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Medicare Advantage | Payers | News, Analysis, Insights

Net Health Acquires Post-Acute Analytics Platform PointRight – M&A

by Fred Pennic 01/12/2021 Leave a Comment

Net Health Acquires Post-Acute Analytics Platform PointRight – M&A

What You Should Know: -  Net Health acquires post-acute market analytics platform PointRight to deepen the company’s analytics capabilities, post-acute presence, and support for SNF networks. Net Health, a provider of cloud-based software for specialty medical providers across the continuum of care, today announced that it has acquired PointRight Inc., a leading provider of analytics and data-driven tools for the post-acute market. The acquisition adds to Net Health’s expanding
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12 Telehealth & Virtual Care Predictions and Trends for 2021 Roundup

by Fred Pennic 01/04/2021 Leave a Comment

12 Telehealth & Virtual Care Predictions and Trends for 2021

Dr. Paul Hain, Chief Medical Officer of GoHealth Telehealth is Here to Stay in 2021 Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows
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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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