- CareMount, New York's top Next-Gen accountable care organization, is partnering with Nuvance Health -- a system of seven hospitals that serve CT and NY -- to better share information for the purpose of providing improved population health services for both organizations.
- CareMount Health Solutions, a physician-owned management services organization, will deliver to Nuvance Health, a suite of population health management services including care coordination and clinical programs, data
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Medicare Advantage | Payers | News, Analysis, Insights
CareMount Health Solutions ACO Generates $779k in Shared Savings
- CareMount Medical’s next-generation ACOs have saved more than $778,582 in shared savings in 2018. CareMount ACO was one of 38 Next Generation ACOs nationally to achieve earned savings for 2018 Performance Year.- In 2019, CMS awarded CareMount Health Solutions ACO, LLC a perfect score of 61 out of 61 points on its Initial Readiness Review (IRR). CMS conducts IRRs for all ACOs entering the Next Generation ACO Model.Chappaqua, NY-based CareMount Medical announces its next-generation ACOs have
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Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020
Encounter data such as diagnosed clinical conditions and services, or items delivered to healthcare consumers to treat these conditions is the key to success for all healthcare organizations participating within the government space. Whether doctors or hospitals are submitting data for medical services rendered under Medicare Advantage, the Affordable Care Act’s state exchanges or Medicaid, encounter data is used for payment reimbursement and reconciliation between the health plan and the
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Teladoc COO Shares 5 Virtual Care Predictions to Watch in 2020
- Teladoc Health’s COO David Sides gives a glimpse of what the future holds as more consumers tap into virtual care.
Forget face to face, healthcare is moving into cyberspace—albeit not as fast as one would like. Yes, there is no question that the interest in virtual care is growing swiftly. However, the adoption of virtual services has been somewhat slow; only about 10 percent of healthcare consumers have used such services, according to a study by J.D Power.
Despite interest from
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How Multi-Payer Portals Incent Providers to Better Manage Their Data
Mark Martin, Director of Payer Solutions for Availity
Value-based healthcare demands meaningful payer-provider collaboration. However, burdensome administrative processes and inefficient solutions stunt the ability of payers and providers to share data, manage risk, validate credentials, process claims, control costs and optimize the consumer experience.
These information bottlenecks are most acute in the area of provider data management (PDM). Each year, payers and providers spend more than
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Bright Health Lands $635M to Expand Medicare Advantage Plans to More Markets
- Bright Health, a diversified consumer-focused healthcare company announced it has raised $635M in Series D funding led by NEA. - The funding will be used to support Bright Health's aggressive growth and hiring as the company continues to strategically expand across products, geographies and consumer bases.- With this round, Bright Health has raised over a billion dollars in equity financing since early 2016, reaching "unicorn status" with a valuation of over $1B. Bright Health, a diversified
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Philips, Humana Partner on 2 Pilot Programs to Improve Care for At-Risk Medicare Advantage Members
- Philips and Human collaborate on new pilot programs designed to help support independent living for at-risk Medicare Advantage members by providing 24/7 access to care. - Humana is identifying a pilot group of members with severe CHF. Philips is providing members with kits that include an interactive tablet that syncs data from connected measurement devices via wireless technology. - Humana is identifying members who are at-risk and offering them Philips Lifeline medical alert service,
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Humana, Epione Health Form Value-Based Care Agreement for Humana Medicare Advantage Members
- Humana and Epione Health team up to offer a patient-centered experience for Humana Medicare Advantage members in Oklahoma. - Humana Medicare Advantage HMO and PPO plan patients will benefit from this relationship as the support offered by Humana enables Epione’s doctors to focus on patient care.Humana Inc., today announced it has collaborated with Epione Health of Oklahoma, LLC on a value-based care agreement designed to offer a coordinated, patient-centered experience to help Humana Medicare
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Can Consumer Price Transparency in Healthcare Live Up to the Hype?
There has been a lot of discussion in recent weeks and months about price transparency in healthcare. The idea is simple—payers and providers reveal the rates they pay or charge for health services in order to help consumers make better choices.
Despite the hype surrounding price transparency, it will undoubtedly come with a whole set of realities and limitations—there are a variety of factors that go into setting prices, and in many cases, the prices that get posted don’t reflect the price
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HMS Holdings Corp to Acquire Payment Accuracy Company Accent for $155M
- HMS Holdings Corp acquires Accent, a payment accuracy, and cost containment business from Intrado Corporation for approximately $155 million.- Accent’s offerings include comprehensive prospective and retrospective claims accuracy solutions, which incorporates both cost avoidance and overpayment recovery services.- Addition of service provider to commercial and Medicare Advantage health plans to expand the breadth of HMS’ prospective and retrospective claims accuracy services.HMS Holdings Corp.
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