Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • CVS Health to Begin Important Work of Integrating Aetna

    January 2, 2019 - On the eve of Christmas, Judge Richard Leon of the United States District Court for the District of Columbia decided against halting the integration of the two companies in a merger valued at $69 billion. “Based on CVS’s constructive and appropriate representations, I am satisfied that, so long as these measures remain in place, the assets involved in the challenged...

  • ACA, Member Engagement Challenges Led Top 10 Stories of 2018

    December 26, 2018 - It’s fair to say that the health payer community had a lot to process in 2018.  Mergers, partnerships, and new entries into the field rocked the traditional industry setup, while federal efforts to chip away at the Affordable Care Act continued to create an environment of uncertainty and financial risk. Meanwhile, the ongoing transition to value-based care – and its...

  • HHS Signals End to Health Plan Identifiers in New Proposed Rule

    December 21, 2018 - Years of pushback from industry stakeholders has motivated an HHS proposal to eliminate a federal requirement for identifying health plans in HIPAA transactions. As everyone prepares to break for the holidays, the federal agency formally announced a notice of proposed rulemaking (NPRM) to eliminate the health plan identifier (HPID) and the voluntary other entity identifier (OEID). The...

  • Humana Value-Based Care Program Unveils First Participants

    December 21, 2018 - Nearly seven months since announcing its value-based care incentive program for hospitals, Humana has revealed its first participants. Four hospitals have agreed to participate in the Hospital Incentive Program (HIP) for commercial members: Cleveland Clinic Florida, Florida’s Jackson Health System, Ohio’s TriHealth, and Georgia’s WellStar Health...


Today's Top Stories

HCTTF Offers Clinical Episode Grouper Resources for Bundled Payments

The Health Care Transformation Task Force (HCTTF) has released a new set of resources to support payers as they develop innovative bundled payment programs. In a white paper titled Episode Groupers: Key Considerations for Implementing...

After Buying Aetna, CVS Health Commits $100M to Address SDOHs

With its $69 billion acquisition of Aetna in the books, the newly expanded CVS Health is now investing heavily in developing and deploying new models to address community wellness and the social determinants of health (SDOH). The...

Anthem Medicare Advantage Members Can Use OTC Allowance at CVS

Anthem Blue Cross (Anthem) Medicare Advantage members in California will now be allowed to purchase over-the-counter products at CVS Pharmacy stores using their health plan allowance. The partnership, launched on January 1, is intended to...

NYC Mayor Announces Plan to Guarantee Health Coverage for All Residents

Mayor Bill de Blasio has announced the launch of a comprehensive, universal healthcare coverage plan that will guarantee benefits for every New Yorker. “Healthcare is a right, not a privilege reserved for those who can afford...

Change Healthcare, Health Fidelity Apply AI to Risk Adjustment

Change Healthcare and Health Fidelity have announced a collaboration to offer AI-driven risk adjustment coding solutions for Medicare Advantage, ACA commercial, and Medicaid payers. The tool leverages natural language processing (NLP) and...

Government Shutdown Spares Medicare, Medicaid, But Has Other Impacts

The partial government shutdown will have no impact on Medicare and Medicaid at the federal level, CMS has stressed to industry observers. The nation’s public payers will continue to operate as normal, since funding for CMS is...

Patient-Centered Methods Help Health Plans Boost Cancer Care

Employers and payers should ensure their health plans use patient-centered methods and provider performance measurement strategies to reduce costs and improve cancer care, a report from the National Alliance of Healthcare Purchaser...

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