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Medicare Advantage | Payers | News, Analysis, Insights

As Telehealth Surges, Are Seniors Being Left Behind?

by Anne Davis, Director of Quality Programs & Medicare Strategy at HMS 12/11/2020 Leave a Comment

As Telehealth Surges, Are Seniors Being Left Behind?

A global health crisis has thrust us into a scenario in which lives quite literally depend on the ability to virtually connect. Telehealth has rapidly emerged as a vital tool, enabling continuity of care, allowing vulnerable individuals to access their physician from home, and freeing up resources for providers to treat the most critical patients. The acceptance of telehealth and expansion of covered services for the senior population demonstrate that this technology will endure long after
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5 Steps for Interoperability Excellence for Healthcare Providers

by Shanti Wilson, Consultant, Freed Associates 12/07/2020 Leave a Comment

5 Steps for Interoperability Excellence for Healthcare Providers

As if 2020 couldn’t be any more challenging for healthcare providers, new federal rules on interoperability and patient access, granting patients direct access to their healthcare data, begin taking effect in 2021 and will continue into 2022. These rules, while ultimately beneficial to patients, bring an additional level of operational complexity to many revenue-stressed healthcare organizations. If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For
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Unite Us, CVS Health, Humana & Ochsner Health Partner to Expand Social Care Throughout Louisiana

by Jasmine Pennic 11/18/2020 Leave a Comment

Unite Us, CVS Health, Humana & Ochsner Health Partner to Expand Social Care Throughout Louisiana

What You Should Know: -   Unite Us today announced its Unite Louisiana network has partnered with CVS Health, Humana, and Ochsner Health in an effort to expand and improve community health and social care throughout the state. - New partners will enable Unite Louisiana, the statewide social care network, to further expand into more parishes and broaden access to care in response to COVID-19 challenges. Unite Us, the technology company building coordinated care networks
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CMS Direct Contracting Model Options for Value-Based Care

by Vanessa Kuhn, Director of Health Policy, PatientPing 10/26/2020 Leave a Comment

CMS Direct Contracting Model Options for Value-Based Care

The Centers for Medicare and Medicaid Innovation (CMMI) created the Direct Contracting Model to expand opportunities for more diverse providers and healthcare organizations to participate in value-based care arrangements for Medicare fee-for-service (FFS) beneficiaries. The goal of the new model is to create the next generation of risk-sharing arrangements to improve outcomes for patients, lower costs, and ensure high-quality care. In developing the Direct Contracting model and associated
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Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

by Jasmine Pennic 10/08/2020 Leave a Comment

Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

What You Should Know: - Humana Inc. and Fresenius Medical Care North America (FMCNA) today announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage members - The agreement between Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021. Humana Inc. and leading renal care company Fresenius Medical Care North America (FMCNA) announced an agreement to broaden their collaboration toward improving the
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Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment

by Fred Pennic 10/06/2020 Leave a Comment

Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment

What You Should Know: - Walmart announced it will begin selling Medicare insurance plans during this year’s annual enrollment period, Oct. 15 through Dec. 7. Today, Walmart announced the launch of Walmart Insurance Services, LLC, a licensed insurance brokerage, which will assist people with enrolling in insurance plans—and simplify what’s historically been a cumbersome, confusing process. Walmart Insurance Services will begin selling Medicare insurance plans during this year’s Annual
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Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

by Jasmine Pennic 09/30/2020 Leave a Comment

Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

What You Should Know: - Independence Blue Cross and Signify Health launches social determinants of health network, CommunityLink to connect data from multiple CBOs to integrate social directly into medical care in the Philadelphia area. - CommunityLink represents one of the first examples nationwide of combining in-home health with social care. Independence Blue Cross (Independence) and Signify Health announce the launch of CommunityLink™, a social determinants of health (SDoH)
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Designating Ownership of Provider Data Will Improve Care Coordination, Study Finds

by Jasmine Pennic 09/18/2020 Leave a Comment

Designating Ownership of Provider Data Will Improve Care Coordination, Study Finds

What You Should Know: - New LexisNexis Risk Solutions Health Care survey reveals that 63% of respondents believe designating ownership of provider data will improve care coordination, yet only 18% of organizations report having a dedicated data governance department - The survey results are based on over 100 qualified responses from organizations across the industry, including independent hospitals, teaching hospitals, independent physician groups, and federally qualified health
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Cone Health to Merge with Sentara Healthcare Totaling $11B in Assets

by Fred Pennic 08/13/2020 Leave a Comment

Cone Health to Merge with Sentara Healthcare Totaling $11B in Assets

What You Should Know: - Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare for a combined $11B in assets. - The merger creates one large health system totaling of 17 hospitals – 11 Sentara hospitals in Virginia and one in Elizabeth City, N.C., and five Cone Health hospitals in the area surrounding Greensboro. Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare. The merger will
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COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever

by Irv Lichtenwald , CEO of Medsphere Systems Corporation 08/07/2020 Leave a Comment

Medsphere CEO Talks Affordable Healthcare IT and Future of EHRs

In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need to provide healthcare for all in the event of calamity upending the basic functions of a civilized society. With that, the UK’s National Health Service (NHS) was born. In 2020, all perspectives about quality and the time it takes to see a provider aside, the NHS remains quite popular
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