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Medicare Advantage | Payers | News, Analysis, Insights

Improving Non-Emergency Medical Transportation: Driving Better Outcomes for Patients and Health Plans

by Andy Auerbach, Chief Revenue Officer of SafeRide Health 05/02/2023 Leave a Comment

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

by Syed Hamza Sohail 04/04/2023 Leave a Comment

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 

by Syed Hamza Sohail 03/30/2023 Leave a Comment

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

by Fred Pennic 03/23/2023 Leave a Comment

Aledade ACO

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

by Fred Pennic 03/15/2023 Leave a Comment

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

by Jasmine Pennic 03/06/2023 Leave a Comment

Signify Health, Remedy Merge to Create Market Leading Value-Based Care Enablement

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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Apixio Launches EHR-Integrated Post-Visit Solution

by Syed Hamza Sohail 02/23/2023 Leave a Comment

Apixio Unveils AI-Powered Risk Adjustment Auditing Solution

What You Should Know: - Apixio, a leading AI platform that powers value-based care launches its new Apicare Post-Visit™ offering, an EHR-integrated intelligent workflow solution for health plans and providers. With the Centers for Medicare & Medicaid Services' recent Medicare Advantage Risk Adjustment Data Validation Final Rule, healthcare organizations need to have complete diagnosis capture and accurate documentation for reimbursement to ensure compliance. - The new Post-Visit
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It’s Time to Stop Accepting the Payer-Provider Dynamic as ‘Adversarial’ and Work Toward Alignment

by Heather Bassett, M.D., Chief Medical Officer, XSOLIS 02/22/2023 Leave a Comment

It’s Time to Stop Accepting the Payer-Provider Dynamic as ‘Adversarial’ and Work Toward Alignment

Today’s relationship between payers and providers is more fraught than ever. With a history of transactional, often adversarial, fee-for-service contract negotiations, it’s no wonder that the healthcare industry has grown too comfortable pitting payers and providers against each other. The lack of trust and transparency between the two groups has led to a perceived misalignment of vision. Across the board, the administrative staff has shouldered the brunt of this friction, which in the end
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Aledade Acquires Curia, Adds More Than 450 New Practices

by Jasmine Pennic 02/21/2023 Leave a Comment

Aledade Acquires Curia, Adds More Than 450 New Practice

What You Should Know: - Aledade today announced the acquisition of Curia, a leader in value-based care analytics using practical applications of artificial intelligence (AI) to optimize the targeting of patient care and engagement programs.  The acquisition will enhance Aledade’s ability to extract valuable insights from disparate data sources, provide more accurate predictions using past data, and optimize primary care workflows through cutting-edge AI algorithms. - In addition, the
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Why It’s Time for Intelligent Prior Authorization

by Alina M. Czekai, MPH, VP of Strategic Partnerships at Cohere Health 02/09/2023 Leave a Comment

It’s Time for Intelligent Prior Authorization

The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients. Specifically, the rule stipulates that health plans adopt electronic prior authorization processes, adhere to shorter turnaround times, clearly communicate denial reasons, publish key metrics annually, and implement the Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface
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