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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Medicare Advantage | Payers | News, Analysis, Insights
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
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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NourishedRx Raises $6M to Accelerate Intelligent Food-for-Health Platform
What You Should Know: - NourishedRx, a digital health company raises $6M in seed funding led by S2G Ventures with additional investors Route 66 Ventures, Connecticut Innovations, Primetime Partners, and other individual investors. - The company will utilize the funding to expand its high-tech, a high-touch platform to provide personalized, culturally relevant food solutions to health plan members nationwide. Personalized Nutrition Founded in 2019, with the support of the Mailman
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Leveraging A More Impactful Analytics Strategy to Improve Your Health Plan Member CX
Healthcare organizations are increasingly eager to leverage analytics technologies, including machine learning and artificial intelligence (AI), in new ways. One telling sign of this is that the global predictive analytics healthcare market, which was valued at $1.8 billion in 2017, is projected to reach more than $8.5 billion by 2025. But as technology evolves, it’s clear that the types and use of analytics platforms that can drive change among health plans — as well as the breadth of
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RecoveryOne, Cigna Offers Virtual Physical Therapy for Medicare Advantage Customers
What You Should Know: - RecoveryOne, a digital health innovator dedicated to improving health outcomes for recovery from musculoskeletal (MSK) injuries of all types and reducing costs, announced an expansion of its partnership with Cigna to offer its virtual physical therapy and broad MSK solution for Medicare Advantage (MA) customers as an in-network benefit. - This new benefit builds on the partnership between Cigna and RecoveryOne announced
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Endear Health Raises $4M for Payor Member Experience Platform for Medicare Advantage Plans
What You Should Know: - Endear Health, a San Francisco, CA-based digital engagement platform built for the rapidly evolving value-based landscape, has successfully closed an oversubscribed $4M seed funding round led by 8VC with participation by GreatPoint Ventures and additional Angel Investors. - Endear Health concurrently announced the appointment of Dr. Robert Mirsky to its Advisory Board to provide guidance as Endear Health expands to additional health plans and provider groups around
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Zing Health Secures $25M to Accelerate SDOH-Driven Medicare Advantage Plans
What You Should Know: - Medicare Advantage provider Zing Health raises $25M from Town Hall Ventures and Leavitt Equity Partners, two leading investors focused on growing innovative healthcare businesses. Zing Health Holdings, a Chicago-based physician-led Medicare Advantage insurance company focused on serving vulnerable populations underserved by traditional insurance models, today announced that Town Hall Ventures and Leavitt Equity Partners, two leading investors focused on
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EasyHealth Secures $135M to Redesign Medicare Experience
What You Should Know: - Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best plan and support them through their healthcare journey. EasyHealth, an LA-based company connecting coverage and care with an end-to-end Medicare experience, today announced it has raised $135M in equity and debt funding to further its mission to improve health outcomes for Medicare members by connecting coverage and care. Funding
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The Helper Bees Taps Roundtrip to Provide Transportation Services for Members
What You Should Know: - The Helper Bees (THB), a full-service insurtech company that creates innovative aging-in-place solutions for both payers and insureds, announced a provider partnership with Roundtrip, the leading technology solution for non-emergency medical transportation (NEMT). This agreement will bring better transportation options to Medicare Advantage (MA), Long Term Care Insurance (LTCI), health systems, and patients nationwide. - By adding Roundtrip to this network, The
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