Humana’s value-based care models in Medicare Advantage helped lower emergency room admissions and, in turn, boosted savings for Medicare Advantage members, according to the payer’s recent...
When a major crisis hits, gathering quality measures data can be challenging or nearly impossible with the current strategies.
In order for a health plan to be accredited by the National Committee for...
Phone calls, secure direct messaging, and remote patient monitoring are the three leading modalities that form the backbone of payer telehealth technologies.
According to the Centers for Disease...
Under Medicaid expansion, Texas could receive around $5.4 billion from the federal government to cover Medicaid costs. The state could also cover a larger portion of its significant uninsured...
For three major payers, surprise billing policies had an impact on premiums, a study published in the American Journal of Managed Care found.
The researchers used data from the Health Care Cost...
A misalignment between payers and providers on their definitions of value, frequency of communication, and trust in their partnership is impeding value-based care efforts, according to research from...
Home healthcare and remote monitoring are increasingly critical to providing value-based care, improving quality while keeping costs low.
Experts have discovered that, in some cases, remote patient...
The Core Quality Measure Collaborative (CQMC), a partnership between America’s Health Insurance Plans, CMS, and the National Quality Forum (NQF) that establishes quality measures to promote...
Private payers are paying hospitals 2.5 times more than the Medicare reimbursement rate and employers have a role to play in rectifying the negotiating process, a recent RAND Corporation (RAND) study...
Going into what would be a tumultuous year for Medicare, twelve Medicare Advantage payers proved to be leaders in their field with five-star Medicare Advantage Star Ratings.
In a recent post, Matt...
Minorities may see a sharper loss in employer-sponsored health insurance than White populations in America, which would drive racial coverage and health disparities even deeper, a recent report from...
CMS has issued a letter to Medicaid directors regarding how states can accelerate their Medicaid value-based care adoption, based largely on lessons learned in CMS efforts toward value-based care in...
UnitedHealthcare and Canopy Health are introducing a new employer-sponsored, concierge-style health plan that incorporates free access to primary care services.
“In designing the California...
Medicare Advantage special needs plans (SNPs) may help control healthcare spending for patients with end-stage renal disease (ESRD), a recent study published by Health Affairs found.
CMS established a...
States, employers, and the federal government must each play a role in supporting sustainable employer-sponsored insurance spending solutions during the coronavirus pandemic, a recent United States of...
While payers are pursuing high quality substance abuse care for their members, supporting employees through substance abuse and reducing stigmas around the opioids epidemic is equally critical,...
Under a newly revised bill from the California state legislature, California health plans will have to cover mental health conditions to the same extent they do medical services in an effort to achieve...
For the past couple of years, employers have increasingly used centers or excellence (COE) to bolster the quality of healthcare benefits, but health plans can leverage these centers as well to improve...
Employers find the health plan selection process cumbersome and are not aware of how to compare health plan quality measures using the National Committee for Quality Assurance (NCQA) tools, two NCQA...
Blue Cross and Blue Shield of Minnesota (Blue Cross) struck a six-year value-based contract with Allina Health that focuses on quality improvement and cost savings through care coordination,...
