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Medicare Advantage | Payers | News, Analysis, Insights

Aledade Raises $64M for Value-Based Care Network of Physician-Led ACOs

by Jasmine Pennic 04/20/2020 Leave a Comment

Aledade Raises $64M for Value-Based Care Network of Physician-Led ACOs

What You Should Know: - Aledade raises $64M in Series C funding led by OMERS Growth Equity to expand its national network of more than 500 physician-driven accountable care organizations (ACOs) across 27 states. - To date, Aledade’s ACOs care for more than 840,000 patients and manage more than $7.5 billion in health care spending through 38 Medicare and 42 other value-based contracts. Today, Aledade announced it has closed a $64 million Series C funding round following
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Addressing Loneliness and Social Isolation in the Medicare Population

by Anne Davis, Director of Quality Programs and Medicare Strategy at HMS 04/09/2020 Leave a Comment

Addressing Loneliness and Social Isolation in the Medicare Population

Anne Davis, Director of Quality Programs and Medicare Strategy at HMS In recent years, the healthcare industry's understanding of social determinants of health (SDoH) and their impact on patient outcomes has grown dramatically. Researchers and practitioners now recognize that social isolation and loneliness fall under the SDOH umbrella. In response, many payers and providers are exploring initiatives to address social isolation among members and patients. The health effects of social
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Puerto Rico’s First Home Delivery Pharmacy Launches During COVID-19 Crisis

by Jasmine Pennic 04/01/2020 Leave a Comment

Puerto Rico's First Home Delivery Pharmacy Launches During COVID-19 Crisis

What You Need to Know: - Pharmacy benefits manager Abarca and Triple-S Salud announced the launch of Triple-S en Casa, Puerto Rico’s first prescription home delivery program during the COVID-19 crisis. - Developed in partnership with one of the Island's largest health plans and pharmacy networks, Triple-S en Casa lets consumers manage and order their prescriptions through an easy-to-use mobile app--and have them delivered by a local pharmacy. Pharmacy benefits manager Abarca and
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Vivify Health Launches COVID-19 Screening, Self-Isolation and Monitoring Pathways

by Fred Pennic 03/16/2020 Leave a Comment

Vivify Health Launches COVID-19 Screening, Self-Isolation and Monitoring Pathways

What You Need to Know: - Vivify Health has announced that availability today of new COVID-19 Screening, Self-Isolation and Monitoring Pathways for Vivify+Go mobile solution to providers at non-cost. - This enables low-risk patients or those with mild symptoms to use their mobile devices to self-screen for COVID-19 by answering a series of questions that follow the current Centers for Disease Control and Prevention (CDC) guidelines. - The self-screening helps providers scale their
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Benefits of Store and Forward, or Asynchronous Telehealth Solutions

by Brooke LeVasseur, CEO of AristaMD 02/24/2020 Leave a Comment

The utility and benefit of store-and-forward, or asynchronous telehealth solutions

Brooke LeVasseur, CEO of AristaMD An introduction to asynchronous, or store-and-forward, as a modality of telehealth  As our healthcare system continues to innovate in order to meet demands and improve the delivery of value, various telehealth solutions have emerged and been implemented to increase efficiency, access to, and quality of care. Telehealth is a broad term encompassing “a collection of technology-based means or methods to enhance healthcare delivery and education.” As
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Analysis: January Health IT M&A Activity; Public Company Performance

by Healthcare Growth Partners (HGP) 02/07/2020 Leave a Comment

Health IT M&A Activity; Public Company Performance

– Healthcare Growth Partners’ (HGP) summary of Health IT/digital health mergers & acquisition (M&A) activity, and public company performance during the month of January 2020. Ten years into the bull market, we operate in a heightened state of awareness for any indication of market weakness that may signal a downturn.  While debt levels are rising and GDP growth somewhat sluggish, the world of private equity, public equity, and M&A continues to be in full swing bull
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CareMount, Nuvance Partner to Expand Population Health Services in NY

by Jasmine Pennic 02/06/2020 Leave a Comment

CareMount, Nuvance Partner to Expand Population Health Services in NY

- CareMount, New York's top Next-Gen accountable care organization, is partnering with Nuvance Health -- a system of seven hospitals that serve CT and NY -- to better share information for the purpose of providing improved population health services for both organizations. - CareMount Health Solutions, a physician-owned management services organization, will deliver to Nuvance Health, a suite of population health management services including care coordination and clinical programs, data
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CareMount Health Solutions ACO Generates $779k in Shared Savings

by Jasmine Pennic 01/30/2020 Leave a Comment

CareMount Health Solutions ACO Generates $779k in Shared Savings in 20189

- CareMount Medical’s next-generation ACOs have saved more than $778,582 in shared savings in 2018. CareMount ACO was one of 38 Next Generation ACOs nationally to achieve earned savings for 2018 Performance Year.- In 2019, CMS awarded CareMount Health Solutions ACO, LLC a perfect score of 61 out of 61 points on its Initial Readiness Review (IRR). CMS conducts IRRs for all ACOs entering the Next Generation ACO Model.Chappaqua, NY-based CareMount Medical announces its next-generation ACOs have
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Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020

by Abhinav Aggarwal, Sr. Director, Encounter Submission and Risk Adjustment Solutions at Edifecs 01/27/2020 Leave a Comment

Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020

Abhinav Aggarwal, Sr. Director, Encounter Submission and Risk Adjustment Solutions at Edifecs Encounter data such as diagnosed clinical conditions and services, or items delivered to healthcare consumers to treat these conditions is the key to success for all healthcare organizations participating within the government space. Whether doctors or hospitals are submitting data for medical services rendered under Medicare Advantage, the Affordable Care Act’s state exchanges or Medicaid, encounter
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Teladoc COO Shares 5 Virtual Care Predictions to Watch in 2020

by Erica Garvin 01/21/2020 Leave a Comment

David Sides, Chief Operating Officer at Teladoc Health - Teladoc Health’s COO David Sides gives a glimpse of what the future holds as more consumers tap into virtual care. Forget face to face, healthcare is moving into cyberspace—albeit not as fast as one would like. Yes, there is no question that the interest in virtual care is growing swiftly. However, the adoption of virtual services has been somewhat slow; only about 10 percent of healthcare consumers have used such services,
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