Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value Based Insurance

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...

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...

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...

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...

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...

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...

Payer Housing Partnership Addresses Social Determinants of Health

by Thomas Beaton

Health Partners Plans (HPP) and two community programs in Philadelphia announced a partnership to address housing-related social determinants of health by connecting homeless individuals to healthcare services, free clinics, free meals,...

Ongoing Payer Consolidation Leads to Consumer Premium Hikes

by Thomas Beaton

The four largest payers in the US have continued to get bigger over the past few years, said Leemore S. Dafny, a professor of the Bruce V. Rauner Professor of Business Administration at Harvard Business School, during a House Energy and...

NCQA Seeks Stakeholder Comments on Updated HEDIS Measures

by Thomas Beaton

NCQA is seeking health plan, provider, and related stakeholder public comments to weigh in on updated HEDIS measures and the implementation of new measures related to chronic disease management. NCQA wants to implement measures related to...

70% of Providers See Data Sharing as Key to Value-Based Care

by Thomas Beaton

Seventy percent of executives participating in a survey conducted by Humana and HFMA believe that the need for interoperability and seamless data sharing will be required for payers and providers to succeed with value-based care. The...

80% of Payers Aim to Address Social Determinants of Health

by Thomas Beaton

Eighty percent of payers believe that addressing the social determinants of health (SDOH) of their beneficiary populations will be a key way to improve their population health programs, according to a new Change Healthcare survey. The...

Lawmakers Propose HDHP Coverage for Chronic Disease Prevention

by Thomas Beaton

A new bill introduced into the House and Senate would allow high-deductible health plans (HDHPs) to provide chronic disease prevention services before a patient meets his or her deductible, which could help to accelerate a growing HDHP...

Employer Guide Offers Strategies for Wellness Program Success

by Thomas Beaton

An employer guide developed by The Transamerica Center for Health Studies (TCHS) and the Interdisciplinary Center for Healthy Workplaces (ICHW) determined that employers may need a better understanding of the factors that inhibit wellness...

71% of Workers Satisfied with Employer-Sponsored Health Plans

by Thomas Beaton

Over 70 percent of employees are generally satisfied with their employer-sponsored health plans, but are concerned with rising health plan costs, an AHIP study found. Employer sponsored health plans have provided fair premium and...

AHIP: 25% of Opioid Prescriptions Top CDC Dosage Guidelines

by Thomas Beaton

An AHIP retrospective analysis of claims data found that 25 percent of opioid prescriptions were above CDC dosage recommendation and provides a basic snapshot of problematic areas where payers could minimize patient safety risks related to...

House Bill Retains Low-Quality Medicare Advantage Plans until 2027

by Thomas Beaton

Update on 2/12/2018: Presdient Trump signed the spending bill into effect on Feburary 9th, 2018 which funds the government for two years and extends quality deadlines for Medicare Advantage plans.  The latest government spending bill...

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