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Value-Based Care News

Payer Investment May Improve Delaware Primary Care Access

January 18, 2019 - Payers can expand primary care access in Delaware by progressively increasing primary care spending until it accounts for 12 percent of all healthcare investment, according to a report from Delaware’s Primary Care Collaborative. Investment should primarily focus on value-based care models that can reduce spending and improve population health. Delaware currently lacks the...


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Blue Cross of NC, Major Health Systems Partner for Value-Based Care

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Blue Cross and Blue Shield of North Carolina has launched Blue Premier, a new value-based care model that increases accountability for participating providers and their accountable care organizations (ACOs). Beginning in January of 2019,...

HCTTF Offers Clinical Episode Grouper Resources for Bundled Payments

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The Health Care Transformation Task Force (HCTTF) has released a new set of resources to support payers as they develop innovative bundled payment programs. In a white paper titled Episode Groupers: Key Considerations for Implementing...

NYC Mayor Announces Plan to Guarantee Health Coverage for All Residents

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Mayor Bill de Blasio has announced the launch of a comprehensive, universal healthcare coverage plan that will guarantee benefits for every New Yorker. “Healthcare is a right, not a privilege reserved for those who can afford...

Patient-Centered Methods Help Health Plans Boost Cancer Care

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Employers and payers should ensure their health plans use patient-centered methods and provider performance measurement strategies to reduce costs and improve cancer care, a report from the National Alliance of Healthcare Purchaser...

47% of Payer, Provider Business Tied to Value-Based Care

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Value-based care is nudging the half-way mark as more and more payers and providers shift their contracts away from fee-for-service arrangements, according to the Health Care Transformation Task Force (HCTTF). In a new report, the Task...

ACA, Member Engagement Challenges Led Top 10 Stories of 2018

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It’s fair to say that the health payer community had a lot to process in 2018.  Mergers, partnerships, and new entries into the field rocked the traditional industry setup, while federal efforts to chip away at the Affordable...

Humana Value-Based Care Program Unveils First Participants

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Nearly seven months since announcing its value-based care incentive program for hospitals, Humana has revealed its first participants. Four hospitals have agreed to participate in the Hospital Incentive Program (HIP) for commercial...

Strategies for Designing Consumer-Centric Health Plans

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The Health Care Transformation Task Force recently released a new set of guiding principles to help healthcare industry leaders and policymakers better integrate consumer needs into benefit design. The goal of the task force, a consortium...

Employer-Sponsored Medicare Advantage Enrollment Up 12% for 2019

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Employer-sponsored Medicare Advantage (MA) enrollment for plan year 2019 increased by 12 percent, representing a bump of more than 443,000 individual members, according to a new analysis by Mark Farrah Associates. Individual Medicare...

BCBSAZ Shared Savings Program Reduces Hospital Readmissions by 26%

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BlueCross BlueShield of Arizona’s (BCBSAZ) shared savings program has reduced 30-day hospital readmission rates by 26.3 percent while generating shared savings for providers.. BCBSAZ also reported 15.2 percent fewer ED visits per...

Consumer Demand for High-Deductible Health Plans Dwindles

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Consumer demand for high-deductible health plans (HDHPs) is expected to decline in 2019 as more beneficiaries look for health plans with customized benefits instead, according to a new survey from Oliver Wyman. Half of consumers surveyed...

Cigna: Integrated Pharmacy, Medical Benefits Improve Overall Health

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Integrating pharmacy benefits with medical benefits can help to improve overall health and reduce employer costs, according to a new study released by Cigna. Individuals with connected medical, behavioral and pharmacy health benefits...

Venture-Funded Medicare Advantage Plans Launch into 2019 Market

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Several Medicare Advantage (MA) plans entering the market for the 2019 plan year are backed by millions in venture capital funding and are planning to compete with established payers by promoting new health plan solutions. The recent...

Engagement, Data Analytics Cut Opioid Dependency in Managed Care

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AmeriHealth Caritas has successfully reduced opioid dependency rates among managed care beneficiaries through member engagement and data analytics techniques that promote alternatives to opioid treatments. The payer’s Opioid...

Insured Critical Illness Beneficiaries Face High Treatment Costs

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Health plan members with critical illnesses face high treatment costs and other financial issues even with comprehensive health insurance, said a new survey conducted by the Harvard T. Chan School of Public Health, New York Times, and...

CMS Releases 2019 Medicare Advantage Health Plan Star Ratings

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CMS has released its 2019 star ratings for Medicare Advantage (MA) health plans, noting that the Medicare Advantage market continues to grow in affordability and access for consumers. CMS estimates that 74 percent of MA beneficiaries will...

Payers Partner with Trade Orgs to Roll Out Association Health Plans

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Healthcare payers are beginning to launch partnerships with trade organizations and chambers of commerce to provide association health plans (AHPs) to small businesses and contractors. The roll out of AHPs follows federal and state...

How Payers Can Develop a Medication Therapy Management Program

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As the cost of medication non-adherence reaches over $300 billion annually, payers are increasingly challenged to provide new solutions to address the healthcare and economic impacts of non-adherence. Payers could develop a medication...

Payers Can Leverage Telehealth for Chronic Disease Management

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Telehealth offers a cost-effective way to improve member satisfaction with benefits and support meaningful chronic disease management, according to a new report from AHIP and the Coalition to Transform Advanced Care (C-TAC)....

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