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Medicare Advantage | Payers | News, Analysis, Insights

Designating Ownership of Provider Data Will Improve Care Coordination, Study Finds

by Jasmine Pennic 09/18/2020 Leave a Comment

Designating Ownership of Provider Data Will Improve Care Coordination, Study Finds

What You Should Know: - New LexisNexis Risk Solutions Health Care survey reveals that 63% of respondents believe designating ownership of provider data will improve care coordination, yet only 18% of organizations report having a dedicated data governance department - The survey results are based on over 100 qualified responses from organizations across the industry, including independent hospitals, teaching hospitals, independent physician groups, and federally qualified health
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Cone Health to Merge with Sentara Healthcare Totaling $11B in Assets

by Fred Pennic 08/13/2020 Leave a Comment

Cone Health to Merge with Sentara Healthcare Totaling $11B in Assets

What You Should Know: - Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare for a combined $11B in assets. - The merger creates one large health system totaling of 17 hospitals – 11 Sentara hospitals in Virginia and one in Elizabeth City, N.C., and five Cone Health hospitals in the area surrounding Greensboro. Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare. The merger will
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COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever

by Irv Lichtenwald , CEO of Medsphere Systems Corporation 08/07/2020 Leave a Comment

Medsphere CEO Talks Affordable Healthcare IT and Future of EHRs

Irv Lichtenwald, President & CEO of Medsphere Systems Corporation In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need to provide healthcare for all in the event of calamity upending the basic functions of a civilized society. With that, the UK’s National Health Service (NHS) was born. In 2020, all perspectives about quality and the
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Cedar Gate Technologies Acquires Citra Health Solutions to Expand Value-based Technology

by Jasmine Pennic 06/26/2020 Leave a Comment

Cedar Gate Technologies Acquires Citra Health Solutions to Expand Value-based Technology

Cedar Gate Technologies (Cedar Gate), a Greenwich, CT-based value-based care performance management company, today announced its acquisition of Citra Health Solutions (Citra), a provider of capitation management software solutions. Expands Value-Based Care Technology Suite with Citra's Capitation Management Solutions By acquiring Citra, Cedar Gate expands its software and services capabilities across the full spectrum of value-based care. By combining Cedar Gate's existing capabilities in
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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

Kevin Riley, SVP and General Manager, Vlocity Health 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
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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

Mansoor Khan, Sc.D., co-founder and CEO of Persivia  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.
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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

Emad Rizk, M.D., President, CEO & Chairman of the Board, Cotiviti 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
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