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Medicare Advantage | Payers | News, Analysis, Insights

CareMax Acquires Steward Health’s Medicare Value-Based Care Business for $25M

by Fred Pennic 06/02/2022 Leave a Comment

CareMax Acquires Steward Health’s Medicare Value-Based Care Business for $25M

What You Should Know: - CareMax, a tech-enabled provider of value-based care to seniors announced an agreement to acquire the Medicare value-based care business of Steward Health Care System for a combination of cash and stock. - CareMax will pay $25 million in cash and issue 23.5 million shares of CareMax’s Class A common stock to the equity holders of Steward at closing, subject to customary adjustments. In addition, CareMax will fund a Medicare receivable to Steward covering accounts
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KAID Health Raises $4.25M for AI-Powered Provider/Payer Whole Chart Analysis Platform

by Fred Pennic 05/24/2022 Leave a Comment

KAID Health Raises $4.25M for AI-Powered Provider/Payer Whole Chart Analysis Platform

What You Should Know:  KAID Health,makers of anartificial intelligence-enabled clinical analysis and provider engagement platform,today announced its $4.25M in Series A funding bringing their total capital raised to $6.45M. - The funding will fuel growth of the provider/payer platform that integrates with the electronic medical records (EMR) to identify high-value tactical care and coding interventions. The company will also expand its Boston, MA office and will hire new team
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Olive Partners with Magenta to Revolutionize Risk Adjustment Process

by Fred Pennic 05/20/2022 Leave a Comment

Olive Partners with Magenta to Revolutionize Risk Adjustment Process

What You Should Know: - Olive, the automation company creating the Internet of Healthcare, today announced its partnership with Magenta Care Continuum, a HIPAA-compliant health records vault that includes care gap analytics. - Through the Olive Library, payers and providers can access Magenta's solutions to help close care gaps, improve billing and claims occurrence and ensure compliance and revenue integrity for value-based population management. Automating the Risk
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COVID-19 Fell Out of Top 5 Telehealth Diagnoses Nationwide in February 2022

by Jasmine Pennic 05/09/2022 Leave a Comment

COVID-19 Fell Out of Top 5 Telehealth Diagnoses Nationwide in February 2022

What You Should Know: - After two months in the top five telehealth diagnoses nationally and in every US census region, COVID-19 fell out of that ranking nationally and in every region in February 2022, according to FAIR Health's Monthly Telehealth Regional Tracker. - The change coincided with a sharp decline in new cases of COVID-19, as reported by the Centers for Disease Control and Prevention, following the January
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3 Senior Living Providers Merge to Form Curana Health

by Jasmine Pennic 05/04/2022 Leave a Comment

3 Senior Living Providers Merge to Form Curana Health

What You Should Know: - Three leading organizations that provide healthcare services to senior living communities – Elite Patient Care, Provider Health Services, and AllyAlign Health – have joined forces to form Curana Health. Curana Health’s mission is to improve the health, happiness, and dignity of senior living residents. The Curana Health ACO is a value-based care program for original Medicare beneficiaries. - The combined Curana Health organization spans 26 states and over 1000+
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Raising Clinical Outcomes and Engagement Through Healthcare Equity: What Health Plans Need to Know

by Anne Davis, VP of Government Markets & Strategy at Wellth 05/04/2022 Leave a Comment

Raising Clinical Outcomes and Engagement Through Healthcare Equity: What Health Plans Need to Know

Structural racism and poverty are correlated with a higher incidence of obesity among Black Americans (49%). Social drivers of health, which impact a disproportionate number of non-white Americans who live below the poverty line, account for as much as 90% of individuals’ health outcomes.   These are just two examples of data that highlight the need for equity.  Health plans are well-aware that shifting this dynamic and boosting clinical outcomes is possible through better,
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BCBS of Michigan Launches Joint Venture with Honest Medical Group

by Fred Pennic 04/25/2022 Leave a Comment

BCBS of Michigan Launches Joint Venture with Honest Medical Group

What You Should Know: - Blue Cross Blue Shield of Michigan (BCBSM) today announced a joint venture with Nashville-based Honest Medical Group to offer physicians comprehensive operational, clinical, and financial support for shared accountability Medicare contracts. - The joint venture is the first of its kind for BCBSM and aligns with the organization's continued expansion of Blueprint for Affordability, its member-focused, value-based care and payment
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Next Generation of Risk Adjustment: Uniting Health Plans and Providers

by Shahyan Currimbhoy, VP & Aaron Fulner, Sr. Director at Edifecs 04/13/2022 Leave a Comment

Next Generation of Risk Adjustment Uniting Health Plans and Providers

Up until now, risk adjustment has been addressed as a mechanism to accurately represent the overall risk profile of a health plan’s membership. A function that will still facilitate a health plan’s payment for taking on at-risk populations is about to go through its first major transformation – the use of risk adjustment data to drive value-based program initiatives. Now that the functional aspects
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Vytalize Health Raises $50M for Value-Based Care Platform for Seniors

by Fred Pennic 04/11/2022 Leave a Comment

Vytalize Health Raises $50M for Value-Based Care Platform for Seniors

What You Should Know: - Vytalize Health raises over $50 million to advance its value-based care platform for seniors helping primary care doctors strengthen relationships with their patients through data-driven, holistic, and personalized care. - Led by Enhanced Healthcare Partners, the financing round signals an enormous opportunity for Vytalize Health to accelerate the adoption of value-based care programs by providers. Vytalize Health, a leading value-based care platform for
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Rural Health Startup Homeward Emerges with $20M to Support Rural Communities

by Fred Pennic 03/10/2022 Leave a Comment

Rural Health Startup Homeward Emerges with $20M to Support Rural Communities

What You Should Know - Homeward, a new company focused on improving access to high-quality, affordable primary and specialty care in rural communities launches with an initial $20M investment. - The organization is rearchitecting care for rural Americans who have a 23% higher mortality rate than those in urban communities. Homeward – a San Francisco, CA-based mobile, in-person, and telehealth hybrid care model (with specialty and primary care providers) for people
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