Care Management

Payers Turn to Younger Vendors for Utilization and Care Management

by Kelsey Waddill

Not price, not incumbency, but functionality is the key to winning and losing payers’ business, the KLAS Decision Insights Report 2019 indicated. Payers want highly functional, integrated,...

UnitedHealthcare Expands Medicare Advantage Bundled Payment Program

by Jessica Kent

UnitedHealthcare is expanding its Medicare Advantage bundled payment program, offering providers in more than 30 states the opportunity to participate in these models for their patients enrolled in MA...

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...

Patient-Centered Medical Home Benefits Payers, Providers, Patients

by Jesse Migneault

Blue Cross-Blue Shield of Michigan has one of the nation’s most successful patient-centered medical home (PCMH) networks.  The model has improved patient outcomes, lowered payer costs and...

Risk-Stratified Care Management Enables Customized Treatment

by Vera Gruessner

Among health payers, one necessary strategy aimed at ensuring superior patient health outcomes is based on risk stratification and the data analytics behind this process. The American Academy of...