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Payers| Payer Industry Impact for Patients, Clinicians, and Healthcare Organizations | News, Analysis, Insights - HIT Consultant

Biofourmis Secures $300M to Expand Virtual Care Offerings

by Digital Health Funding 04/26/2022 Leave a Comment

Biofourmis Secures $300M to Expand Virtual Care Offerings

What You Should Know: - Biofourmis, a global leader in virtual care and digital medicine raises $300 million in Series D investment led by leading global growth equity firm General Atlantic. CVS Health and existing investors also participated in the round, - Biofourmis also announced that former Medtronic CEO and Chairperson at Intel, Dr. Omar Ishrak, will join the company’s Board of Directors as Chairman. Transforming Patient Health Through Personalized, Predictive Care Founded in
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Former OptumRx CEO Launches Waltz Health with $33M to Lower Drug Costs

by Digital Health Funding 04/26/2022 Leave a Comment

Former OptumRx CEO Launches with $33M to Low Drug Costs

What You Should Know: - Mark Thierer -- the former CEO of OptumRx who took that role after selling Catamaran to UnitedHealth Group for $13B, today announced the launch of Waltz Health with $35.4M led by GV (Google Ventures) including participation from Define Ventures, Echo Health Ventures, Blue Venture Fund, Byers Capital, and Twine Ventures. Other funding came from a prestigious list of seasoned healthcare executives. - Waltz Health plans to
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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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How Automation Can Help with Healthcare’s “Messy” Data Problem

by Dr. Bob Lindner, Co-Founder & Chief Scientific Officer at Veda 04/25/2022 Leave a Comment

How Automation Can Help with Healthcare’s “Messy” Data Problem

Efficient data processing and data sharing are essential functions across healthcare—from patient care, clinical research, and health services planning to billing and government reporting for funding and research. But most of the data that the industry is processing is human-generated, meaning it’s messy and riddled with errors, and often manually inputted from Excel spreadsheets into various disparate platforms and technology systems. In some cases, our healthcare system is running on
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Why a Focus on Behavioral Health is Key to Improving Quality Measures

by Tom Zaubler, MD, Chief Medical Officer of NeuroFlow 04/20/2022 Leave a Comment

Why a Focus on Behavioral Health is Key to Improving Quality Measures

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. healthcare system has been moving towards value-based care (VBC) which encourages health providers to improve care quality by reimbursing them based on successful outcomes rather than individual medical services. The overarching goal of VBC is to improve the patient experience, improve population health, and reduce per capita health costs. As part of this VBC model, hospitals and health systems
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Free Market Health Secures $13.5M for Advance Specialty Pharmacy Ecosystem

by Fred Pennic 04/19/2022 Leave a Comment

What You Should Know: Free Market Health, a Pittsburgh-based healthcare technology company transforming the specialty pharmacy ecosystem with a care-driven marketplace platform, today announced its $13.5M in Series A financing led by Alta Partners and with participation from existing investors Highmark Ventures and 653 Investment Partners. - The capital will enable the company’s team of specialty pharmacy industry experts to scale beyond the hundreds of millions of dollars in specialty
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The Critical Shift in ASC EHR Adoption: Overcoming Barriers

by Maura Cash RN, BSN, CASC, VP of Clinical Strategies for HST Pathways 04/19/2022 Leave a Comment

Maura Cash RN, BSN, CASC, VP of Clinical Strategies for HST Pathways

Extraordinary advances in technology have opened up previously unthinkable possibilities for the healthcare industry and improvements in patient care. Electronic health records (EHRs) are one of many health IT advancements in recent years, and they prove to have a significant impact on both providers and patients alike. While an EHR optimizes workflow efficiencies for providers, it also enables a more comprehensive view of a patient’s health. By pulling together data points and health
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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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4 Keys to Delivering A Retail-Like Patient Experience Journey

by Melinda Cisneros, Healthcare Industry Analyst & Grant Harland, Retail and Hospitality Industry Analysts at Windstream Enterprise 04/11/2022 Leave a Comment

4 Keys to Delivering A Retail-Like Patient Experience Journey

When it comes to the quality of their healthcare journey, patients, it seems, are losing patience with their healthcare providers. In Cedar’s latest Healthcare Consumer Experience Study, for example, the share of consumers who said they won't pay a bill if they cannot understand the administrative experience tripled from 2020 to 2021, to 37%. A vast majority (93%) indicated the quality of the billing and payment experience is important to their decision to return to a healthcare provider in
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Forge Health Secures $11M for Value-Based Behavioral Health Model

by Digital Health Funding 04/07/2022 Leave a Comment

Forge Health Secures $11M to Expand Value-Based Behavioral Health Model

What You Should Know: – Forge Health, a White Plains, NY-based behavioral healthcare provider with a proven, national-payer-validated ability to drive clinical outcomes that span all areas of health, today announced an $11M growth funding round led by HC9 Ventures. - Innovative behavioral health company works with payers and health systems to enable value-based care for mental health and substance use populations. Transforming Addiction and Mental Health Treatment Founded in 2016,
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