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Medicare Advantage | Payers | News, Analysis, Insights

UnitedHealthcare Dental Rolls Out New Teledentistry Option

by Jasmine Pennic 06/24/2020 Leave a Comment

UnitedHealthcare Dental Rolls Out New Teledentistry Option

What You Should Know: - New offering is part of UnitedHealthcare Dental’s comprehensive response to COVID-19, which also includes financial support for customers and enhanced payments for network providers. - Dental care ranks among the most frequently avoidable ER visits, with the emergence of teledentistry providing a key resource to help people make more informed decisions about where to go for care and avoid potential exposure risks with in-person care facilities. With
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DispatchHealth Raises $135.8M to Expand On-Demand In-Home Care Model

by Fred Pennic 06/23/2020 Leave a Comment

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

What You Should Know - Today DispatchHealth announced the closing of $135.8 million growth capital financing led by Optum Ventures and included participation from existing and new strategic investors. - The additional funding enables DispatchHealth to continue to provide in-home medical care to even more vulnerable, high-needs patients by growing its existing 19 markets, expanding to new markets, and launching additional services.  - Many health systems, including Renown Health and
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How Social Determinants of Health Will Impact the Future of Benefit Coverages

by Kevin Riley, SVP and General Manager, Vlocity Health 06/18/2020 Leave a Comment

How Social Determinants of Health Will Impact the Future of Benefit Coverages

Do you have access to healthy foods, transportation to a doctor, high-speed internet for telemed appointments, or a roof over your head? These are assumptions that most of us take for granted, and are not the questions that insurers usually take into consideration. But, as they look to increase member outcomes and foster long-term customer loyalty, considering the changing needs of many consumers in the face of today’s current affairs, it’s time they did. In fact, forward-looking health plans
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The New Normal: Rethinking Healthcare Delivery in a Post-COVID World

by Mansoor Khan, Sc.D., co-founder and CEO of Persivia 06/11/2020 Leave a Comment

The New Normal: Rethinking Healthcare Delivery in a Post-COVID World

It’s becoming clearer that, while we are all hoping that things are going to go back to the way things were at the beginning of the year, the COVID-19 crisis will result in a new normal. That’s especially true in healthcare, due to four issues that are being wildly amplified by the COVID-19 crisis. Namely:  1. The US government has huge deficits, and healthcare is a major driver of the unsustainable increase in these deficits. 2. Addressing the demand for healthcare as a right (not a
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Inovalon Launches FHIR-Based Solution for Health Plan Compliance

by Jasmine Pennic 05/22/2020 Leave a Comment

Big Data Firm Inovalon Files First Digital Health IPO of 2015

What You Should Know: - Inovalon announced the availability of its Cloud-Based “Consumer Health Gateway” Module, alleviating the need for health plans to build their own Patient Access API to comply with the new requirement of the 21st Century Cures Act. - The Consumer Health Gateway is a consumer portal allowing the FHIR®-based exchange of a patient’s claims and clinical data securely with authorized third-party applications. It consists of a robust patient consent and authentication
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How AI-Driven Insight Could Fuel Medicare Advantage Success

by Our Thought Leaders 04/22/2020 Leave a Comment

Navigating Healthcare’s Uncertain Future: Three Data-Driven Approaches for Payers

Medicare Advantage plans need more than consumer-centric design, payer/provider alignment, and strong connections across the continuum of care to drive value. The high-value performance also depends on their ability to use data to make a meaningful difference in members’ health. With 11,000 people aging into Medicare daily, proficiency in managing Medicare Advantage populations is critical for demonstrating value in a competitive market. Enrollment in these plans is growing significantly,
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Aledade Raises $64M for Value-Based Care Network of Physician-Led ACOs

by Jasmine Pennic 04/20/2020 Leave a Comment

Aledade Raises $64M for Value-Based Care Network of Physician-Led ACOs

What You Should Know: - Aledade raises $64M in Series C funding led by OMERS Growth Equity to expand its national network of more than 500 physician-driven accountable care organizations (ACOs) across 27 states. - To date, Aledade’s ACOs care for more than 840,000 patients and manage more than $7.5 billion in health care spending through 38 Medicare and 42 other value-based contracts. Today, Aledade announced it has closed a $64 million Series C funding round following the
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Addressing Loneliness and Social Isolation in the Medicare Population

by Anne Davis, Director of Quality Programs and Medicare Strategy at HMS 04/09/2020 Leave a Comment

Addressing Loneliness and Social Isolation in the Medicare Population

In recent years, the healthcare industry's understanding of social determinants of health (SDoH) and their impact on patient outcomes has grown dramatically. Researchers and practitioners now recognize that social isolation and loneliness fall under the SDOH umbrella. In response, many payers and providers are exploring initiatives to address social isolation among members and patients. The health effects of social isolation and loneliness are costly and harmful. According to Health
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Puerto Rico’s First Home Delivery Pharmacy Launches During COVID-19 Crisis

by Jasmine Pennic 04/01/2020 Leave a Comment

Puerto Rico's First Home Delivery Pharmacy Launches During COVID-19 Crisis

What You Need to Know: - Pharmacy benefits manager Abarca and Triple-S Salud announced the launch of Triple-S en Casa, Puerto Rico’s first prescription home delivery program during the COVID-19 crisis. - Developed in partnership with one of the Island's largest health plans and pharmacy networks, Triple-S en Casa lets consumers manage and order their prescriptions through an easy-to-use mobile app--and have them delivered by a local pharmacy. Pharmacy benefits manager Abarca and
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Vivify Health Launches COVID-19 Screening, Self-Isolation and Monitoring Pathways

by Fred Pennic 03/16/2020 Leave a Comment

Vivify Health Launches COVID-19 Screening, Self-Isolation and Monitoring Pathways

What You Need to Know: - Vivify Health has announced that availability today of new COVID-19 Screening, Self-Isolation and Monitoring Pathways for Vivify+Go mobile solution to providers at non-cost. - This enables low-risk patients or those with mild symptoms to use their mobile devices to self-screen for COVID-19 by answering a series of questions that follow the current Centers for Disease Control and Prevention (CDC) guidelines. - The self-screening helps providers scale their
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