Value-Based Contracting

How to Drive Enrollment in the ACA Health Plan Marketplaces

by Thomas Beaton

Payers and states wishing to increase enrollment in the ACA health plan marketplaces should  create targeted advertisements, benchmark silver-tier plans as their primary exchange plan, and help...

Customer Satisfaction with Medicare Advantage Health Plans Remain Low

by Thomas Beaton

Medicare Advantage (MA) plans are not meeting their customer satisfaction goals, and tend to leave consumers feeling less-than-pleased with the way health plans communicate and the availability of...

Narrow Networks, Customer Satisfaction Contain Payer Spending

by Thomas Beaton

Payers can curb spending on medical care by investing in narrow networks and customer satisfaction tools, says a new PricewaterhouseCoopers (PwC) Health Research Institute (HRI) analysis. PwC found...

Humana, Walgreens Offer Primary Care Clinics for Medicare Members

by Thomas Beaton

Humana and Walgreens have announced the launch of two primary care clinics, designed to meet the needs of Medicare beneficiaries, that will operate within Walgreens locations in the Kansas City...

Beneficiaries Want More Holistic Health, Wellness Benefit Options

by Thomas Beaton

Health plan beneficiaries are increasing their demand for holistic health and wellness benefits, which can help payers deliver value and improve outcomes, according to a new report from Aetna. The...

Amazon, Berkshire, JPMorgan Name Atul Gawande Healthcare CEO

by Thomas Beaton

Amazon, Berkshire Hathaway, and JPMorgan Chase have named Atul Gawande, a surgeon at Brigham & Women’s Hospital, as the CEO of their joint healthcare company. The company will be...

Customer Service is Primary Driver of Health Plan Satisfaction

by Thomas Beaton

Health plan members are seeking high-quality customer service experiences from their insurers, and will use positive interactions to make decisions about continued loyalty, according to a new Forrester...

Value-Based Payment Adoption Drives 5.6% Reduction in Care Costs

by Thomas Beaton

Payers that implemented value-based payment models reduced healthcare costs by an average of 5.6 percent, improved provider collaboration, and created more impactful member engagement, according to a...

AHIP, BCBSA, AMA Join to Improve Public, Private Payer Ecosystem

by Thomas Beaton

The Partnership for America’s Health Care Future (PAHCF), a newly formed coalition, consisting of leading healthcare provider societies and payer organizations, has committed to strengthening the...

Amazon, Berkshire Hathaway, JP Morgan to Name Healthcare CEO

by Thomas Beaton

The new Amazon, Berkshire Hathaway, and JP Morgan & Chase healthcare company will have its inaugural CEO in the next two weeks, Berkshire Hathaway’s CEO Warren Buffett told...

WellCare Buys Meridian for $2.5B to Grow Medicaid Footprint

by Thomas Beaton

WellCare has entered into a definitive agreement to purchase Meridian Health Plan of Michigan, Meridian Health Plan of Illinois, and MeridianRx in order to increase revenues and expand its footprint in...

Short-Term Wellness Interventions Improve Employee Well-Being

by Thomas Beaton

Short-term wellness interventions can improve employee well-being and may help employers reduce their overall costs while maintaining employee health and productivity, according to a new study...

How Can Payers Get Providers to Use Electronic Payment Systems?

by Thomas Beaton

Healthcare, an industry that lags behind others in technology adoption, is slow to embrace innovative solutions that address business challenges. For payers that want to implement electronic payment...

First Steps for Payers Developing Value-Based Care Initiatives

by Thomas Beaton

Successful value-based care initiatives require payers to learn which populations experience a high prevalence of chronic disease, where their organizations overspend, and how value-based contracting...

How Payers Identify, Succeed in Health Plan Market Opportunities

by Thomas Beaton

Healthcare payers that wish to be known as innovators need to continually be on the lookout for emerging health plan market opportunities that offer strong profit potential. Payers need to monitor...

Assessing Providers for Participation in Value-Based Care Contracts

by Thomas Beaton

Creating strong networks of high-quality healthcare providers can be a major challenge for any payer looking to expand its value-based care contract portfolio. Providers aren’t the only ones...

Cigna Files with SEC to Begin $67B Express Scripts Acquisition

by Thomas Beaton

Cigna has submitted a filing to the Securities and Exchange Commission (SEC) to complete a $67 billion acquisition of the pharmacy benefit manager (PBM) Express Scripts. The payer filed the merger...

Adding Telehealth, Remote Care Benefits into Health Plan Options

by Thomas Beaton

Payers that include telehealth and remote care benefits in their health plan options could position themselves as leaders in health plan value, convenience, and innovation. Health plans are challenged...

MD Extends All-Payer Model, Targets $1B in Medicare Savings

by Thomas Beaton

Maryland Governor Larry Hogan and CMS have announced a five year extension of the state’s All-Payer Model, targeting an additional $1 billion in Medicare savings over the coming years, according...

More Competition May Benefit Medicare Advantage Bidding Process

by Thomas Beaton

The Medicare Advantage (MA) bidding process requires more competition to increase the availability of high quality MA plans for beneficiaries and reduce federal spending, according to a new Brookings...