Medicare Advantage

Alignment Healthcare aims to raise up to $516M in IPO

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Alignment Healthcare, an insurtech startup, has launched its IPO and plans to price its individual shares between $17 and $19. The company offers Medicare Advantage plans and says it uses predictive analytics technology to pinpoint seniors’ care needs.

‘This Is What Patients Want’: Home-Based Care Model Lowers Total Cost of Care by 44%

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A new report from Washington, D.C.-based health care consulting firm Avalere Health is shining a brighter light on home-based care and its ability to drastically lower total cost of care. Released Tuesday, the report takes a comprehensive look at Hartford, Connecticut-based CareCentrix, a health-at-home solutions… Read More »‘This Is What Patients Want’: Home-Based Care Model Lowers Total Cost of Care by 44%

Four takeaways from Alignment’s IPO filing

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Insurance startup Alignment Healthcare filed preliminary paperwork with the Securities and Exchange Commission to go public. It’s another healthcare startup that is banking on the value of its technology in an IPO.

In-Home Care Providers ConcertoHealth, Perfect Health Merge to Form ‘ConcertoCare’

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Two in-home care providers — ConcertoHealth and Perfect Health — announced Wednesday that their organizations have merged. Together, the companies will operate under the name “ConcertoCare.” Aliso Viejo, California-based ConcertoHealth is a value-based care provider organization that delivers a variety of home-based care services. The… Read More »In-Home Care Providers ConcertoHealth, Perfect Health Merge to Form ‘ConcertoCare’

After Successful PDGM Transition, Humana Projects ‘Further Operating Model Advancement’ for Kindred at Home

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Humana Inc. (NYSE: HUM) continues to make significant investments when it comes to building a home-based care strategy. Currently, the Louisville, Kentucky-based company’s in-house home-based care business lines include Humana At Home and Kindred at Home, the largest home health provider in the U.S., according… Read More »After Successful PDGM Transition, Humana Projects ‘Further Operating Model Advancement’ for Kindred at Home

Number of MA Plans Offering SSBCI ‘Social Needs Benefit’ Up 568% in 2021

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In September, the U.S. Centers for Medicare & Medicaid Services (CMS) released high-level data suggesting a huge expansion of new Medicare Advantage (MA) supplemental benefits for 2021. CMS followed that up with specific information on MA supplemental benefits under the “primarily health-related” pathway a month… Read More »Number of MA Plans Offering SSBCI ‘Social Needs Benefit’ Up 568% in 2021

Encompass Health Building MA Momentum, Still Exploring ‘Strategic Alternatives’ for Home Health Business

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All eyes have been on Encompass Health Corp. (NYSE: EHC) since the company first announced it would be “exploring strategic alternatives” for its home health and hospice segment in December. At the time, Encompass Health said it was exploring a number of options for its… Read More »Encompass Health Building MA Momentum, Still Exploring ‘Strategic Alternatives’ for Home Health Business

Value-based care platform Signify Health files for IPO

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Signify Health, a startup that provides in-home healthcare services and value=based payment programs, filed early paperwork for an IPO. The company plans to be traded on the New York Stock Exchange under the ticker “SGFY.”

Net Health Acquires Post-Acute Analytics Platform PointRight – M&A

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What You Should Know: –  Net Health acquires post-acute market analytics platform PointRight to deepen the company’s analytics capabilities, post-acute presence, and support for SNF networks. Net Health, a provider of cloud-based software for specialty medical providers across the continuum of care, today announced that… Read More »Net Health Acquires Post-Acute Analytics Platform PointRight – M&A

MA Beneficiaries See Nearly 20% Fewer Home Health Days Than Traditional Medicare Peers

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Under the Trump administration, federal health care policymakers have long been vocal about the ability of Medicare Advantage (MA) to lower costs and improve outcomes among vulnerable populations. A recent report from the Washington, D.C.-based Better Medicare Alliance (BMA) and consulting firm Avalere Health is… Read More »MA Beneficiaries See Nearly 20% Fewer Home Health Days Than Traditional Medicare Peers

5 Steps for Interoperability Excellence for Healthcare Providers

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Shanti Wilson, Consultant, Freed Associates  As if 2020 couldn’t be any more challenging for healthcare providers, new federal rules on interoperability and patient access, granting patients direct access to their healthcare data, begin taking effect this November and continue into 2022. These rules, while ultimately beneficial… Read More »5 Steps for Interoperability Excellence for Healthcare Providers

Payer Credibility Helps Propel Home-Based Care Company Prospero Health into 16 New States

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Home-based care company Prospero Health announced Tuesday it is expanding into 16 additional states to serve 8,000 new patients in 2021. That vastly increases the company’s footprint. Previously just in 10 states, the move now puts Prospero into 26 states total, allowing it to serve… Read More »Payer Credibility Helps Propel Home-Based Care Company Prospero Health into 16 New States

UnitedHealthcare Advances Home Strategy, Expects to Make 1.7M House Calls in 2020

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A number of major Medicare Advantage (MA) carriers are expanding their supplemental benefit offerings shaped around in-home care next year. UnitedHealthcare, the insurance arm of UnitedHealth Group (NYSE: UNH), is among them. Overall, UnitedHealthcare partners with more than 1.3 million physicians and care professionals across… Read More »UnitedHealthcare Advances Home Strategy, Expects to Make 1.7M House Calls in 2020

Humana Accelerates Value-Based Care Strategy with Home Health Providers, Others

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Humana Inc. (NYSE: HUM) continues to shift its operations toward value-based care payment models, both with internal service lines and with external provider partnerships. The Louisville, Kentucky-based insurance giant is also doubling down on social determinants of health at the same time. Those are just… Read More »Humana Accelerates Value-Based Care Strategy with Home Health Providers, Others

States with the Most ‘Primarily Health-Related’ Medicare Advantage Opportunities for Home Care Agencies

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With hundreds of plans reportedly offering in-home support services in 2021, the coming year is certain to bring more Medicare Advantage (MA) opportunities for home care agencies. But some home care operators will have more opportunities than others due to geographic variability across the MA… Read More »States with the Most ‘Primarily Health-Related’ Medicare Advantage Opportunities for Home Care Agencies

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