Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Costs

Centene to Acquire Medicaid, Medicare Advantage Provider Group

by Thomas Beaton

Centene signed an agreement to acquire Florida-based Community Medical Holdings Corp (CMG), a community medical group, to expand Centene’s Medicaid, Medicare Advantage (MA), and marketplace health plan businesses. Centene stated in...

HCSC Invests $1.5B to Develop Insurance Affordability Solutions

by Thomas Beaton

HCSC is investing $1.5 billion to develop health insurance affordability solutions including employee wellness programs, ways to address social determinants of health, and collaborative care. Dubbed Affordability Cures, the initiative...

Uninsured Adults Apprehensive About Health Insurance Costs

by Thomas Beaton

About 71 percent of uninsured adults aware of open enrollment periods did not enroll in state or federally-based health plans because of apprehension to rising health insurance costs and waning confidence that the ACA will remain in...

Payer Meal Program Addresses Social Determinants of Health

by Thomas Beaton

Philadelphia-based Health Partners Plan (HPP) reduced blood glucose levels of diabetics and care utilization of other chronically ill members by implementing a healthy meal program to address food-related social determinants of health...

Aetna Highlights Emerging Drivers of Value-Based Care

by Thomas Beaton

Payer-provider collaboration, holistic healthcare approaches that address the social determinants of health (SDOH), and the use of health IT tools will be among the most important drivers of value-based care, Aetna says in a new report....

Medicare Wellness Programs Promise Better Health Outcomes

by Thomas Beaton

Medicare wellness programs have the potential to improve physical and mental health for beneficiaries with chronic conditions, according to a new report from the Center for Medicare and Medicaid Innovation (CMMI). Medicare members that...

Payers Address Opioid Safety Via Education, $0 Narcan Co-Pays

by Thomas Beaton

Commercial payers are addressing the nation’s opioid crisis and promoting opioid safety by funding patient education programs and waiving Narcan co-pays to reduce barriers to access. Patient-centered strategies have allowed payers...

Reinsurance, CSR Reinstatement May Stabilize Individual Premiums

by Thomas Beaton

AHIP supports a number of policy solutions that could reverse Trump Administration actions that have resulted in higher premiums and unstable markets. In a new policy brief, the payer advocacy group suggests that lawmakers focus on the...

Payer Housing Partnership Addresses Social Determinants of Health

by Thomas Beaton

Health Partners Plans (HPP) and two community programs in Philadelphia announced a partnership to address housing-related social determinants of health by connecting homeless individuals to healthcare services, free clinics, free meals,...

Ongoing Payer Consolidation Leads to Consumer Premium Hikes

by Thomas Beaton

The four largest payers in the US have continued to get bigger over the past few years, said Leemore S. Dafny, a professor of the Bruce V. Rauner Professor of Business Administration at Harvard Business School, during a House Energy and...

National Healthcare Expenditures Expected to Reach $5.5T by 2026

by Thomas Beaton

The CMS Office the Actuary forecasts that national healthcare expenditures will reach $5.5 trillion by 2026 due to a 5.5 percent yearly growth rate. CMS said that the anticipated average growth rate of healthcare spending is lower than...

Employer Guide Offers Strategies for Wellness Program Success

by Thomas Beaton

An employer guide developed by The Transamerica Center for Health Studies (TCHS) and the Interdisciplinary Center for Healthy Workplaces (ICHW) determined that employers may need a better understanding of the factors that inhibit wellness...

71% of Workers Satisfied with Employer-Sponsored Health Plans

by Thomas Beaton

Over 70 percent of employees are generally satisfied with their employer-sponsored health plans, but are concerned with rising health plan costs, an AHIP study found. Employer sponsored health plans have provided fair premium and...

Alaska Bill to Alter Emergency Room Payment Rules Brings Concern

by Thomas Beaton

A bill in the Alaska Senate intended to repeal protections around emergency room payments has drawn significant concern from the state’s chapter of the American College of Emergency Physicians (ACEP).  The bill would remove a...

How All-Payer Claims Databases Can Identify Wasteful Spending

by Thomas Beaton

An all-payer claims database (APCD) can hold data on millions of patients and the services they receive, giving payers, providers, and related stakeholders the ability to identify wasteful spending and develop strategies to cut costs and...

Member Incentives for Lower Cost Health Services Saved Payer $3.2M

by Thomas Beaton

Commercial payers struggling to curb costs and encourage their members to make smarter financial choices may be able to save millions of dollars each year by investing in modest member incentives. Offering small financial rewards for...

Amazon, JP Morgan, Berkshire Hathaway Form Healthcare Company

by Thomas Beaton

Amazon, JP Morgan Chase & Co., and Berkshire Hathaway have announced a long-term partnership to form an independent company that focuses on cost-effective healthcare for employees. The company will aim to remove profit-making...

Consumer-Directed Care, High Deductibles Popular for Employees

by Thomas Beaton

Consumer-directed care, high-deductible health plans (HDHPs), and financial benefits related to healthcare spending have increased in popularity and demand by employees from 2017 to 2018, according to a new report from Benefitfocus. The...

DE Shifts Managed Medicaid Contracts to Value-Based Agreements

by Thomas Beaton

Delaware’s Department of Health and Social Services (DHSS) announced it is translating the state’s managed Medicaid Contracts into value-based agreements to improve the outcomes and costs of the state’s public healthcare...

Health Insurance Costs Placing Stress on Majority of Americans

by Thomas Beaton

Sixty-nine percent of Americans with an income of $50,000 a year or more cited the cost of health insurance as a major stressor and 63 percent of Americans with incomes less than $50,000 per year cited insurance costs as a major life...

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