.
If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For
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Medicare Advantage | Payers | News, Analysis, Insights
Unite Us, CVS Health, Humana & Ochsner Health Partner to Expand Social Care Throughout Louisiana
What You Should Know:
- Unite Us today announced its Unite Louisiana
network has partnered with CVS Health, Humana, and Ochsner Health in an effort
to expand and improve community health and social care throughout the state.
- New partners will enable Unite Louisiana, the statewide
social care network, to further expand into more parishes and broaden access to
care in response to COVID-19 challenges.
Unite Us, the technology company
building coordinated care networks
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CMS Direct Contracting Model Options for Value-Based Care
The Centers for Medicare and Medicaid Innovation (CMMI) created the Direct Contracting Model to expand opportunities for more diverse providers and healthcare organizations to participate in value-based care arrangements for Medicare fee-for-service (FFS) beneficiaries.
The goal of the new model is to create the next generation of risk-sharing arrangements to improve outcomes for patients, lower costs, and ensure high-quality care. In developing the Direct Contracting model and associated
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Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members
What You Should Know:
- Humana Inc. and Fresenius Medical Care North America
(FMCNA) today announced an agreement to broaden their collaboration toward
improving the health of eligible Humana Medicare Advantage members
- The
agreement between Humana and Fresenius Medical Care North America goes into
effect Jan. 1, 2021.
Humana Inc. and leading renal care company Fresenius Medical Care North America (FMCNA) announced an agreement to broaden their collaboration toward improving the
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Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment
What You Should Know:
- Walmart announced it will begin selling Medicare
insurance plans during this year’s annual enrollment period, Oct. 15 through
Dec. 7.
Today, Walmart
announced the launch of Walmart
Insurance Services, LLC, a licensed insurance brokerage, which will assist
people with enrolling in insurance plans—and simplify what’s historically been
a cumbersome, confusing process. Walmart Insurance Services will begin selling
Medicare insurance plans during this year’s Annual
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Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly
What You Should Know:
- Independence Blue Cross and Signify Health launches
social determinants of health network, CommunityLink to connect data from multiple
CBOs to integrate social directly into medical care in the Philadelphia area.
- CommunityLink represents one of the first examples
nationwide of combining in-home health with social care.
Independence Blue Cross
(Independence) and Signify Health
announce the launch of CommunityLink™, a social
determinants of health (SDoH)
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Designating Ownership of Provider Data Will Improve Care Coordination, Study Finds
What You Should Know:
- New LexisNexis Risk Solutions Health Care survey reveals
that 63% of respondents believe designating ownership of provider data will
improve care coordination, yet only 18% of organizations report having a
dedicated data governance department
- The survey results are based on over 100 qualified
responses from organizations across the industry, including independent
hospitals, teaching hospitals, independent physician groups, and federally
qualified health
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Cone Health to Merge with Sentara Healthcare Totaling $11B in Assets
What You Should Know:
- Cone Health has signed a letter of intent to merge with
Norfolk, Virginia-based Sentara Healthcare for a combined $11B in assets.
- The merger creates one large health system totaling of
17 hospitals – 11 Sentara hospitals in Virginia and one in Elizabeth City,
N.C., and five Cone Health hospitals in the area surrounding Greensboro.
Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare. The merger will
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COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever
In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need to provide healthcare for all in the event of calamity upending the basic functions of a civilized society. With that, the UK’s National Health Service (NHS) was born.
In 2020, all perspectives about quality and the time it takes to see a provider aside, the NHS remains quite popular
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Cedar Gate Technologies Acquires Citra Health Solutions to Expand Value-based Technology
Cedar Gate Technologies
(Cedar Gate), a Greenwich, CT-based value-based care
performance management company, today announced its acquisition
of Citra Health Solutions (Citra), a
provider of capitation management software solutions.
Expands Value-Based Care Technology Suite with Citra's Capitation
Management Solutions
By acquiring Citra, Cedar Gate expands its software and
services capabilities across the full spectrum of value-based care. By
combining Cedar Gate's existing capabilities in
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