Medicare Advantage

Medicare Advantage Enrollment Up 125% Among Dual-Eligible Beneficiaries

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In-home care providers with a mission to serve particularly vulnerable populations often target “dual eligibles,” or individuals signed up for both Medicare and Medicaid benefits. The focus on dual-eligible populations is partly driven by mission and values, but it’s also supported by reimbursement. While in-home… Read More »Medicare Advantage Enrollment Up 125% Among Dual-Eligible Beneficiaries

Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

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What You Should Know: – Humana Inc. and Fresenius Medical Care North America (FMCNA) today announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage members – The agreement between Humana and Fresenius Medical Care North America goes into… Read More »Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members

Medicare Advantage Startup Clover Health Slated to Go Public in a $3.7 Billion SPAC Deal

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Clover Health recently announced that it will go public through a merger with a special purpose acquisition company (SPAC), Social Capital Hedosophia Holdings Corp. III. “Going public will enhance our ability to execute on our mission of improving every life, providing significant capital for the… Read More »Medicare Advantage Startup Clover Health Slated to Go Public in a $3.7 Billion SPAC Deal

Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

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People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu illness and are more likely to die of the flu than younger people. This analysis explores variation in the rate… Read More »Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

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What You Should Know: – Independence Blue Cross and Signify Health launches social determinants of health network, CommunityLink to connect data from multiple CBOs to integrate social directly into medical care in the Philadelphia area. – CommunityLink represents one of the first examples nationwide of… Read More »Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

Whistleblower lawsuit accuses Cigna of Medicare Advantage fraud

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A recently unsealed whistleblower case filed by the Department of Justice accuses Cigna of fraudulently overbilling for its Medicare Advantage plans. Allegations claim the company submitted unsupported diagnoses that resulted in “billions” in overpayments.

COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever

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Irv Lichtenwald, President & CEO of Medsphere Systems Corporation In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need… Read More »COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever

Primary care startup Oak Street Health goes public for $328M

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Oak Street Health, which operates primary care centers for Medicare patients, went public on Thursday for $328 million. Its capitation payment model has helped the company continue on where many clinics have struggled during the Covid-19 pandemic.

Humana’s Bruce Broussard: Consumer Demand for Home-Based Care Models Will Continue to Increase

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Humana’s (NYSE: HUM) long-standing home- and community-based focus served the insurer well in Q2 2020 — a quarter dominated by the COVID-19 emergency. The coronavirus pushed more senior care into the home, boosting business for Louisville, Kentucky-based health insurance giant. As a result, the insurer… Read More »Humana’s Bruce Broussard: Consumer Demand for Home-Based Care Models Will Continue to Increase

Oak Street Health files for IPO

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Oak Street Health, a Chicago-based company that operates primary care centers for Medicare patients, filed initial IPO paperwork on Friday. The company has not yet priced the offering, but it plans to use the proceeds to repay a loan and grow its business.

Leading During Disruption: How Synergy HomeCare’s New CEO Took Control Amid COVID-19 Chaos

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Securing stockpiles of personal protective equipment (PPE), doubling down on company-wide training efforts and implementing educational initiatives are just some of the responsibilities that home care leadership teams have taken on during the COVID-19 crisis. While most home care agencies were navigating the public health… Read More »Leading During Disruption: How Synergy HomeCare’s New CEO Took Control Amid COVID-19 Chaos