Low-value care services were less common for Medicare Advantage (MA) beneficiaries—particularly those in health maintenance organizations (HMOs)—than for traditional Medicare (TM)...
As the nation continues to experience a mental health crisis, health insurers have developed numerous strategies to help members manage their mental health needs, according to a resource from...
Chronic disease management in diabetes may benefit slightly from value-based care and alternative payment models, but the results will not be substantial until certain policy changes take place,...
Blue Cross and Blue Shield of Florida (Florida Blue) recently formed a value-based care agreement with Healthcare Outcomes Performance Company (HOPCo), a value-based health outcomes...
To decrease the number of complications experienced in home healthcare, Humana expanded the boundaries of onehome, which will now provide various post-acute needs such as infusion care, nursing, and...
HHS and CMS leaders have voiced their affirmation of four states that recently expanded Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage.
California, Florida,...
Payers can offer essential support to providers starting their journey through the value-based care continuum, while further research on value-based care in Medicare Advantage can help inform payers about best practices in this...
Updated 5/13/2022: This article has been corrected to adjust the name of the company which was incorrectly referred to as "Arcadia.io" throughout its section of the article. The company is...
Medicare beneficiaries in low socioeconomic status (SES) areas had higher rates of avoidable hospital admissions and emergency department visits but lower instances of physician and care management...
Blue Cross & Blue Shield of Rhode Island (BCBSRI) has entered into a global capitation agreement in its Medicare Advantage program, according to a press release which HealthPayerIntelligence...
When it comes to obesity and diabetes benefit design, employers can—and should—adopt a health equity mindset, according to a flipbook from the Northeast Business Group on Health...
Maternal healthcare costs in the US are too expensive, but value-based care may provide a solution, according to a brief from AHIP.
“Americans need and deserve safe, high-quality, equitable and...
AHIP called on providers and policymakers to join payers in their efforts to integrate behavioral healthcare and physical healthcare in an issue brief on the subject.
The payer organization laid out...
The healthcare industry is making strides in diminishing low value care spending for commercially-insured patients with chronic low back pain (LBP), according to a research letter published in JAMA...
Payers have a significant role to play in ensuring that underserved populations receive whole person care, particularly among Medicaid beneficiaries.
First, they can serve as a bridge between Medicaid beneficiaries and their primary care...
As Oregon establishes a public option in order to address health equity, it could merge this work with its efforts to unify health equity goals across health insurance markets and the state, a Manatt...
In order to best leverage episodes of care models, employers have to take more ownership of their own data and partnerships.
When Kevin Lembo, former comptroller of the state of Connecticut, took on the role in 2010, the State of...
Priority Health has announced a partnership with Epic and plans to implement the EHR vendor’s payer platform to facilitate patient data exchange with providers, lower healthcare costs, and...
Low-value care in pediatric inpatient care has a high price tag, according to a recent study published in JAMA Network Open on pediatric hospital spending for low-value services.
“As...
Humana has partnered with Vancouver Clinic to expand value-based primary care services to Medicare Advantage members in Oregon.
The primary care practice, Enliven by Vancouver Clinic, will be...
