Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Payers

Payer Input is Key for High Performance Provider Networks

by Thomas Beaton

Payer input is critical for developing high performance networks (HPNs) that are efficient and cost-effective while delivering high quality care, says the Academy of Actuaries in a new report.   HPNs are narrow provider networks...

Cigna, Amazon Alexa Offer Voice Control Beneficiary Education

by Thomas Beaton

Cigna is entering the voice control product space with an Amazon Alexa feature called “Answers by Cigna” that educates beneficiaries about complex health insurance terminology and customizes health benefits...

UnitedHealthcare Finds Value-Based Care Closed 50M Gaps in Care

by Thomas Beaton

Value-based care helped close 50 million gaps in care between 2013 and 2017 while reducing care costs, lowering ED utilization, and increasing provider care quality, according to a new report from UnitedHealthcare (UHC). UHC examined data...

Cigna to Acquire Express Scripts for $67B to Expand Consumer Value

by Thomas Beaton

Update 8/24/2018: Cigna shareholders have overwhelmingly voted to approve the acquisition of Express Scripts.  Approximately 90 percent of shareholders voted in favor of the deal, which is anticipated to close before the end of...

CMS: Payers Must Make Claims Data Available to Beneficiaries

by Thomas Beaton

CMS Administrator Seema Verma recently called on healthcare payers to make claims data available to their beneficiaries. The agency also announced a new initiative called MyHealthEData to give patients control of their healthcare...

UnitedHealthcare Integrates Apple Watch Into Wellness Incentives

by Thomas Beaton

UnitedHealthcare is integrating the Apple Watch into beneficiary wellness incentives, where members can earn the device and financial rewards by participating in a walking program aimed at improving overall member health. The payer will...

BCBS Earned Positive ACA Health Plan Revenues in Uncertain Market

by Thomas Beaton

BlueCross BlueShield of North Carolina (BCBS of NC) earned positive ACA health plan revenues after years of financial losses, citing low medical claims and more available consumers after other payers exited the sale of plans through...

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...

Idaho’s Expansion of Association Health Plans Risks ACA Market

by Thomas Beaton

The Academy of Actuaries warned insurance officials and government leaders in Idaho that the decision to expand the sale of association health plans (AHP) will destabilize ACA individual health plan risk pools and reduce essential health...

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...

Value-Based Care Key to Bipartisan Healthcare System Reform

by Thomas Beaton

A group of five governors developed a bipartisan plan to reform the US healthcare system by using value-based care strategies such as quality reporting, insurance stabilization policies, and encouraging consumers to have a more proactive...

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....

Apple to Launch Healthcare, Wellness Clinics for Employees

by Thomas Beaton

Apple is launching a new healthcare venture, called AC Wellness, that will deliver healthcare and wellness services to the company’s employees, according to major news outlets. The health and wellness clinics will primarily serve...

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...

UnitedHealth Offers Data Analytics to CMS Bundled Payment Program

by Thomas Beaton

UnitedHealth Group will help support a new Medicare bundled payment program by offering data and analytics services to participating providers. The payer announced in a press release that it will contribute data and analytics, technology,...

Medicare Advantage Evaluation Requires Transparent Claims Data

by Thomas Beaton

The growth of the Medicare Advantage (MA)  market requires the release of more claims data to evaluate the commercial and government impact of the program, according to a recent JAMA commentary from the Health Care Cost Institute,...

Employers, Employees Face Disconnect Over Wellness Programming

by Thomas Beaton

More than half of employers believe that their wellness programming is effective for improving health and reducing spending, but only a third of their employees think the same thing, according to a new Willis Watson Towers...

96% of Payers Are Committed to Electronic Prior Authorization

by Thomas Beaton

The vast majority of payers are committed to implementing electronic prior authorization solutions as a way to address administrative problems with prior authorization procedures, according to research published through the ePA National...

X

Sign up for our free newsletter:

Our privacy policy


no, thanks

Continue to site...