Intermountain Healthcare has formed a new comprehensive health platform company named Castell that will enable other organizations to accelerate their transition from volume to value-based systems of care, while keeping care more affordable and accessible. Rajesh Shrestha has been named as the president and CEO of Castell. In addition to leading Castell, Shrestha serves as vice president and chief operating officer of Community Based Care for Intermountain Healthcare. He has more than two
Read More
Medicare Advantage | Payers | News, Analysis, Insights
How Medicare Advantage Plans Reduced Their Disenrollment Rates by 30% Through Welltok
The average Medicare Advantage plan turns over about 10% of its members every year, and for a 100,000 member plan, that can equate to about $110 million in lost premium reimbursements as well as a decline in Star ratings. This is why retaining members is a top priority among health plans. Welltok’s Medicare Retention Solution has helped leading Medicare plans reduce disenrollment rates by up to 30%, improve disenrollment-related Star ratings from 2.5 to 4 and retain up to $97 million
Read More
Carenet Health Acquires Engagement, Telehealth Subsidiary of Citra Health
Carenet Health, a San Antonio, TX-based provider of healthcare engagement, clinical support, advocacy and 24/7 telehealth solutions, has acquired the engagement and telehealth solution subsidiary of Citra Health Solutions. The acquisition is the second acquisition of its kind by Carenet in a span of seven months. Financial terms of the acquisition were not disclosed.The recent acquisition complements Carenet’s ongoing commitment to delivering high-quality, cost-effective, on-demand telehealth
Read More
Healthcare’s Uncertain Future: 3 Data-Driven Approaches for Payers
Nine out of 10 healthcare leaders expect disruptive pressures to increase tremendously in the year ahead, according to a recent survey. However, fewer than half believe their organizations are prepared to withstand these forces.
In an era of transformation—in which traditional business models are continually being revamped in response to pressures such as consumerism, policy changes, and the market entrance of non-traditional healthcare players such as Amazon and Apple—payers face daunting
Read More
AdhereHealth And Papa Partner to Tackle Social Determinants of Health
AdhereHealth, a healthcare technology company focused on medication adherence, announced a partnership with Papa, a companionship platform company serving the elderly, blind and disabled. AdhereHealth and Papa will work together to address social determinants of health such as loneliness, food insecurity, and transportation to improve health outcomes for Medicare beneficiaries. The partnership addresses these foundational barriers to care through a combination of advanced technologies and
Read More
3 Ways Health Plans Can Leverage Lab Data Analytics
Payers have long realized the value of leveraging disparate data sets to gain greater insight on patients, with popular data sources including claims, electronic health records, and surveys on social determinants and behavioral health.
More recently, health plans have begun to appreciate another source of data that can help them avoid missed revenues, predict emerging conditions and improve risk management: laboratory data. This category includes data on critical health factors such as
Read More
Survey: 83% of Consumers Are Interested in Receiving Virtual Care, But Only 17% Have Access To It
Virtual care received an essential boost in November 2018 when CMS Administrator Seema Verma addressed the Alliance for Connected Care Telehealth Policy Forum for Health Systems. Verma told the audience, "Telehealth is changing the very face of healthcare.” This shift is apparent in the behaviors of healthcare consumers. While consumers may love the idea of virtual care, a new study shows few are taking advantage of it.Patients Hungry for Virtual CareThat’s the core message coming out of a
Read More
5 Ways Health Plans Can Motivate Medicare & Medicaid Members to Complete Their Annual Wellness Visits
Despite the fact that Annual Wellness Visits (AWVs) have been offered as a benefit to Medicare Advantage and Medicaid members for several years, less than one in five members actually receive one. That number is even more surprising when you consider just how important AWVs can be for health plans, providers, and most importantly, consumers.
For example, Medicare Advantage members who complete an AWV are 4.2 times more likely on average to complete other high-value health care activities, such
Read More
DispatchHealth Nabs $33M to Expand On-Demand Healthcare Model to High Acuity Patients
DispatchHealth (formerly known as True North Health Navigation), a Denver, CO-based provider of on-demand healthcare delivery to a patient’s home has raised $33 million in growth capital funding led by Echo Health Ventures, a strategic collaboration of Cambia Health Solutions and Mosaic Health Solutions. The funding also included participation from existing investors Alta Partners, Questa Capital and additional strategic investors.Founded in 2013 by two mobile health executives, DispatchHealth’s
Read More
Vericred Launches Medicare Advantage API to Support Insur Tech & Digital Health Companies
Vericred, an NYC-based data services platform powering the digital distribution of health insurance and employee benefits, announced today a Medicare Advantage rating API enabling InsurTech and digital health companies to build innovative solutions that serve the fast-growing Medicare-eligible population.Growth of Medicare Advantage PlansMedicare Advantage – also known as Medicare Part C – is a program in which individuals who qualify for Medicare enroll in certified health plans offered by
Read More
