What You Should Know:
Wolters Kluwer Health, a leading provider of healthcare information and analytics, has introduced a new weapon in the fight against potential financial penalties for Medicare Advantage Organizations (MAOs) – the Regulatory Audit Module.
- The AI-enabled tool leverages artificial intelligence (AI) to streamline the risk adjustment audit process, potentially saving MAOs millions of dollars.
The Challenge: A Complex and Costly Regulatory
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Medicare Advantage | Payers | News, Analysis, Insights
Humana & Strive Health Offers Value-Based Kidney Care to More Medicare Advantage Members
What You Should Know:
- Humana Inc. (NYSE: HUM) and kidney care provider Strive Health announced today a new multi-state, value-based care agreement for kidney care to more Medicare Advantage members.
- This expanded value-based kidney care partnership extends access to Strive's innovative kidney care model to Humana Medicare Advantage HMO and PPO plan members living with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) across five states.
Transforming Kidney Care
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UnitedHealthcare, RUSH Health Form Medicare Advantage Relationship
What You Should Know:
- UnitedHealthcare and RUSH Health announced a new relationship that will give UnitedHealthcare Medicare Advantage plan members network access to all RUSH Health locations in Illinois for the first time, effective immediately.
- The multi-year agreement, effective Oct. 1, provides UnitedHealthcare Medicare Advantage plan members with enhanced access to quality care and provides a new option as they choose which health plan best meets their healthcare needs
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M&A: MultiPlan Acquires Benefits Science LLC for $160M
What You Should Know:
MultiPlan, a provider of data-enabled cost management, payment, and revenue integrity solutions for 700+ healthcare payors announced the acquisition of Benefits Science LLC (BST) for $160M in cash and stock.BST was founded in 2012 by a group of MIT-trained experts in data science, including Dimitris Bertsimas, Ph.D., who is recognized as an early pioneer in healthcare analytics and who serves as the company’s chief data scientist. Dr. Bertsimas will continue with BST
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Improving Non-Emergency Medical Transportation: Driving Better Outcomes for Patients and Health Plans
As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. Non-emergency medical transportation (NEMT) plays a crucial role in helping patients get to where care is delivered. As healthcare reform efforts continue to gain momentum, transportation benefits have become an increasingly critical component of providing equitable care to patients. NEMT helps close the health equity gap
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Q1 2023 Digital Health Funding Reaches $3.4B Across 132 Deals
What You Should Know:
2023 started off with the hallmarks of a rebound year. While Q4 2022 signaled the tail end of the digital health funding cycle, January and February funding numbers began to suggest that sector investment was slowly but surely inching back upwards. Inflation was easing ever so slightly. Investors were rediscovering their confidence and launching new projects, signaling optimism in the sector, according to a new Rock Health report. However, recent news—the collapse of
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Uber Health Embeds Same-Day Prescription Delivery Into Its Care Platform
What You Should Know:
Uber Health, Uber’s healthcare arm, today announced same-day prescription delivery on its HIPAA-supported, centralized platform.For the first time, those using Uber Health—including healthcare providers and health plans—will be able to manage prescription delivery from any pharmacy in their service area through the same platform they already use to coordinate transportation for patients. This launch enables providers to offer a full suite of care solutions that
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Aledade Expands Access to Value-Based Care for More Medicare Advantage Customers
What You Should Know:
- Aledade is continuing its strong momentum today, announcing that Cigna Healthcare Medicare Advantage customers can now receive value-based care from Aledade’s network of independent primary care practices.
- Participating practices can access Aledade’s cutting-edge data analytics, user-friendly guided workflows, and health care policy expertise, as well as integrated care services supported by AledadeCare Solutions.
- This news comes shortly after Aledade
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PointClickCare Acquires Value-Based Care EHR Patient Pattern
What You Should Know:
- PointClickCare Technologies, a healthcare technology platform enabling meaningful collaboration and access to real‐time insights at every stage of the patient healthcare journey, today announced the acquisition of Patient Pattern. Financial terms of the transaction were not disclosed.
- The combination of PointClickCare and Patient Pattern will further the companies’ shared vision of enabling better care and outcomes for high-needs populations and provide
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Signify Health, Cardinal Health Partner to Offer In-Home Medication Therapy Management
What You Should Know:
- Signify Health announced a partnership with Cardinal Health, a medical device and pharmaceuticals supplier, to provide in-home medication therapy management to Medicare members.
- In order to provide a more coordinated care experience and help members with their often-complex medication regimens, Signify’s mobile network of 11,000 credentialed clinicians will be able to offer medication management services for health plan members through in-home health evaluations
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