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Medicare Advantage | Payers | News, Analysis, Insights

Health-Tech C2Q:22 Preview: 5 Key Driving Factors to Watch

by Syed Hamza Sohail 08/23/2022 Leave a Comment

Executive Insights: Top Healthcare Predictions & Trends to Watch in 2020

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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How Actionable Data and Expert Analysis Supports Service Providers, Fosters Better Care and Ensures Financial Benefits

by Ashish Kachru, CEO, DataLink 08/16/2022 Leave a Comment

How Actionable Data and Expert Analysis Supports Service Providers, Fosters Better Care and Ensures Financial Benefits

Approximately 42% of Medicare beneficiaries are enrolled in Medicare Advantage plans—a segment projected to reach 46% by 2025. Due to rapid growth of the 65-and-older portion of the population, Medicare expenditures are forecast to reach $1,559.4 billion in 2028, with spending per enrollee reaching $20,751.  Key trends are influencing this growth, including: - An aging population - Continued increase in overall Medicare costs - Government support and benefit flexibility (e.g.,
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CVS Health in Talks to Acquire Signify Health

by Syed Hamza Sohail 08/08/2022 Leave a Comment

Signify Health Shares Soar More Than 33% in IPO, Valuing Company at Over $7.12B

What You Should Know: - Signify Health is exploring strategic alternatives including a sale, according to a Wall Street Journal report. Initial bids are due this coming week. Additional companies are also in acquisition discussions with Signfiy Health, and CVS could face competition from other managed-care providers and private-equity firms. - The potential Signify acquisition has a market value of around $4.7 B after its shares rose on the news of a potential sale. Leveraging
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Telehealth Utilization Grew 10.2% Nationally in May 2022

by Fred Pennic 08/08/2022 Leave a Comment

Telehealth Utilization Grew 10.2 Percent Nationally in May 2022

What You Should Know: - In May 2022, for the second straight month, telehealth utilization, as measured by telehealth's share of all medical claim lines, grew nationally and in every US census region (Midwest, Northeast, South, West), according to FAIR Health's Monthly Telehealth Regional Tracker. - FAIR Health reports national telehealth utilization increased 10.2 percent, from 4.9 percent of medical claim lines in April to 5.4 percent in May. Regionally, the greatest increase
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Netsmart Acquires SNF Claims Data Analytics Solution CORE Analytics

by Syed Hamza Sohail 08/08/2022 Leave a Comment

Netsmart Acquires SNF Claims Data Analytics Solution CORE Analytics

What You Should Know: - Netsmart announced that it has acquired CORE Analytics, the industry-leading skilled nursing facility (SNF) claims data analytics offering from Zimmet Healthcare. - With the addition of Core Analytics, Netsmart Simple™is now the only solution suite in the market capable of calculating quality measures and Five-Star ratings leveraging Minimum Data Set (MDS), Payroll-Based Journaling (PBJ) and UB-04 claims data. Software Solutions to Problems in
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Homeward Raises $50M, Inks Value-Based Contract with Priority Health

by Syed Hamza Sohail 08/04/2022 Leave a Comment

Homeward Raises $50M, Inks Value-Based Contract with Priority Health

What You Should Know: - Homeward raises $50M Series B funding round co-led by ARCH Venture Partners and Human Capital. - The funding round also includes participation from General Catalyst, which led Homeward’s Series A funding, and Lee Shapiro and Glen Tullman, Co-Founders of 7wireVentures, one of the country’s most successful early-stage healthcare venture funds. Value-Based and Comprehensive Care Americans living in rural communities are experiencing increasing health disparities
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Caption Health, Heartbeat Health Partner to Provide Access to Cardiac Care

by Syed Hamza Sohail 07/28/2022 Leave a Comment

Caption Health, Heartbeat Health Partner to Provide Access to Cardiac Care

What You Should Know: - Caption Health and Heartbeat Health today announced a partnership that will enable providers to offer their patients earlier access to cardiovascular care than ever before possible. - Together, the partners are increasing access to early cardiac evaluations and care by providing these two innovations as a value-based bundle for health providers, payers, and value-based care organizations. Improving Access To Cardiac Care Limited access to cardiac diagnosis and
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Curana & Innovaccer Partner to Improve Outcomes for Senior Living Communities

by Jasmine Pennic 07/19/2022 Leave a Comment

Curana & Innovaccer Partner to Improve Outcomes for Senior Living Communities

What You Should Know: - Today, Innovaccer Inc., the Health Cloud company, announced that Curana Health is partnering with Innovaccer to build a leading edge value-based care solution to support delivery of exceptional care quality at the lowest possible cost for one of healthcare’s highest risk populations: residents in senior living communities across the country. - Together, Curana Health and Innovaccer will build an industry-leading value-based-care toolkit using the Innovaccer Health
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6 Success Strategies as CMS Drives More Accountable Care by 2030

by Siddharth Thakkar, VP, Product and Marketing at IKS Health 07/13/2022 Leave a Comment

6 Success Strategies as CMS Drives More Accountable Care by 2030

For the better part of a decade, the shift toward value-based care in the U.S. has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Working to develop, test and evaluate new payment and delivery models in Medicare, Medicaid and the Children’s Health Insurance Program, CMMI has taken aim at improving the provider experience, generating better patient outcomes and reducing the overall cost of care. Recently, CMMI stated that by 2030 every Medicare
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Geisinger Taps Cohere Health to Streamline Prior Authorizations

by Fred Pennic 07/13/2022 Leave a Comment

Geisinger Taps Cohere Health to Streamline Prior Authorizations

What You Should Know: - Today Geisinger Health Plan (GHP) and Cohere Health, a provider of utilization management (UM) technology, announced they are joining forces to streamline the prior authorization process for providers. - Cohere’s collaborative UM platform will help GHP support value-based care delivery, reduce administrative costs, and lead the nation in aligning quality improvement initiatives across all its lines of business, including
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