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Medicare Advantage | Payers | News, Analysis, Insights

Why Medicare Advantage Will Lead the Way on Healthcare Consumerism

by Jeff Carroll, Senior Vice President, Health Plans, Lumeris 09/16/2019 Leave a Comment

Why Medicare Advantage Will Lead the Way on Healthcare Consumerism

  For years, the healthcare industry has been abuzz with the concept of “consumerism” and the potential implications to insurance companies, providers and patients. Stakeholders from across the industry have opined on what it means create a healthcare system more focused on consumers, often with little impact to actual consumer experience or outcomes. One spot of genuinely consumer-centric innovation and execution is in the Medicare Advantage (MA) space, where select health plans can offer
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Aledade, The Physicians Integrated Network Forms Value-Based Care Collaboration in Greater Philadelphia

by Jasmine Pennic 09/04/2019 Leave a Comment

Aledade ACO

- Aledade ACOs and the Physicians Integrated Network (TPIN) join forces to improve care coordination, quality of care, and patient health outcomes - Under the value-based care agreement, and TPIN’s leading network of independent specialists have agreed to a care compact and intend to explore additional opportunities for clinical collaboration across all payers. - TPIN’s network is made up of 700 physicians practicing in 24 clinical specialties throughout greater Philadelphia, Delaware
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Top 5 Factors Impacting the US Population Health Management Market

by Michael Liberty, Sr. Market Analyst at Signify Research 08/29/2019 Leave a Comment

Top Five Factors Impacting the US Population Health Management Market

The North American Population Health Management (PHM) reached the $4 billion milestone for the first time in 2018, despite growth slowing for the second consecutive year. With the US provider market consolidating and vertical integration increasing, vendors are having to adapt their offerings to keep up with changing needs. Here is our take on the five trends that will impact market growth over the coming years: 1 – A Market Still Maturing As the market has evolved, providers are taking
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Telehealth Adoption: Convenience & Cost Drive Adoption For Consumers

by Fred Pennic 08/27/2019 Leave a Comment

Telehealth Adoption: Convenience & Cost Drive Adoption For Consumers

Convenience and cost are the key drivers of telehealth adoption for American consumers, but lack of awareness is an issue, according to recent findings from American Well’s Telehealth Index: 2019 Consumer Survey. Telehealth leader American Well commissioned Harris Poll to conduct an online study among over 2,000 adults to measure usage and sentiment toward telehealth. The results are weighted to be representative of the American adult population across standard demographics.Majority of Consumers
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PeerWell Lands $6.5M to Commercialize its Worker’s Comp Musculoskeletal Surgery Optimization Platform

by Fred Pennic 08/27/2019 Leave a Comment

PeerWell Announces $6.5 Million in Series A Funding to Rollout Musculoskeletal Surgery Optimization Platform

Today PeerWell, a San Francisco, CA-based PreHab company helping patients prepare physically and mentally for orthopedic surgery and recover faster has raised $6.5M in Series A funding led by OMERS Ventures with participation from investors Emmett Shear (Co-Founder CEO of Twitch) and Travis May (CEO of Datavant). Existing investors include XSeed Capital and angel investors Auren Hoffman (CEO SafeGraph, Co-founder of LiveRamp), Kevin Lin (COO of Twitch), Michael Seibel (CEO of Y Combinator),
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Health2047 Spins Out Zing Health to Offer SDOH-Driven Medicare Advantage Plans

by Fred Pennic 08/20/2019 Leave a Comment

Health2047 Spins Out Zing Health to Offer SDOH-Driven Medicare Advantage Plans

Today Health2047 Inc. is launching Zing Health, community-focused, physician-led Medicare Advantage plan that addresses social determinants of health (SDOH). Co-founded by Health2047 with experienced entrepreneurs Dr. Eric Whitaker and Dr. Ken Alleyne, Zing Health will initially offer a Medicare Advantage plan built around community and member health outcomes to consumers in the Midwest. With significant seed funding, a passionate and seasoned founding team and major market interest in its
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Maine Health, Anthem Form Joint Venture to Offer Medicare Advantage Plans

by Jasmine Pennic 08/19/2019 Leave a Comment

Maine Health, Anthem Form Joint Venture to Offer Medicare Advantage Plans

 Anthem Blue Cross and Blue Shield in Maine and MaineHealth today announced the two organizations will be collaborating on a joint venture to offer Medicare Advantage health insurance plans for 2020 under the Anthem | MaineHealth brand. This joint venture effort, named AMH Health, LLC, will bring together the core strengths of the region’s leading health care system and health insurer, their brand recognition, as well as their expertise in providing a comprehensive approach to care that will
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Why Real-Time Health Data Is a Requirement in Today’s Health System

by Sara Radkiewicz, Head of Product, CarePort Health 08/14/2019 Leave a Comment

Why Real-Time Health Data Is a Requirement in Today’s Healthcare Environment

Thanks to technological innovation in the industry and CMS’ push for interoperability, today there’s more patient health data being collected than ever before. The problem is that the data is either not easily accessible to providers or it’s claims based and therefore not timely. The lag time between the collection and sharing of health data makes it difficult, and in some cases impossible, for providers to get a complete picture of their patients’ health, to appropriately treat ongoing
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Medicare Advantage Plans Struggle With Internal Challenges to Keep Pace With Growth

by Fred Pennic 08/01/2019 Leave a Comment

Medicare Advantage Plans Struggle With Internal Challenges to Keep Pace With Growth

Many Medicare Advantage health plans (35%) struggle with internal challenges in keeping pace with growth, including technology and infrastructure limitations, according to results of its latest Voice of the Market Survey. In addition, 33.8% struggle with a lack of IT staff or resources to make necessary changes and 29.4% lack the in-house Medicare experts necessary to implement adjustments in response to business fluctuation.The survey was commissioned by HealthEdge and conducted by Survata, an
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Innovaccer Launches a Single Data System to Empower Medicare Advantage Plans

by Jasmine Pennic 07/18/2019 Leave a Comment

Innovaccer launches a Single Data System to Empower Medicare Advantage Plans

To assist Medicare Advantage plans in eliminating these complications and achieve the top Star Ratings, Innovaccer Inc., a San Francisco-based data activation company, has strengthened its solution for Medicare Advantage plans. The solution for MA plans is a comprehensive suite of solutions designed to solve all grassroots challenges to empower MA plans to ensure healthier patients and increased profits.Rise in Medicare Advantage EnrollmentThe CMS has projected that Medicare Advantage enrollment
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