Care Coordination

6 Expectations Employers Have for Provider Care Coordination

by Kelsey Waddill

Providers are not meeting employees’ needs in certain areas and employers expect more from their provider partners' care coordination strategies, employers expressed in a report compiled...

Humana Joins Traditional Medicare Value-Based Contracting Model

by Kelsey Waddill

Humana has announced that it will be participating in a CMS traditional Medicare value-based contracting model and will offer coordinated care for traditional Medicare...

CVS, Aetna Care Coordination Plan May Cut Out-Of-Pocket Costs

by Hannah Nelson

CVS Health and Aetna announced a health plan set to increase care coordination and healthcare access while lowering patient out-of-pocket costs for Southern Californians. The Aetna Connected Plan with...

Employer-Sponsored Health Plans See Strong Member Satisfaction

by Kelsey Waddill

Most Americans who have employer-sponsored health plans expressed confidence in their health plans’ support and financial protection, according to a survey conducted on behalf...

Humana Will Begin Transitioning Senior Services Into New Brand

by Kelsey Waddill

Humana has announced that some of its senior services and other payer-agnostic services will begin to transition into CenterWell, the payer’s newest brand. Transitioning various services into...

Humana Launches MA Value-Based Care Model, Hospice Care Coordination

by Hannah Nelson

Humana announced the launch of a Medicare Advantage (MA) value-based care model for hospice patients, which aims to improve care coordination.  The program comes as part of a four-year...

CMS Rule Targets Prior Authorization with Interoperability

by Hannah Nelson

Today, the Centers for Medicare & Medicaid Services (CMS) passed a final rule that promotes data sharing, patient access to health information, coordinated care, and interoperability to streamline...

SDOH Awareness, Care Coordination Key to Payer Leader Development

by Kelsey Waddill

Payers that are looking to develop strong healthcare leaders should focus on strengthening learners' care coordination and social determinants of health awareness. Payers and healthcare...

How to Rethink Population Health Management for Rare Disease Care

by Kelsey Waddill

About four and a half years ago, Chris Carlson, senior vice president of customer experience and complex health solutions at UnitedHealth Group, had a significant conversation with his colleague about...

How Payers Can Drive A Quicker Transition to Value-Based Care

by Kelsey Waddill

Value-based care is a perennial goal for the payer industry, but transitioning into risk-based, outcomes-based contracts has proven to be a slow process. However, Blue Cross and Blue Shield of North...

Highmark Expands Partnership to Personalize Substance Abuse Care

by Kelsey Waddill

Highmark Inc. (Highmark) has expanded its partnership with an end-to-end substance abuse care vendor, axialHealthcare, to better serve members in Pennsylvania with substance abuse care...

Medicare Value-Based Contracting Model Emphasizes Care Coordination

by Kelsey Waddill

CMS has introduced a new Medicare value-based contracting model that encourages greater care coordination and requires participants to take full risk for Medicare fee-for-service beneficiaries based on...

How Do Medicaid Programs Cover Pediatric Curative, Hospice Care?

by Kelsey Waddill

States use Affordable Care Act flexibilities in innovative ways to set definitions for curative care, implement reimbursement models, and care coordination in Medicaid pediatric care for children with...

Payer, Provider Value-Based Contract Targets 10% Lower Cost Trend

by Kelsey Waddill

Blue Cross and Blue Shield of Minnesota (Blue Cross) struck a six-year value-based contract with Allina Health that focuses on quality improvement and cost savings through care coordination,...

Top 4 Recent Health Payer Innovative Consolidations, Partnerships

by Kelsey Waddill

Although not as active as prior years due to the coronavirus pandemic, the landscape of payer dealmaking continues to show signs of life through innovative consolidations and partnerships. Payers...

Humana Tackles CKD Through Home Healthcare, Care Coordination

by Kelsey Waddill

Humana will be partnering with a chronic kidney disease management and awareness organization to provide home healthcare and care coordination to Medicare Advantage members, the payer recently...

How to Improve Medicaid Member Engagement, Care Coordination

by Kelsey Waddill

California’s whole person care 1115 Medicaid demonstration waiver illustrates the challenges Medicaid programs face in providing care coordination for Medicaid beneficiaries and offers insight on...

Payers Seek National Recognition as Essential Businesses

by Kelsey Waddill

As governors across the nation order nonessential businesses to close their doors as coronavirus spreads, payers are pushing to be officially recognized as “essential businesses.” For more...

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