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UnitedHealthcare Adopts Bundled Payment Model for Surgeries

January 19, 2017 - The national health insurance company UnitedHealthcare has followed the lead of the Centers for Medicare & Medicaid Services (CMS) and implemented a bundled payment model specifically for hip, spine and knee surgeries much like the CMS Comprehensive Care for Joint Replacement Model. UnitedHealthcare invested in the value-based bundled payment model in January 2017 to improve...


Articles

Aetna, Humana, Harvard Pilgrim Target Patient Health Outcomes

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Commercial health insurance companies have pursued a number of different approaches to improve patient health outcomes and reduce wasteful medical spending. The payers Aetna, Humana, and Harvard Pilgrim conducted some key collaborations to achieve...

Humana Advances Population Health Management, Value-Based Care

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The health insurer Humana has been progressing with population health management and value-based care by partnering with the population health company FullWell in December 2016, according to a company press release. The partnership creates a...

Cigna Partners with Scripps Health in Pay-for-Performance Model

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The national health insurer Cigna announced in a company press release yesterday that it will be partnering with the nonprofit healthcare delivery system Scripps Health through a pay-for-performance contract to provide employers in the San Diego...

Cigna’s Key Principles for Healthcare Quality Measures

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Cigna is one national health insurance company that has moved forward with creating successful healthcare quality measures for their provider networks. The company uses national standards along with physician feedback when creating its own healthcare...

Key Steps for Payers to Improve Population Health Management

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In recent years, population health management has become a larger factor in the success of a health insurance company. With more payers transitioning to value-based care reimbursement platforms, the quality of care and patient outcomes have grown...

Humana, Aetna, Cigna Invest in Value-Based Care Payment Models

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Value-based care payment models are continuing to make headlines among major health insurance companies around the nation. Last month, Humana entered into a value-based care arrangement with the population health management company Fullwell,...

Blue Cross Health Plans Expand Value-Based Care Reimbursement

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Along with other national payers, Blue Cross Blue Shield health plans have been investing in expanding value-based care reimbursement. For example, New York-based Excellus Blue Cross Blue Shield has partnered with vendors to use analytics and...

How Blue Cross Health Plans Affect Anthem-Cigna Merger Lawsuit

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The Anthem-Cigna merger lawsuit has brought significant evidence to light ever since the case began on November 21, 2016. The Department of Justice has been able to illuminate that the health insurance merger would create major market concentration...

Humana Standardizes Healthcare Quality Measures for Physicians

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Last week, Humana announced in a company press release the development of a Clinical Quality Metrics Alignment (CQMA) program meant to simplify and regulate healthcare quality measures. The new strategy will be used specifically among doctors...

UnitedHealthcare Cut Costs through Value-Based Care Programs

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Last month, UnitedHealthcare released a report outlining the benefits of value-based care programs. The report called Collaborative and Coordinated: How Value-Based Care Programs are Driving Improvements in Quality and People’s Health began...

How 4 Healthcare Payers Fare in 2016’s Health Insurance Market

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The health insurance market has gone through significant changes in 2016. A number of payers have pulled back from the health insurance exchanges such as UnitedHealth and Humana. The Department of Justice has also filed lawsuits against the mergers...

AMA: Health Insurance Merger Cuts Medicare Advantage Competition

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The American Medical Association (AMA) announced in a press release earlier this week their position against the health insurance merger between Aetna and Humana, particularly regarding its impact on the Medicare Advantage market. The AMA is...

Payers See High Financial Losses on Health Insurance Exchanges

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Healthcare payers have been facing significant financial losses on the health insurance exchanges in recent years. UnitedHealth Group lost $475 million in 2015 and was predicting a loss of $650 million in 2016, according to Kaiser Health News....

Payers Continue to Drop Out of the Health Insurance Exchanges

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Healthcare payers have seen significant obstacles when it comes to operating on the public health insurance exchanges with large, national insurance companies losing money through this marketplace. Below we outline some key insurers that have...

UnitedHealth Group Adopts Bundled Payment Models for Surgeries

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The commercial payer UnitedHealth Group has begun expanding its involvement in bundled payment models. Forbes reported that UnitedHealth will be implementing bundled payment models for spinal surgeries as well as hip and knee replacement operations...

Health Insurance Merger Lawsuit Considers Efficiencies Factor

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On Monday, November 21, the court trial filed by the Department of Justice against the health insurance merger between Anthem and Cigna began. The drive to stop the $48 billion health insurance merger started due to concerns over a negative impact...

Deductibles, Out-of-Pocket Healthcare Spending Rose 3% in 2015

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Healthcare spending within the private health insurance market has grown 4.6 percent in 2015, according to a press release from the Health Care Cost Institute (HCCI). This type of growth in spending is higher than in recent years. For instance,...

Humana Spent $93M in Quality Payments for Provider Network

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The national payer Humana announced in a company press release earlier this week that it has reimbursed more than $93.6 million to more than 4,000 provider groups countrywide participating in their Provider Quality Rewards Program. These particular...

Healthcare Insurance Literacy Vital for Higher Coverage Rate

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New research from the RAND Corporation shows that uninsured Americans who have better healthcare insurance literacy were more likely to purchase coverage when the Affordable Care Act’s health insurance exchanges opened in 2014, according...

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