Care Coordination

Humana Expands Value-Based Care Options for Medicare Advantage

by Jessica Kent

Humana has announced a series of initiatives to increase value-based care for orthopedic services among its Medicare Advantage members. The organization will partner with orthopedic and neurosurgery...

Cigna, Sentara Healthcare Join Payer Blockchain Initiative

by Jessica Kent

Cigna and Sentara Healthcare have joined a new healthcare-focused collaborative that aims to build, share, and deploy solutions using blockchain technology. The collaborative also includes Aetna,...

CA Payers Tackle Provider Directories with Data, Collaboration

by Jessica Kent

Provider directories are often a patient’s primary source of information when making decisions about their care and coverage. Healthcare consumers use these directories to find out which...

How Payers Can Improve the Value of Long-Term Support Services

by Thomas Beaton

Providing long-term support services (LTSS) impact commercial payers who need to address complications and billions in costs associated with this kind of care. In 2016, the United States spent $92.4...

Payers Support Integrated Care Services for NC Medicaid Patients

by Thomas Beaton

Payers and provider organizations that support integrated care systems can help lower healthcare costs by addressing the healthcare concerns of vulnerable patient populations, including Medicaid...

Pre-Authorizations, Rx Limits Cut Opioid Abuse by 30% Nationwide

by Thomas Beaton

Anthem BlueCross BlueShield (BCBS) organizations across the country collectively pledged to lower opioid abuse by 30 percent, and the company as a whole reached that goal two years ahead of schedule...

Boston Children’s, Cleveland Clinic Partner for Pediatric Care

by Thomas Beaton

Boston Children’s Hospital and Cleveland Clinic have announced a partnership to provide complex pediatric heart care through Cleveland Clinic’s national employer-based insurance...

Opioid Use Fell 32% in CA BCBS Prescription Drug Safety Program

by Thomas Beaton

The Blue Shield of California Health Plan, an independent member of Blue Cross Blue Shield (BCBS), successfully lowered overall opioid use by 32 percent during the first two years of its Narcotic...

Humana, Oscar Health to Deliver Small Business Insurance

by Thomas Beaton

Humana and startup insurance provider Oscar Health have entered into a strategic partnership that aims to provide commercial small business insurance to consumers in a nine-county area surrounding...

Care Coordination is Tops for Health Insurance Satisfaction

by Jesse Migneault

Coordination of care among healthcare providers is the single most important criteria influencing member satisfaction with their health insurance plan, according to the J.D. Power 2017 Member Health...

Aetna to Offer New HMO Option for Delaware State Employees

by Jesse Migneault

Health insurer Aetna was recently awarded a three-year contract as a provider of Delaware’s health plan offerings for its employees and pensioners.  Aetna has chosen a coordinated care...

Payers, Providers Collaborate to Combat Opioid Abuse, Addiction

by Jesse Migneault

Insufficient control of opioid prescriptions is one of the key reasons why opioid abuse and addiction have risen dramatically over the past few years.    To mitigate the epidemic, payers...

Key Steps for Payers to Improve Population Health Management

by Vera Gruessner

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...

How Payers Could Improve Population Health Management with Tech

by Vera Gruessner

When payers transition their reimbursement structures toward a value-based care payment model, healthcare quality improvement needs to be addressed. In order to boost quality, payers could target...

Empire BlueCross BlueShield Rewards Strong Care Coordination

by Vera Gruessner

Healthcare payers are often looking for ways to improve care coordination in an effort to enhance patient outcomes and reduce medical spending. Empire BlueCross BlueShield is one healthcare payer that...

How the Bundled Payment System Supports Coordinated Care

by Vera Gruessner

The bundled payment system offers a method for reducing skyrocketing costs throughout the healthcare delivery continuum by moving away from fee-for-service reimbursement. In particular, the bundled...

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