- Humana and Epione Health team up to offer a patient-centered experience for Humana Medicare Advantage members in Oklahoma. - Humana Medicare Advantage HMO and PPO plan patients will benefit from this relationship as the support offered by Humana enables Epione’s doctors to focus on patient care.Humana Inc., today announced it has collaborated with Epione Health of Oklahoma, LLC on a value-based care agreement designed to offer a coordinated, patient-centered experience to help Humana Medicare
Read More
Medicare Advantage | Payers | News, Analysis, Insights
Can Consumer Price Transparency in Healthcare Live Up to the Hype?
Meg Koepke, Vice President of Strategy at NovuHealth
There has been a lot of discussion in recent weeks and months about price transparency in healthcare. The idea is simple—payers and providers reveal the rates they pay or charge for health services in order to help consumers make better choices.
Despite the hype surrounding price transparency, it will undoubtedly come with a whole set of realities and limitations—there are a variety of factors that go into setting prices, and in many cases,
Read More
HMS Holdings Corp to Acquire Payment Accuracy Company Accent for $155M
- HMS Holdings Corp acquires Accent, a payment accuracy, and cost containment business from Intrado Corporation for approximately $155 million.- Accent’s offerings include comprehensive prospective and retrospective claims accuracy solutions, which incorporates both cost avoidance and overpayment recovery services.- Addition of service provider to commercial and Medicare Advantage health plans to expand the breadth of HMS’ prospective and retrospective claims accuracy services.HMS Holdings Corp.
Read More
Inaccurate Provider Directories Costs Physician Practices $2.76B Annually
- Providers spend $2.76 billion each year on provider directory maintenance, a new survey by CAQH found. - For individual practices, this intensive process costs $998.84 per month--the equivalent of one staff day per week. That is time and money that most providers can't afford to waste.- CAQH surveyed 1,240 physician practices last month and just released "TheHidden Causes of Inaccurate Provider Directories"-- a new white paper that details the burdens the survey uncovered and what the industry
Read More
Disruptors or Interrupters? How Apple Is Faring In Their Healthcare Initiatives
Key Highlights
- Part one of our new in-depth series on Apple, Google, and Amazon's latest healthcare efforts since our last report in April 2019.
- A look at Apple's recent healthcare developments, as well as an analysis of what goes beyond the news.
Over the last few decades the “digital age” has enabled many garage-based startups to transform into sustained successes by targeting problems that begged to be solved digitally. Sometimes their leaders identified and
Read More
How Value-Based Care is Changing the Way You Build Digital Health Companies
Sean Walker, Partner at The Bowdoin GroupJosh Gottlieb, Managing Director, Digital Health) at The Bowdoin GroupMichelle Mattson-Hamilton, Associate Principal at ST Advisors
After years of talk, fee-for-service payment models are finally being challenged in a real way. With value-based care, providers are reimbursed based on patient health outcomes rather than the number of patients they see, which has begun to pass the burden of cost from insurers and employers to providers and
Read More
N.J. Physician Group ACO Generates $6.4M in Medicare Savings
- Partners In Care ACO generated $6.4M in savings and is among top 3 performers statewide under Medicare Shared Savings Program in New Jersey. - While providing high-quality care for patients, Medicare is sharing a portion of these savings with the providers in return.Partners In Care Accountable Care Organization (ACO) generated $6.4 million in savings – an average of $546 per Medicare patient – in 2018. The savings are tracked by the Centers for Medicare and Medicaid Services (CMS), under the
Read More
Why Medicare Advantage Will Lead the Way on Healthcare Consumerism
Jeff Carroll, Senior Vice President, Health Plans, Lumeris
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
Read More
Aledade, The Physicians Integrated Network Forms Value-Based Care Collaboration in Greater Philadelphia
- 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,
Read More
Top 5 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
Read More
