What You Should Know:
- Value-based care (VBC) has been established as a priority among healthcare organizations and payers as participants have gained more experience in managing their quality metrics and contracts, ultimately realizing returns on their investments.
- For their latest report, Value-Based Care Reimbursement 2022, KLAS talked to 54 healthcare executives—including CEOs, CFOs, CIOs, CMIOs, COOs, VPs and directors of population health, and VPs of analytics—to gauge how
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Medicare Advantage | Payers | News, Analysis, Insights
How Will New FDA Hearing Aid Regulations Impact Health Plans?
The time has finally arrived. The Food & Drug Administration’s new over-the-counter (OTC) hearing aid regulations are now in effect and health plans are starting to explore what it means for them. Among the many questions they may need to grapple with, a few are particularly salient:
- How will the new rules impact their benefit offerings?
- What new opportunities will arise?
- What potential pitfalls should they be aware of?
Introducing OTC hearing
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HealthTap Launches Eval360 for Health Plans to Expand PCP Care for Members
What You Should Know:
- HealthTap, the leading virtual primary care provider, announced today the official launch of Eval360, an innovative product for health plans that enables HealthTap’s primary care doctors to conduct comprehensive virtual medical evaluations and easily share useful health data back with those partner plans, by providing a 360-degree view of a member’s health status.
- HealthTap completed a successful beta period for Eval360 for over 15,000 seniors through its
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First-Ever Medicare Advantage Plan for LGBTQ+ Older Adults Launches
What You Should Know:
- SCAN Health Plan, a Medicare Advantage insurer known for its expertise in keeping older adults healthy and independent is launching SCAN Affirm partnered with Included LGBTQ+ Health (HMO), a first-of-its-kind Medicare Advantage plan developed exclusively for LGBTQ+ older adults, in collaboration with Included Health, the only integrated virtual care and navigation platform.
- SCAN Health Plan will offer the SCAN Affirm plan to members in
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Digital Fax Solutions Alleviate Administrative Burden and Reduce Costs
At the LeadingAge Illinois 2022 Annual Meeting, Elizabeth McLaren, VP of Reimbursement and Community-Based Services, along with Steven Wermuth, MPA at Strategic Health Care, presented their analysis on the top billing mistakes. What did they find? Within long-term care providers, 8-10% of Medicare Advantage claims were denied. Shockingly, the 10% denial rate impacted revenue by $200 million! They also found that 80% of denied claims are due to missing or incorrect information used during intake
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Castlight + Vera Appoints New CEO; Rebrands as Apree Health
What You Should Know:
- Vera Whole Health, Inc. and Castlight Health, Inc. appoints former Cerner President Donald Trigg as chief executive officer (CEO)
- In addition, the companies have rebranded as apree health that will be combine Castlight’s healthcare navigation platform with Vera’s advanced primary care solutions to improve patient outcomes and transform the healthcare industry.
Donald Trigg Background
Donald Trigg most recently served as president of
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AI-Powered Pop Health and SDOH – The Good, The Bad and The Best Practices
Artificial intelligence (AI) has emerged as a powerful tool for making population health analytics more accurate and interventions more effective. Not all AI-powered pop health tools are created equal, and while many still exhibit different types of bias that limit their ability to accurately identify issues affecting certain populations, we have learned a lot about the sources of bias in AI and how to eliminate them. AI shortcomings aside, pop health analytics have advanced to the point that we
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HealthTeam Advantage Integrates With Bamboo Health’s Pings Solution
What You Should Know:
- Bamboo Health™ recently announced that HealthTeam Advantage (HTA), the business name of Care N’ Care Insurance Company of North Carolina, Inc., has integrated Bamboo Health’s Pings™ solution.
- The Pings rollout delivers real-time admission, discharge, and transfer (ADT) e-notifications for HTA’s 15,000 North Carolina PPO and HMO Medicare Advantage plan members.
Using Real-Time E-Notifications to Lower Costs and Improving High Quality Care
Bamboo Health
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Oak Street Health Opens Ninth Center in Arizona
What You Should Know:
- Oak Street Health, a network of value-based primary care centers for adults on Medicare and the only primary care provider to carry the AARP name, is now welcoming patients at the new Rolling Hills Square center at 7040 East Golf Links Road in Tucson.
- This is Oak Street Health’s ninth center in Arizona.
Oak Street Health Background
Oak Street Health delivers personalized, preventive primary care through a model that was created to meet the unique needs of
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Health-Tech C2Q:22 Preview: 5 Key Driving Factors to Watch
What You Should Know:
- David Larsen, healthcare IT and digital health analyst at BTIG published a note highlighting his preview for health-tech Q2 earnings.
- Given high inflation rates, costs for traveling nurses, and light volumes in 2Q:22, he is cautious on stocks that sell into the acute care market in the near term.
An Overview
According to the report, there are many macro headwinds that continue to affect the HCIT sector and the broader market, including inflationary pricing
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