Population Health Management

Member Engagement Requires Advanced Analytics, Specialized Team

by Kelsey Waddill

Member engagement strategies need to make better use of advanced analytics, be more attuned to members’ journeys of care, and culminate in a tight, dedicated team with a broad range of...

UnitedHealth Group Unveils Self-Administered COVID-19 Test

by Kelsey Waddill

UnitedHealth Group Research & Development and OptumCare clinicians have determined that self-administered COVID-19 tests are as effective as provider-administered tests and may extend resources and...

Integrated Care Reduces Hospital Stays for Medicaid Children

by Samantha McGrail

Children enrolled in Medicaid and exposed to an integrated care management program experienced a decrease of 0.39 monthly hospital admissions and 2.20 monthly bed-days per 1,000 children, compared to...

3 Ways Payers Drive Population Health Management in Cancer Care

by Kelsey Waddill

The industry’s transition into value-based care is characterized by a focus on data and patient centered care. By driving strong population health management, payers can excel in this value-based...

Community Data Informs Payer Philanthropy for Housing Stability

by Emily Sokol, MPH

Poor or unstable housing contributes to a myriad of negative health outcomes. Developmental risks in young children, asthma exacerbations, and increased rates of depression are just a few of the...

Mergers and Acquisitions Will Strengthen Payer Identity in 2020

by Kelsey Waddill

Payers will seek to strengthen their identities in 2020 and they will use mergers and acquisitions as the tools for transformation, according to a recent HRI’s PricewaterhouseCoopers (PwC)...

Why the Future of Value-Based Care Begins with Children’s Health

by Emily Sokol, MPH

The healthcare industry is continuing to shift its focus from volume to value. Various value-based care models focus on delivering the highest quality care to patients for the lowest...

Payer Philanthropy Won’t Improve Social Determinants of Health

by Jacob Reider, MD

The concept of payer philanthropy has been getting more attention lately as a novel means of solving social determinants of health (SDoH) issues, but it’s an approach that may not be the right...

Strategies for Managing Chronic Conditions in Rural Areas

by Emily Sokol, MPH

Over half of American adults have a chronic condition, including hypertension, diabetes, and chronic lung disease, the leading drivers of health care costs. Access to proper medical treatment, proper...

Payer-Provider Partnership, Data Management Promote Population Health

by Emily Sokol, MPH

Successful value-based contracts are contingent on payer-provider partnerships. These partnerships must be built on clear lines of communication so payers can support providers in delivering the best...

Health2047 Launches Medicare Advantage Plan to Address SDOH

by Kelsey Waddill

California-based Health2047’s new health plan, Zing Health, will offer a Medicare Advantage plan that aims to address social determinants of health, the company announced. "Zing Health is...

How Payers Transform Volumes of Data into Actionable Information

by Kelsey Waddill

Payers want to know how to drive a personalized care management plan, how to excel at member engagement, and how to improve outcomes, all ultimately to cut costs. But when a payer attempts to answer...

ACA Medicaid Expansion Reduces Mortality Rates, Study Shows

by Kelsey Waddill

The Affordable Care Act’s Medicaid expansion could have saved 15,600 lives in the three years following its initiation if it was put into effect nationwide, according to a recent study from the...

Most Medicare Dual-Eligibles See Social Determinants of Health

by Sara Heath

Over half of dual-eligible Medicare Advantage beneficiaries experience the social determinants of health, revealing a need for better social health programming within the program, according to data...

Using Medically-Tailored Meals to Boost Chronic Disease Care

by Jessica Kent

Chronic diseases are both costly and prevalent, with the healthcare industry shelling out billions each year to manage and treat these conditions. Although illnesses like diabetes, heart disease, and...

CMS to Test New Models for Medicare, Medicaid Dual Eligibles

by Jessica Kent

CMS has issued a letter to state Medicaid directors inviting them to test new, integrated care models for individuals dually eligible for Medicare and Medicaid. There are 12 million dual eligible...

Humana Sees Population Health Gains for Medicare Advantage Members

by Jessica Kent

Medicare Advantage members living in Humana’s seven original Bold Goal communities have seen an improvement in population health, with these individuals experiencing a 2.7 percent reduction in...

Large Employers to Average $3.6M on Wellness Programs in 2019

by Jessica Kent

Large employers across the country are expected to spend an average of $3.6 million on wellness programs in 2019 to support a healthier and more productive workforce, according to a survey from...