This analysis shows that more than half of Medicare beneficiaries do not compare coverage options annually during the open enrollment period, despite the fact that Medicare Advantage and Part D plans often change from one year to the next, which could lead to unexpected and… Read More »More Than Half of All People on Medicare Do Not Compare Their Coverage Options Annually
As Medicare Advantage (MA) enrollment explodes and plans begin to offer more benefits to members, home health and home care agencies alike need to prove their value in order to gain new business. Specifically, home health providers need to demonstrate how they can lower costs… Read More »Home Health Agencies Need to be ‘Best of the Best’ to Land MA Business
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
The U.S. Centers for Medicare & Medicaid Services (CMS) last month released new Medicare Advantage (MA) figures highlighting a massive expansion of plans offering home-focused supplemental benefits in 2021. The agency shared additional data on Wednesday — and it now appears the ongoing home care… Read More »Number of MA Plans Offering In-Home Support Services to Increase by 93% in 2021
When it announced plans to go public through a blank-check company, Clover Health shared ambitious projections for its future membership. Much of that growth is pinned on plans to launch a direct contracting business.
Today on Health in 2 Point 00, Jess and I gossip about the wild rumor that UnitedHealthcare is acquiring Amwell. On Episode 157, we discuss Lark raising $55 million in a Series C along with a deal with Anthem to be their preferred DPP provider,… Read More »#Healthin2Point00, Episode 157 | The phrase is “Takeout Speculation”!
Humana, Fresenius Medical Care Expand Partnership to Improve Care Coordination for Medicare Advantage Members
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
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
Medicare Advantage startup Clover Health will go public in a blank-check acquisition led by billionaire Chamath Palihapitiya. The deal will value Clover at $3.7 billion.
What You Should Know: – Walmart announced it will begin selling Medicare insurance plans during this year’s annual enrollment period, Oct. 15 through Dec. 7. Today, Walmart announced the launch of Walmart Insurance Services, LLC, a licensed insurance brokerage, which will assist people with enrolling… Read More »Walmart to Offer Medicare Insurance Plans During 2020 Open Enrollment
Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts
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
The insurer plans to increase the footprint for its Medicare Advantage plans by 50%, adding plans in 300 additional counties.
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
What You Should Know: – Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare for a combined $11B in assets. – The merger creates one large health system totaling of 17 hospitals – 11 Sentara hospitals in Virginia and one… Read More »Cone Health to Merge with Sentara Healthcare Totaling $11B in Assets
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.
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
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 (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
Home health admissions saw a slight decline in volume during the fourth quarter of 2019. Meanwhile, referral trends appear to be holding steady. That’s according to recent data from PlayMaker Health, a post-acute growth platform that serves hundreds of organizations across the country. Specifically, Q4… Read More »Home Health Admissions Down 2.45%; MA Enrollment Up 4%
While the Medicare Advantage (MA) home care opportunity continues to expand, cynics have been quick to criticize it. Some say the opportunity is too small to be worthwhile — and that it’s more of a trendy talking point than a viable business option for most… Read More »24 Hour Home Care Gets Candid About Logistical, Day-to-Day Aspects of MA Partnerships
Clover Health said it plans to triple its footprint in the next year, pending CMS approval. But the insurer has also posted a net loss in recent years.
GoHealth, an online insurance broker focusing on Medicare Advantage plans, went public on Wednesday for $914 million. The company will trade on Nasdaq under the ticker “GOCO.”
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.
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
Walmart quietly launched a new health insurance business. The company, called Walmart Insurance, was filed with the Arkansas Secretary of State last month.
The coronavirus could be the match that finally sparks the Medicare Advantage (MA) boom for home care. The explosion has been a long time coming. It all started when the Centers for Medicare & Medicaid Services (CMS) first expanded the scope of MA supplemental benefits… Read More »Milliman Actuary: COVID-19 Adding Fuel to Medicare Advantage’s Home Care Fire