What You Should Know:
- Molina Healthcare acquires New York-based Medicaid managed care organization Affinity Health Plan for $330M in cash serving members in New York City, Westchester, Orange, Nassau, Suffolk, and Rockland counties.
- As of August 31, 2020, Affinity served approximately 284,000 Medicaid members. Affinity’s premium revenue for the trailing twelve months ended July 31, 2020, was approximately $1.3 billion.
- The net purchase price of approximately $380 million
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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Revel, NovuHealth Merge to Create Largest Healthcare Member Engagement Platform
What You Should Know:
- NovuHealth and Revel merge to bring together NovuHealth’s
personalized healthcare loyalty programs with Revel’s applied behavioral
research and health action technologies.
- Together, Revel and NovuHealth work with more than 50
healthcare organizations, including seven of the top 10 largest health insurers
in the United States representing more than 65 percent of all members in
government programs such as Medicare and Medicaid.
Revel and NovuHealth, two
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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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The COVID-19 Data Challenges Facing Payers
Both payers and providers can benefit from the same or similar high-quality data and can work together to provide the best possible services to patients with COVID-19 while avoiding overloading the healthcare system. The key is to use combined payer, clinical, and social data plus technology such as telehealth and artificial intelligence (AI).
Payer Perspective on COVID-19
The overriding concern for payers during the COVID-19 crisis is the need to support member health. During an
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Equality Health Launches Social Determinants Program to Tackle Health Disparities
What You Should Know:
- Equality Health launches Social
and Cultural Risk Assessment (SCRA™) program to address social determinants of health
(SDoH)
- With Equality Health’s SCRA program, social determinants act as any other quality metric, with a far less
burdensome reporting process.
Equality Health, a whole-health delivery
system, has pioneered a comprehensive cultural care program that enables
providers to identify and
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After COVID-19, Healthcare’s Next Big Challenge: Reforming Surgery
Nearly six months after the World Health Organization declared COVID-19 a global pandemic, many hard-hit healthcare systems have begun resuming elective surgeries and redeploying surgeons, residents, and fellows back to their home departments after enlisting them in COVID wards and ICUs.
These practitioners are returning physically exhausted and emotionally strained from the harrowing experience of serving on the front lines of the COVID response. Meanwhile, they have also seen their training
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Walmart, Oak Street Health to Launch 3 Health Clinics in Dallas-Fort Worth Area
What You Should Know:
- Walmart and Oak Street Health ink a partnership to
launch three joint health clinics in the Dallas-Forth Worth, TX area this year.
- Each clinic will offer value-based primary care and urgent
care services with a focus on adults on Medicare.
Retail leader Walmart
announced a partnership with Oak
Street Health, a value-based
primary care network for adults on Medicare to launch three joint health
clinics the Dallas-Forth Worth, TX area.
The new Oak Street
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Carrum Health Adds Mayo Clinic to COE Platform for Cost-Effective Surgical Care
What You Should Know:
- Carrum Health, a digital health company that connects
employers and employees with hospital Centers of Excellence (COEs) to provide
more cost-effective surgical care announces the addition of Mayo Clinic to
Carrum's COE platform.
- As part of the collaboration, employees and covered
dependents at self-insured companies offering the Carrum Health surgery benefit
will now have access to Mayo Clinic providers with little or no cost.
- Self-insured employers,
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The Coronavirus Crisis’ Silent Death Toll: Chronically Ill Patients
The impact of the coronavirus crisis is shining a bright light on many of the challenges facing the U.S. healthcare system.
So much more than a lack of primary care physicians and hospital beds, the all-hands-on-deck approach to combating the spread of COVID-19 has forced patients fearful of engaging with the healthcare system for needs unrelated to the virus to put elective procedures, routine care and timely treatment for chronic or critical conditions on the back burner.
Compounding
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Report: Modern Revenue Integrity Solutions Driving Payment Performance
What You Should Know:
- New Chilmark Research report on revenue integrity
in healthcare reveals a transitional market making strides to address the new
burdens of modern care economics.
- The ongoing COVID-19 public health emergency underscores
the imperative need for automation and reduced administrative costs even
clearer.
Revenue cycle
has and continues to be one of the most difficult challenges in healthcare.
These issues manifest in the claims process of submission,
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