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Dispelling the Most Common Myths About Virtual Care
Virtual care has become a staple of healthcare during the coronavirus pandemic, and the positive experiences of patients with remote access signal that its utility will extend well into the...Payers See Low Employer Satisfaction, Provide Limited Support
Employers are largely underwhelmed by payer efforts in a variety of areas including value-based care payment reform, resulting in low employer satisfaction rates, according to a survey from The...5 Ways Payers Can Improve Quality Measures for Chronic Members
Updated 7/7/2020: This article has been updated to reflect that CitiusTech is solely responsible for the “COVID-19 Impact on Quality Management” survey. A previous version associated...AMA: Payers Did Not Fix Prior Authorization, Cut Provider Burden
Payers have not lived up to their promise to improve the prior authorization process, the American Medical Association (AMA) charged in a recent statement. In 2018, groups including America’s...Challenges in Adopting a State-Based Health Insurance Marketplace
As several states look to launch a state-based health insurance marketplace (SBM), experts warn that policymakers should weigh the decision carefully and pursue a marketplace only as part of a...Out-of-Pocket Costs for Supplemental Coverage a Problem for MA
More Medicare beneficiaries are accessing dental, vision, and hearing coverage through Medicare Advantage, but their plans are not getting adequate financial protections from out-of-pocket costs for...Members Won’t Back Healthcare Price Transparency If Costs Go Up
Three in four adults would not support a federal regulation that improved healthcare price transparency if the rule raised the cost of health insurance premiums, according to a new Morning Consult...Humana Foundation Allots $7.6M to Social Determinants of Health
The Humana Foundation announced it is investing $7.6 million in eight communities across the southeastern United States to address social determinants of health (SDOH), according to a recent press...BCBS NC, Quartet Partner to Implement Value-Based Payment Model
Blue Cross and Blue Shield of North Carolina and New York City startup Quartet have announced a partnership to implement a new value-based payment model for mental healthcare. The...Louisiana’s Medicaid Managed Care Contracts in Disarray
Louisiana’s chief procurement officer recently threw out several multibillion-dollar Medicaid managed care contracts after uncovering the mismanagement of the bid process, according to national...How Medical Rideshare Deals in Medicare Drive Quality Outcomes
Keeping a Medicare patient healthy might seem clear cut at first glance – lean on primary care, foster medication adherence, and address mental health concerns. But quality outcomes are difficult...Payers Kick-Start 2020 Social Determinants of Health Strategies
2019 was a big year for payers in pursuit of social determinants of health. Many payers invested resources and funds toward addressing the challenges their members faced in accessing quality...Value-Based Reimbursements Hit 53% in 2017, Reform Slows
Update 1/7/2020: This article was updated to reflect that half of the reimbursements in the commercial sector made in 2017 were value-based. Previously, the first line of the article stated that half...Highmark Health Plan Brings Inpatient Quality to MA Home Health
Highmark Health Plan and Contessa are collaborating to raise post-discharge home health to inpatient quality of care levels for Medicare Advantage members. "Creating a value-based experience that...Eliminating Waste, Promoting Value Across the Health System
Healthcare spending accounts for 18 percent of the entire United States GDP. While nearly one-quarter of this spending is unnecessary and wasteful, removing waste from the healthcare system is a...Sponsored Article
