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Value-Based Care News

Humana Expands Value-Based Care Options for Medicare Advantage

March 14, 2019 - Humana has announced a series of initiatives to increase value-based care for orthopedic services among its Medicare Advantage members. The organization will partner with orthopedic and neurosurgery practices to launch a new value-based bundled payment initiative specifically designed to provide coordinated care to Humana Medicare Advantage members undergoing spinal fusion...


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Amazon-Backed Health Venture Reveals Name: Haven Healthcare

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The partnership between Amazon, Berkshire Hathaway, and JPMorgan Chase now has a name in addition to a high-profile executive team.  The venture, which aims to reduce costs and develop innovative approaches to care will be known as...

70% of Employers Offer Packaged Health, Dental, Pharmacy Benefits

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Seventy-one percent of employers with 100 or more employees are either actively integrating or considering integrating their medical, dental, vision, and pharmacy benefits under their health and wellness programs in the next five years,...

HHS Launches Emergency Services Payment Model for FFS Medicare

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HHS and the CMS Innovation Center have announced a new payment model for emergency and ambulance services that will enable Medicare fee-for-service beneficiaries to receive quality care with lower out-of-pocket costs. The new payment...

Blue Cross, HCSC to Reduce Food Insecurity Among Plan Members

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Blue Cross Blue Shield (BCBS) Institute and Health Care Services Corporation (HCSC) have launched a health food delivery service that will help reduce food insecurity and health disparities for plan members. Called foodQ, the service will...

NCQA Seeks Comment on Proposed Updates to HEDIS Quality Measures

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The National Committee for Quality Assurance (NCQA) is seeking comments from health plans, purchasers, consumers, and other stakeholders on proposed updates to the Healthcare Effectiveness Data and Information Set (HEDIS)...

Humana, Aledade Bring Value-Based Care to Medicare Advantage Members

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Humana and Aledade have announced a value-based care agreement that will increase access to value-based care for Medicare Advantage members. The partnership will enable physicians in Aledade’s accountable care organizations (ACOs)...

Atrius Health, Blue Cross to Create Alternative Payment Model

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Atrius Health and Blue Cross Blue Shield of Massachusetts have partnered to launch an advanced alternative payment model that will deliver a higher quality, more affordable healthcare experience. In this new venture, the organizations...

Cigna Value-Based Care Participation Tops 50%, Saving $600M

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Cigna has surpassed its goal of having 50 percent of its Medicare and commercial health reimbursements tied to value-based care models in top markets by the end of 2018, the payer announced. Between 2013 and 2017, value-based care...

UPMC, AstraZeneca Enter Value-Based Pharmaceutical Contract

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UPMC Health Plan and AstraZeneca are taking on the challenge of a value-based pharmaceutical contract for one of the manufacturer’s cardiovascular medications. Reimbursement for prescriptions of BRILINTA, a drug intended to help...

CMS Tackles Drug Costs with New Medicare Advantage, Part D Models

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CMS’s Center for Medicare and Medicaid Innovation has launched a new payment model and updated an existing model aimed at helping Medicare Part D and Medicare Advantage plans to lower drug prices and better serve...

Payer Investment May Improve Delaware Primary Care Access

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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...

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...

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