Health Plans

“There Isn’t One Health Plan to Save Them All”: Flume Health’s CEO on New Build-A-Plan Biz

By JESSICA DaMASSA, WTF HEALTH Two of the most notable payer venture funds, Optum Ventures and Cigna Ventures, just headed up a $30 million dollar Series A funding round for Flume Health, a startup that basically builds “challenger” health plans. How did this go down? Cédric Kovacs-Johnson CEO & Founder of Flume introduces us to …

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Lark Health nabs $100M to pour into AI health coaching platform

The company, which offers an AI platform that provides personalized health coaching for chronic disease patients, will use the new funds to invest in research and development and to expand its virtual integrations with health plans and employers.

Survey: 40% of health systems ramping up hiring efforts amid workforce shortage

A majority of organizations (93%) said they are focused on both attracting and retaining top talent, a new survey from Aon shows. They are offering various benefits to do so, including onsite or near-site health clinics for employees.

Justice Department joins False Claims lawsuits against Kaiser Permanente

The government has intervened in complaints alleging Kaiser Permanente entities defrauded Medicare out of “tens of millions of dollars” by knowingly submitting false diagnoses for Medicare Advantage beneficiaries. Kaiser denies the allegations, saying it is in compliance with program requirements.

Report: First half of 2021 sees massive spike in number of data breach victims

Provider organizations accounted for 73% of all data breaches reported to the HHS in the first six months of 2021, impacting about 22.7 million individuals overall, a new report shows. This represents a 185% jump in individuals affected compared to the same period last year.

UnitedHealthcare nixes some out-of-network coverage for non-emergencies

Per a policy update that went in to effect July 1, the health insurance giant is not covering non-emergency services that members receive at out-of-network facilities that are outside of their service area. This update mainly affects residential treatment facilities, inpatient rehabilitation and other non-hospital-based services.

Driving member engagement with health plan data analytics

As Spotify and Amazon can attest, digital technology plus personalization is a winning formula. Consumers want anytime-anywhere access to the services and products they enjoy, without having to sift through irrelevant information. They want tailored recommendations that will make their life easier. More than eight in ten consumers say they’re more likely to choose businesses …

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CMS’ new Geo care delivery model: 5 things to know

The new Geographic Direct Contracting Model aims to improve quality of care and slash costs for Medicare beneficiaries across an entire region. It involves setting up risk-sharing arrangements where participants will be responsible for the total cost of care for beneficiaries in the region.

Health in 2 Point 00, Episode 138 | Health Tech Funding in Late July?

There is still health tech funding going on in late July? Wow! On Episode 138 of Health in 2 Point 00, Jess asks me about Ro getting $200M from General Catalyst to expand their Telehealth platform, Indigo Diabetes raising 38M Euros to develop its CGM Sensor, Angle Health landing $4M to create a health plan …

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