These next few months are a tremendous opportunity to build trust with customers — imagine the reciprocal goodwill if a payer’s message helps its members get to the front of the line.
The new joint venture will bring K Health’s artificial intelligence-driven technology to the consumer, employer and insurer markets. The solution enables patients to understand their symptoms and connect with a doctor if needed.
As part of its ongoing effort to improve maternal outcomes in the country, the government has approved Illinois’ request to extend full Medicaid coverage for new mothers. The approval extends the coverage from 60 days to one year and will give about 2,500 women living… Read More »Illinois first state to offer full Medicaid benefits to women one year postpartum
What You Should Know: – Boston-based health IT company Cohere Health has closed a $36 million Series B funding round led by Polaris Partners, with additional participation from new investors Longitude Capital and Deerfield Management, as well as existing investors Flare Capital Partners and Define Ventures. The round comes less than a… Read More »Cohere Health Raises $36M to Automate Prior Authorization Between Payers & Providers
Cohere Health raised $36 million in a Series B funding round less than two years after its inception. It will use the new funds to expand its prior authorization platform and integrate health plan benefits to eliminate missed opportunities for care.
The first quarter of 2021 has been one of investor optimism as the vaccine rollout continues ahead of expectations and economic activity begins to accelerate in response. Within the Health IT industry, the already strong investment and M&A trends seen in 2020 have only accelerated. Over the… Read More »Q1 2021 Health IT/Digital Health PC/VE, M&A, IPOs/ SPACs Activity
Traditional patient care patterns have been radically altered by the COVID-19 pandemic. And after more than a year of disruption, it’s doubtful that everyone will revert to those patterns after the pandemic. New habits have been formed, and consumers are more willing to pursue the… Read More »Does Telemedicine Impede or Help the Patient-Centered Medical Home?
Centene has rebutted the accusations made in a sealed lawsuit filed by the Ohio attorney general that accused the insurer of over-billing the state’s Medicaid department. The lawsuit is based on a misunderstanding of how Medicaid billing operates and should be unsealed, Centene said.
Sandeep Pulim, MD, Chief Medical Officer at Bluestream Health There’s no question that the demand for telehealth and virtual care has grown exponentially over the last twelve months. With that growth has come a fundamental shift in the attitude toward virtual care. No longer do… Read More »How a Virtual Care Mindset Leads to Greater Patient Acceptance and Sustainable Telehealth Growth
Insurance technology startup Bright Health has purchased Zipnosis, which provides telehealth services. Though details of the new transaction are sparse, the acquisition aims to lower healthcare costs and expand access to quality care.
A group of healthcare stakeholders in Oregon signed a compact that aims to spread advanced value-based payment models across the state. Though it is not legally binding, the agreement sets a target to tie 70% of healthcare payments to value within the next four years.
U.S. Anesthesia Partners has filed lawsuits against UnitedHealthcare in Colorado and Texas, accusing the payer of forcing it out of network and intentionally interfering with its relationships with providers in those states. But, according to UnitedHealthcare, the lawsuits are an attempt to get the insurer… Read More »Lawsuit: Like a “boa constrictor,” UnitedHealthcare squeezed anesthesia group out of competition
Insurance startup Bright Health is reportedly planning to raise up to $1 billion in an IPO that will be launched in the second quarter of 2021. The company, which provides several insurance products as well as an IT platform, could be valued at more than… Read More »Report: Bright Health eyes $1B IPO
Peter Nelson, VP & General Manager, Global Alliances at GHX There’s an old adage that every challenge is merely an opportunity in disguise. COVID-19 highlighted the healthcare industry’s ongoing challenge with producing clean, standardized data. As the industry looks to rebound from the severe financial… Read More »Boost Operational, Clinical and Financial Performance with Good Data
Birju Shah, Head of Product for Uber Health & Communities Nick Jordan, Founder and CEO, Narrative In a world where technology and Big Data can provide us with instantaneous access to our banking transactions, and our financial information and credit reports can be retrieved with a… Read More »COVID Exposed The Dire Need for Real-Time Healthcare Data Sharing
Medicare Advantage beneficiaries spend $1,640 less per year on healthcare than those enrolled in traditional fee-for-service Medicare plans, a new report shows. But, despite the difference in savings, satisfaction levels for both types of plans are similar.
As Amazon starts to roll out its telehealth and pharmacy offerings, most big health systems and insurers don’t yet view it as a threat. But pharmacy benefit managers and vertically integrated payers will be keeping a watchful eye on the company as it starts to… Read More »With telehealth, pharmacy offerings, Amazon starts to encroach on PBMs
Dr. Miller, Medical Director of CancerLinQ LLC Despite decades of scientific progress against cancer, access to treatment remains highly unequal. Some of the reasons — like institutional racism and poverty — are a reflection of our broader society. Other inequities may go unrecognized but are… Read More »To Advance Health Equity, Put Real-World Cancer Data to Work
The partnership between the insurer and EHR giant — announced a year and a half ago — will now focus on streamlining prior authorizations and offering providers enhanced insights about their patients. Ochsner Health will be among the first to implement the new capabilities offered… Read More »Epic-Humana partnership enters new phase focused on prior authorizations
What You Should Know: – NeoGenomics, Inc., a provider of cancer-focused genetic testing services and global oncology contract research services announced it has reached an agreement to acquire precision oncology platform Trapelo Health for $65M. The agreement purchase price of $65 million, consists of $35… Read More »NeoGenomics Acquires Precision Oncology Platform Trapelo Health for $65M
Becoming mired in discussions about public versus private options is not the best avenue, Instead, we can work to make Covid-related state executive orders permanent.
What You Should Know: PatientPing, a comprehensive care collaboration platform, today announced that it has entered into a definitive agreement to acquire Appriss Health, a cloud-based care coordination software and analytics solutions focused on behavioral health and substance use disorder. – Together, PatientPing and Appriss, backed by Clearlake Capital Group, L.P. and… Read More »Apriss Health Acquires Care Coordination Platform PatientPing
What You Should Know: – AppliedVR, a Los Angeles, CA-based company advancing the next generation of digital medicine, today announced $29 million in Series A funding, bringing its total funds raised to date to $35 million. The round, which includes key investors F-Prime Capital, JAZZ… Read More »AppliedVR Lands $29M for VR Platform to Treat Chronic Pain
– Innovaccer, Inc., a leading healthcare technology company, announced the launch of its Provider Network Management solution to assist healthcare payers access complete view and exercise control over their provider network performance. – The Provider Network Management solution is powered by the Innovaccer Health Cloud… Read More »Innovaccer Launches Provider Network Management Solution for Payers on the Innovaccer Health Cloud
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.
The healthcare analytics company will use the funds, raised in a Series C financing round, to scale its cloud-based platform that offers providers, payers and pharma companies insights to inform business decision-making.
While Covid-19 requires physicians and hospitals to be more efficient than ever, a number of legal structures must be considered before providers consolidate their resources. To optimize patient care and ensure rapid payment for services, avoid running afoul of these sometimes counterintuitive regulatory schemes.
The federal price transparency rule for hospitals went into effect Jan. 1, but a new analysis shows that a majority of providers studied were “unambiguously noncompliant.”
President Joe Biden recently signed the $1.9 trillion Covid-19 relief package into law. The American Rescue Plan Act includes several provisions to boost coverage under the ACA, like widening eligibility for premium tax credits.
For providers and payers, a limited budget is the biggest hurdle to executing their data strategy, followed by disparate data sources and the quality of data available, according to a new survey that includes responses from 200 healthcare leaders.
What You Should Know: – Tegria today announced the acquisition of Cumberland, a leading healthcare IT consulting and services firm for payers and providers. Financial details of the acquisition were not disclosed. – The acquisition accelerates the growth of Tegria, launched by Providence in October… Read More »Providence-Backed Tegria Acquires Healthcare IT Consulting Firm Cumberland
Whether it is conquering the last mile in healthcare, meeting the country’s mental health crisis head-on or leveraging digital health tools effectively, trust will be central to the future of the member experience.
CMS has increased the Medicare payment rate to $40 for administering single-dose Covid-19 vaccines and $80 for two-dose vaccines. The payment increase aims to support providers as they ramp up vaccine administration.
The Ohio attorney general has filed a lawsuit alleging that a Centene subsidiary, which provides Medicaid services in the state, hired multiple companies to administer pharmacy benefits in order to inflate costs. As a result, the state’s Medicaid department paid millions in overcharges.
In a lawsuit filed three years ago, Aetna alleged that Mednax had overbilled for medical procedures and services. Now, the insurer is accusing the medical group of destroying evidence pertaining to the suit and has asked a federal court to sanction Mednax.
Blue Cross and Blue Shield of Minnesota has filed a class-action lawsuit — on behalf of itself and insurers from 30-plus states — against Martin Shkreli and Vyera Pharmaceuticals. The suit alleges the defendants intentionally monopolized the market for Daraprim to raise the price of… Read More »Insurers sue ‘pharma bro’ Martin Shkreli, company for alleged price gouging
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.
Members of America’s Health Insurance Plans and the Blue Cross Blue Shield Association are launching an initiative to help seniors in underserved communities get access to the Covid-19 vaccine. They aim to get 2 million Americans, older than 65, vaccinated.
A new startup has entered the highly competitive insurtech market — with $50 million in new funds. Circulo, co-founded by Olive CEO Sean Lane, is a Medicaid managed care company that plans to build a platform to improve care delivery and member experience.
Eric Demers, CEO of Madaket Health Provider data management is usually discussed from the provider perspective: the busy staff, the needless paperwork amid a pandemic, the faxing, emailing and uploading of data. In these scenarios, the health plans are often painted as the villains for… Read More »Payers Struggle with Provider Data Management Too
Hillrom axed plans to acquire cardiac monitoring company Bardy Diagnostics over reimbursement changes by a Medicare contractor. Bardy filed suit against Hillrom on Sunday.
Per the partnership, Geisinger Health Plan’s half a million members will gain access to Tomorrow Health’s services, which focus on coordinating medical supplies for home-based care. Tomorrow Health’s platform connects patients to medical equipment suppliers and guides them through the purchase process.
What You Should Know: – Health Gorilla raises $15M to scale its FHIR-based API solutions for digital health and expand into new markets. – Health Gorilla will introduce new APIs to enable consumer access to medical records, payer-to-payer data sharing, and data quality assessments. Health… Read More »Health Gorilla Nabs $15M to Expand FHIR-based APIs for Digital Health
Prior authorization is a massive and growing problem for patients and providers, and regulation is not likely to solve it completely or anytime soon.
A new CMS rule would require insurers to cover Covid-19 tests, even for asymptomatic patients. It builds on previous legislation requiring payers to cover the cost of both testing and vaccines for their members.
The health system and payer are joining forces to offer Medicare Advantage patients access to Mercy’s telehealth center. They also plan to implement a value-based payment model, tying reimbursement for Mercy clinicians to care quality measures.
The insurer is buying the telehealth company for an undisclosed sum through its health services portfolio Evernorth. The acquisition will enable Evernorth to offer a 24/7 virtual care platform to health plans and employers, including non-Cigna members.
What You Should Know: – Innovaccer closes Series D round of growth capital bringing Innovaccer at a total valuation of $1.3 billion. – In addition, the company has launched the Innovaccer Health Cloud, a platform as a service that combines the company’s Data Activation Platform… Read More »Innovaccer Reaches $1.3B Valuation, Launches Health Cloud Platform
Insurance startup Oscar Health plans to price its IPO between $32 and $34 per share. The New York-based startup plans to trade on the New York Stock Exchange under the ticker “OSCR.”
As Covid-19 joins the ranks of cancer and chronic diseases to be tracked and prevented through testing, health plans will need testing solutions that can be distributed quickly and at scale.
Moha Desai, Principal, Healthcare Strategy & Transformation Health systems across the country will require a plan to react to government deep spending cuts and revenue shortfalls due to the COVID-19 pandemic. Hospital services have seen a significant downturn in demand in 2020, and the recent… Read More »11 Best Practices of a Successful Care Model Transformation Plan
There were nearly 600 healthcare data breaches in 2020, a 55% jump from 2019, a new report shows. Not only did the number of data breaches spike in the past year, but the average cost per breach increased by about 10%.
Insurer participation in the ACA individual marketplace is on the rise and the trend is driven by policy changes at the federal level and the lingering effects of the Covid-19 pandemic.
After completely exiting the ACA exchanges in 2018, CVS plan to re-enter them in 2022. Last year, enrollment through federal exchanges increased, and Aetna CEO Karen Lynch said the markets have stabilized.
Through a new collaboration, Humana’s Employer Group members will gain access to IBM Watson Health’s AI-powered digital assistant. The chatbot will provide information on member benefits, claims, referrals and cost estimates for medical services.
The Missouri-based health system and payer have entered into a new cooperative care agreement that aims to reduce costs while improving both outcomes and patient experience. The agreement includes a closer alignment between clinical care and reimbursement as well as increased data flow between Mercy… Read More »Mercy, Anthem ink agreement to enhance care, drive down costs
Insightin Health aims to help payers retain and engage their members via its proprietary platform. The funding round was co-led by the Blue Venture Fund, a collaboration between Blue Cross Blue Shield companies, the Blue Cross Blue Shield Association and Sandbox.
Paging Dr. Burnout: How to alleviate physician administrative burden and still reach value-based care goals
Engaging and listening to physician leadership early and often can make the VBC transition smoother and less complex over time for both providers and payers.
Two UnitedHealthcare policies have raised several concerns among providers, including that they may display anti-competitive behavior and could block patient access to certain healthcare services. The American Hospital Association is asking the FTC and CMS to review and potentially block these policies.
Oscar Health filed preliminary paperwork for an IPO on Friday. The health insurance startup is betting that its technology can give it an edge as it fights for market share with bigger competitors.
Astrata, a spinout of UPMC’s innovation arm, has developed natural language processing tools that can help providers and payers adhere to quality measures. This can, in turn, help healthcare organizations bolster their finances as reimbursement is increasingly being tied to these measures.
What You Should Know: – Each year, the US healthcare industry spends $39 billion on 9 administrative transactions, according to a new report from CAQH. – The 2020 CAQH Index also uncovered that by automating these transactions, the industry could save $16.3 billion annually–a 42%… Read More »Healthcare Can Save $16.3B Automating Administrative Transactions, Report Finds
After a scathing report from short-seller Hindenburg claiming that Clover faced a False Claims Act investigation, the insurance startup’s stock plummeted. Clover went public last month after merging with a special-purpose acquisition company under billionaire investor Chamath Palihapitiya.
Medicare Advantage providers need to get ahead of the tide by proactively considering what they can do to suit their enrollees’ new, tech-savvy preferences — now and in the future.
The upcoming MedCity INVEST conference will include a new session, Ask the Investor. The goal is to provide a forum for healthcare startups to better understand investment strategies for different groups and to ask investors questions.
The payer is expanding access to Freespria’s digital device that aims to eliminate or reduce symptoms of panic disorders and post-traumatic stress disorder. The expansion will give Highmark’s managed Medicaid and Medicare Advantage members access to the device as well as to telehealth coaching on… Read More »Highmark expands access to device that helps manage panic, PTSD symptoms
Chris Evanguelidi, Director, Enterprise Healthcare Market for Redpoint Global Inc. Researchers from Johns Hopkins published a study in October on the impact of the pandemic on health care delivery. Among its findings, the data show a 21.4% decrease in primary care visits in Q2 of… Read More »A Patient Engagement Strategy Needs to Deliver a Holistic Experience
At this time every year payers employ teams of people whose full-time job is calling a doctor’s office, requesting information, and waiting weeks for the data to be mailed in hard copy or being required to physically drive to the provider location to pick up… Read More »It’s that time of year – payer Groundhog’s Day
Interest in home-based care is rising amid the Covid-19 pandemic. In line with this trend, Humana is joining forces with an in-home care provider to offer its members access to hospital-level care at home.
Amnon Drori, CEO of Octopai The healthcare industry, like many others, has become a data driven industry collecting data from patients, doctors, labs, and payers that are all crucial to patient healthcare diagnosis and outcome. When it comes to research, data can be useful in… Read More »Healthcare Metadata Management: 3 Critical Capabilities to Creating A Unified, Automated Approach
The payer-agnostic subsidiary, Partners in Primary Care, operates primary care centers for thousands of senior U.S. citizens. It has an aggressive growth strategy, with plans to open up to 20 new centers this year. The company is also on track to have 100 centers open… Read More »Humana’s primary care subsidiary to open 100 centers for seniors by 2023
The Biden administration established a special enrollment period to give uninsured Americans a chance to sign up for insurance on the HealthCare.gov markets. Providers and payers applauded the announcement, but it remains to be seen whether the move will encourage people to get insured.
doc.ai logo What You Should Know: – Sharecare acquires doc.ai to expand its engineering expertise, accelerate digital transformation of healthcare through innovative AI platform for an undisclosed sum. – Founded in 2016, the company licenses AI modules and creates products for a portfolio of clients,… Read More »Sharecare Acquires AI-Enabled Digital Transformation Platform doc.ai
Aetna will now cover breast augmentation for trans women, signaling hope for increased access to healthcare for the transgender community. The coverage expansion comes after transgender individuals and groups advocated for the change.
What You Should Know: – Care Simple, Epic, and MetroHealth System announced that they have entered into a strategic remote patient monitoring integration partnership. – Under the terms of the agreement, CareSimple will empower the Cleveland, Ohio public health system with simple, patient-friendly RPM solutions… Read More »MetroHealth System, Care Simple, Epic Launch Remote Patient Monitoring Program
The new startup unicorn’s insurance product enables members to shop for medical services and pay directly for care. The company raised $125 million in a recent funding round, boosting its valuation, which it will use to increase its footprint and launch new products.
With the Democrats leading the Senate and House, and Joe Biden installed as president, the Affordable Care Act will be restored and strengthened over the next four years, an expert from the Kaiser Family Foundation predicts.
Strategic decisions payers make today will determine how ready they will be for a future where patients expect their healthcare to be as seamless as online shopping.
Health plans have been fighting against inaccurate member data, incomplete member profiles and duplicate records for years. Without a watertight way to keep track of patient identities so health data is reliably linked and accessible across multiple services, payers can’t always be confident that the… Read More »How a unique patient identifier gets health plans closer to interoperability
UnitedHealth’s 2020 revenue jumped by $15 billion from the year before. As the payer gears up for 2021, leaders except to see demand for telehealth and online pharmacies continue, driving their focus on these services.
The Pennsylvania-based insurer is offering members using its small group products access to the NeuroFlow app, which provides self-guided activities to combat mental health issues.
What You Should Know: – Aledade raises $100 Million in Series D funding to help more primary care practices thrive in value-based care. – The new funding will power the growth of a nationwide network of more than one million patients by further expanding into… Read More »Aledade Secures $100M for Value-Based Primary Care, Reaching $2.1B Valuation
In the face of COVID-19, healthcare witnessed how crises can become the long-awaited push for creativity and innovation that the industry needs. When our healthcare infrastructure’s weaknesses were exposed, telehealth helped to stitch them up, with the number of telehealth claims increasing 8,336% nationally from… Read More »3 Steps to Maintain Telehealth’s Momentum Post-Pandemic
The telehealth company and managed care organization are launching a new HMO plan on the Texas health insurance exchange. The ‘virtual-first’ plan is designed for those who do not qualify for Medicaid or Medicare.
Partners David McClellan, Rock Morphis, Paul Wallace (Left to Right) What You Should Know: – Healthcare private equity firm Heritage Group launches a $300M fund to invest in high-growth healthcare services and technology companies. – Heritage is backed by some of the leading healthcare organizations… Read More »Healthcare PE Firm Heritage Group Launches $317M Health Tech Fund
The agency has finalized a rule that allows it to provide immediate Medicare coverage for FDA-approved products that are deemed “breakthrough devices.” The new coverage process would enable seniors to get access to these devices more quickly, but some provider and payer groups are concerned… Read More »New CMS rule to enable immediate coverage for FDA-designated ‘breakthrough’ devices
What You Should Know: – NeuroFlow raises $20M to expand its technology-enabled behavioral health integration platform, led by Magellan Health. – NeuroFlow’s suite of HIPAA-compliant, cloud-based tools simplify remote patient monitoring, enable risk stratification, and facilitate collaborative care. With NeuroFlow, health care organizations can finally… Read More »NeuroFlow Secures $20M for Tech-Enabled Behavioral Health Integration Platform
In a wide-ranging discussion at J.P. Morgan’s Annual Healthcare Conference, former CMS Administrator Andy Slavitt talked about the future of the ACA, telehealth and Medicare Advantage with a Democrat-led House, Senate and presidency.
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
The Missouri-based payer is expanding its partnership with the technology company to offer an incentive and rewards program for its Affordable Care Act members in an effort to increase engagement.
What You Should Know: – COVID-19 care deferrals lead to three major boomerang conditions that payers and providers must proactively address in 2021, according to a newly released report by Prealize. – COVID-19’s hidden victims—those who avoided or deferred care during the pandemic—will increasingly return… Read More »COVID-19 Deferrals Lead to 3 Major Conditions Payers/Providers Must Address in 2021
A new report, from cybersecurity firm Fortified Health Security, shows that nearly 200 more data breaches occurred in the first 10 months of 2020 compared with the year prior — around 80% of which targeted providers.
Mike McSherry, CEO & Co-founder of Xealth HIT Consultant sat down with Mike McSherry, CEO, and co-founder of Seattle-based digital prescription platform Xealth to discuss digital health lessons learned in 2020 and what we can expect in 2021. As Xealth’s CEO, Mike also works with… Read More »Xealth’s CEO Shares Impact of Digital Health in 2020 and What’s Ahead in 2021
Back in 2019, the Proposed Interoperability rules were released from ONC and CMS, and the […]
Lillian Phelps, Sr. Director of Product Management, Availity As the COVID-19 pandemic has gripped the world, many providers have adopted an all-hands-on-deck approach and mentality for treating COVID-19 patients, stretching their resources to the breaking point. We have heard about the frontline heroes who have… Read More »4 Quick Tips for Getting COVID-19 Claims Paid Promptly
Optum, a subsidiary of insurance giant UnitedHealth Group, agreed to buy healthcare technology company Change Healthcare for $13.5 billion in cash. The acquisition will add data analytics, research and revenue cycle management offerings to Optum’s service roster.
What You Should Know: – UnitedHealth Group has reached an agreement to acquire Change Healthcare in a deal valued at more than $13 billion, marking the first major acquisition of 2021. – Change Healthcare will be combined with OptumInsight to advance a more modern, information,… Read More »UnitedHealth Group Acquires Change Healthcare to Combine with OptumInsight for $13B
The insurer will pay $95 per share in cash to acquire Magellan Health, a company providing an array of services, including pharmacy benefit management and behavioral health and employee assistance program services. The companies aim to develop a behavioral health platform.
Teladoc Health and Livongo Merge The combination of Teladoc Health and Livongo creates a global leader in consumer-centered virtual care. The combined company is positioned to execute quantified opportunities to drive revenue synergies of $100 million by the end of the second year following the… Read More »2020’s Top 20 Digital Health M&A Deals Totaled $50B
Scott Galbari, CTO, Lyniate Drew Ivan, Chief Product and Strategy Officer, Lyniate Healthcare data security has been a growing concern for CIOs for the last year or so, as hackers are increasingly targeting health information. Now, with a global pandemic forcing a shift to telemedicine… Read More »CIO: 3 Rules for Meeting ONC/CMS Interoperability, While Improving Cybersecurity
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021. Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various… Read More »30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021
The panel, What It Takes To Build A Successful, Regional BioInnovation Hub (sponsored by Independence Blue Cross) focuses on Philadelphia — one of many cities seeking to support the continued growth of cell and gene therapy and connected health industries.
In the new year, payers with an abundance of capital resulting from deferred care amid the pandemic will look to make investments in technology and ramp up acquisition activity in the primary care arena, a PwC expert predicts.
The insurer picked digital health startup Vida to offer a virtual diabetes management program for Medicaid patients in Kentucky.
An email hacking incident exposed the information of close to 500,000 Aetna health plan members, the payer reported to HHS last week. The incident occurred when an unauthorized person gained access to an email account of Aetna’s vision benefit services provider.
Rideshare app Lyft is partnering with corporations and healthcare organizations to create an initiative that will help connect members of underserved communities to vaccination sites once the Covid-19 vaccine becomes widely available.
Regence, MultiCare Health System to Deploy HL7 Da Vinci Member Attribution List for Value-Based Care Arrangements
What You Should Know: – Regence and MultiCare ink first-in-the-nation value-based care partnership to deliver improved health outcomes at lower costs. Health insurance provider Regence and MultiCare Health System, an independent accountable care organization (ACO) have partnered to deploy a first-in-the-nation value-based model that delivers… Read More »Regence, MultiCare Health System to Deploy HL7 Da Vinci Member Attribution List for Value-Based Care Arrangements
John Harrison, Chief Commercial Officer of Concord Technologies Communication problems and inadequate information flow are two of the most common root causes of medical errors. The potential for miscommunication and faulty exchange of information in healthcare is substantial. Consider: patient information is dispersed among multiple… Read More »Gaps in Clinical Communication, Document Exchange Lead to Gaps in Care
With the new funds, the health data optimization and interoperability company will invest in product development. The latest funding round was led by Centene Corp.
The payer will offer its Motion well-being program members access, at no additional cost, to Apple Fitness+ workout classes for six months.
On the heels of a $140 million funding round, insurance startup Oscar Health confidentially filed for an IPO.
Congress finally reached an agreement on a $900 billion stimulus package, which includes a ban on surprise medical billing. A previous, but very similar version of the bill, raised concerns among providers and payers.
An in-depth look at twelve recently released COVID-19 vaccine management solutions as COVID-19 vaccines are being distributed nationwide. 1. Microsoft Microsoft launches a COVID-19 vaccine management platform with partners Accenture and Avanade, EY, and Mazik Global to help government and healthcare customers provide fair and… Read More »12 Recently Launched COVID-19 Vaccine Management Solutions to Know
The health system and payer will coordinate care for eligible Medicare Advantage patients through the ACO, with the aim of improving health outcomes and reducing costs. The ACO expands a long-standing relationship between the two entities.
The newly created organization, dubbed OneTen, aims to create 1 million jobs for Black people over the next decade. Its founders include some big names in healthcare, such as Cleveland Clinic, Intermountain Healthcare and Humana.
The managed care company picked six mental health apps that it made available to its members over the past two years. It recently published a paper showing patients were more likely to download or use digital health tools when referred by a physician.
The HHS has proposed changes to the HIPAA Privacy Rule — the biggest in seven years, a healthcare lawyer said. But while the changes aim to improve information sharing, they could also bring about challenges for providers and payers.
By implementing a standardized, automated, and modernized set of processes to manage critical enrollment information across multiple lines of business, plans have greater potential to expand member footprint, enter new markets and drive competitive differentiation.
The rule would require payers in the Medicaid, CHIP and QHP programs to build and maintain application programing interfaces to improve data exchange and the prior authorization process. But the rule does not include Medicare Advantage plans, which the American Hospital Association called “disappointing.”
What You Should Know: – DispatchHealth launches Clinic Without Walls, a new service line offering patients a telemedicine visit with in-person assistance for more complex medical visits. – The initial service line will be available in a pilot to MultiCare patients in the Tacoma and… Read More »DispatchHealth Launches New Clinic Without Walls for Enhanced Virtual Visits to MultiCare Patients
What You Should Know: – LeanTaaS raises $130 million in Series D Funding to strengthen its machine learning platform to continue helping hospitals achieve operational excellence during a time where they are facing mounting financial pressures due to COVID-19. – LeanTaaS provides software solutions that… Read More »LeenTaaS Secures $130M for ML Platform to Help Hospitals Achieve Operational Excellence
As precision medicine gains steam, the question arises: how can reimbursement models evolve to support these often costly therapies and ensure patient access is not blocked? Drugmakers and payers are working together to find some answers.
In the last 20 years, access to genetic testing has expanded significant as technology has advanced. But there’s still lots of work to be done to get tests covered and make them more accessible, panelists said at a virtual conference hosted by MedCity News.
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.
SoftBank’s second Vision Fund led the recent funding round. Pear plans to use it to accelerate reimbursement coverage for its three FDA-cleared products.
The expanded partnership increases the number of Highmark health plan members eligible for enrollment in Lark Health’s AI-driven health coaching programs aimed at managing and preventing chronic diseases.
What You Should Know: – On the heels of $225.5 million dollars in funding and a $1.5B valuation this week, Olive today announced its acquisition of Verata Health to create a combined AI prior authorization solution for providers and payers under the Olive name. –… Read More »M&A: Olive Acquires AI Prior Authorization Company Verata Health
Breaking Media’s MedCity News and Above the Law are collaborating to launch Healthcare Docket, a newsletter featuring the latest in litigation, regulation, transactions, and trends for in-house counsel in the healthcare and life sciences industries.
Millions of Americans without healthcare insurance could be eligible to get coverage for free, or nearly free, through financial assistance offered under the Affordable Care Act. But many who recently lost their employer-based coverage may not be aware of the options available to them.
Recent Executive Hires: CVS Health New President, Cleveland Clinic/Amwell Joint Venture Leadership, Others
Neela Montgomery, EVP & President at CVS Pharmacy/Retail CVS Health Corporation names Neela Montgomery Executive Vice President and President of CVS Pharmacy/Retail, effective November 30, 2020. Montgomery will oversee the company’s 10,000 pharmacies across the United States. Montgomery, currently a Board Partner at venture capital… Read More »Recent Executive Hires: CVS Health New President, Cleveland Clinic/Amwell Joint Venture Leadership, Others
Elizabeth Bierbower, Former President of Humana’s Group & Specialty Division Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest… Read More »COVID-19: How Can Payers Prepare for Mandates and Support Pandemic Relief Efforts
WithMe Health, a startup trying to build a new approach to pharmacy benefits, spun off a medication guidance service that can be layer on top of existing PBMs. It also raised $20 million in funding, led by OMERS Ventures.
Here’s a preview of some of the panel discussions at INVEST Precision Medicine, including diagnostics, investment trends, and building a bioinnovation hub.
Signify Health, a leading provider of technology-enabled healthcare solutions designed to keep people healthy and happy at home has acquired PatientBlox, an Atlanta-based technology company with deep expertise in applying distributed ledger technology in healthcare. The acquisition accelerates Signify’s prospective provider payment capabilities for episodes… Read More »Signify Health Acquires Healthcare Payment Blockchain Company PatientBlox
The technology company is partnering with major insurers, including Aetna and Humana, as well as providers like Ochsner Health to expand access to its platform that connects patients to community-based social services.
What You Should Know: – COTA, Inc., a healthcare technology company that uses real-world data to bring clarity to cancer care, has secured $34M in funding. – Access to over one million patient data records and additional funding support enhanced real-world data and analytics services… Read More »COTA Lands $34M to Drive Innovation in Oncology Using Real-World Data
The New York based startup is working to build a network of therapists and other mental health providers. It recently raised a $26 million series A round led by Thrive and GV.
Brett Furst, President at HHS Technology Group Blockchain technology has somewhat infamously been described as “a solution in search of a problem,” but as the healthcare industry responds to the demands of the pandemic, several valuable use cases have surfaced that could benefit from employing… Read More »How COVID-19 Has Revealed Healthcare’s Blockchain Use Cases
CMS will cover monoclonal antibody treatments for Medicare beneficiaries with Covid-19. Though this is a step forward in increasing access to these treatments, there are still hurdles to its widespread use.
Prasad Dindigal, Vice President, Healthcare & Life Sciences, EXL. Over the past few months, primarily as a result of the COVID-19 pandemic, telehealth has gone from a “nice-to-have” to a “must-have” for healthcare providers. The surge of COVID-19 patients in the spring, coupled with “stay-at-home”… Read More »8 Ways Advanced Analytics Can Help You Decide If Telehealth Should Be Temporary or Permanent
The health insurer and Michigan-based physician organization are partnering to expand access to in-network care for around 40,000 individual and group Medicare Advantage plan members. The partnership will go into effect Dec. 1.
Now with a 6-3 conservative majority, the nation’s highest court still seems reticent to throw out the Affordable Care Act altogether. If the law stays in place, it would be the foundation for many of President-elect Biden’s planned healthcare policies.
CVS Health named a new CEO in its earnings call on Friday. Between plans to further integrate its pharmacy and insurance businesses, and discussion about how a Covid-19 vaccine would be distributed, here are four other things the company is preparing for in the coming… Read More »Four takeaways from CVS Health’s Q3 earnings
Although the Covid-19 pandemic has had a significant impact on healthcare delivery, in many ways it has underscored the need for a healthcare system that can help patients easily navigate healthcare concerns as well as price transparency.
The survey, conducted by Optum, shows that healthcare executives’ confidence in AI is high, and most expect to soon see cost savings from implementing the technology. Further, a majority are looking to hire talent with experience developing AI.
In a review of real-world claims data, Pear Therapeutics found that its digital therapeutic for opioid use disorder resulted in a reduction in spending $2,150 per patient over six months.
In a trial last year, a federal judge found that a UnitedHealth subsidiary had illegally denied mental health and substance use disorder claims. The same judge has now ordered the payer to reprocess all the claims and reform its guidelines.
A new survey of U.S. physicians shows that they have differing views on how the payer market needs to evolve, but a vast majority agree that affordable insurance is necessary to provide access to high-quality care while reducing costs.
What You Should Know: – Cardiac patients and their cardiologists are experiencing a high number of false positives with remote patient monitoring devices as a result of signal artifact providing inaccurate data, which can lead to many complications—other than medical, such as unnecessary tests and… Read More »AI Leads Way to Less False Positives on Remote Cardiac Monitoring Devices, Improved Results
Access to mental healthcare continues to be a hurdle amid the Covid-19 pandemic, prompting Aetna and telehealth provider Inpathy to expand their existing mental health partnership to include three more states.
Lark Health, which offers AI-powered digital care platforms for chronic diseases, has raised $70 million in new funds, which it plans to use to expand its relationship with Anthem and eventually deepen partnerships with other payers and telehealth providers.
The final rule requires insurers to disclose information on prices for healthcare services and cost-sharing with patients. The government says it will help lower prices, but insurers aren’t so sure.
CMS’ interim rule states that Medicare will cover Covid-19 vaccines approved by the FDA, including those receiving emergency use authorization, in a reversal from its usual policy. The vaccine will be made available at no cost to Medicare beneficiaries.
MedCity Pivot Podcast: A conversation with Mark Bertolini about healthcare policy, Covid-19 and 5G in healthcare
Expanding Medicaid and then adjusting Medicare coverage based on financial and income status would be one way to improve healthcare policy and make sure that more Americans have healthcare when they need it.
Innovaccer Launches Member Engagement Solution to Scale-Up Digital Transformation Efforts with Payers
What You Should Know: – Innovaccer launches member engagement solution for healthcare payers to drive improvement in healthcare cost and quality boosts member satisfaction and enhances member enrollment and retention. – Innovaccer’s solution create member-oriented care plans, enhance connectivity with care managers, and drive interventions… Read More »Innovaccer Launches Member Engagement Solution to Scale-Up Digital Transformation Efforts with Payers
Deferred care because of Covid-19 will lead to additional stress on the healthcare system in the very near future and here’s how insurers can manage it.
What You Should Know: – Healthify in partnership with Algorex Health Technologies, announced the results of new social determinants of health (SDoH) population analysis of Excellus BlueCross BlueShield (BCBS) members. – SDoH are non-clinical conditions that significantly affect health outcomes. The analysis identified Excellus BCBS… Read More »Healthify, Algorex Health & Excellus BCBS Tap into SDoH Analytics to Address Social Disparities
With the annual INVEST Population Health virtual conference coming up November 16-18, here’s a look at our collaboration partner New Orleans Business Alliance. It plays a vital role in helping to stimulate the local economy by supporting the development and advancement of the healthcare and… Read More »How is population health innovation unfolding in Louisiana? [Sponsored]
Vanessa Kuhn, Director of Health Policy, PatientPing The Centers for Medicare and Medicaid Innovation (CMMI) created the Direct Contracting Model to expand opportunities for more diverse providers and healthcare organizations to participate in value-based care arrangements for Medicare fee-for-service (FFS) beneficiaries. The goal of the… Read More »CMS Direct Contracting Model Options for Value-Based Care
Insurance startup Bind Benefits just raised $105 million in a Series B funding round to further expand into the fully insured market. CEO Tony Miller sees the company’s health plan product as a way for employers to stay agile while offering insurance in a rapidly… Read More »How Bind Benefits’ CEO will use $105M to upend the health insurance market
The COVID-19 pandemic has forever changed patient expectations for healthcare delivery, including offered services and health office operations. Although health systems have remained dynamic in adopting telehealth capabilities, their long-term capital, like real estate and supply chain management (SCM) protocols, have not adapted to match… Read More »5 Trends Driving The Future of Healthcare Real Estate in 2020 & Beyond
What You Should Know: – FDA awards AppliedVR Breakthrough Device designation for treating treatment-resistant fibromyalgia and chronic intractable lower back pain – AppliedVR’s EaseVRx program helps patients learn self-management skills grounded in evidence-based cognitive-behavioral therapy (CBT) principles and other behavioral methods. AppliedVR, a pioneer advancing… Read More »FDA Grants AppliedVR Breakthrough Designation for Virtual Reality Chronic Pain Treatment
What You Should Know: – CommonWell Health Alliance enables payer access with the addition of a new service provider, DataFile Exchange to support the operational services specific to the Payment and Health Care Operations use case. CommonWell Health Alliance today announced it is extending… Read More »CommonWell Enables Payer Access to Nationwide Interoperability Network
After Nebraskans cast their vote for Medicaid expansion in 2018, the state is finally expanding coverage to more residents. As part of the state’s rollout, it split its expanded Medicaid plans into two tiers, with work and other requirements to access dental and vision coverage.
What You Should Know: – Health technology leader WellSky has agreed to acquire CarePort Health to power coordinated care transitions for acute and post-acute care patients for $1.35B. – By providing end-to-end visibility across the continuum, WellSky and CarePort can improve outcomes, lower costs, and… Read More »WellSky Acquires CarePort Health from Allscripts for $1.35B
Medicare doesn’t currently cover drugs approved under emergency use designations. But CMS Administrator Seema Verma said the agency was coming up with a plan to make sure Medicare beneficiaries were covered once a coronavirus vaccine is developed.
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.
What You Should Know: – Virta is expanding its suite of treatment options to include prediabetes reversal, obesity reversal, and type 2 diabetes management. – By making this crucial expansion, Virta can scale its treatment to support the tens of millions of additional patients with… Read More »Virta Expands Offerings to Treat New Group of Chronic Illnesses
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.
Roland Therriault, President, InSync Healthcare Solutions Since COVID-19 emerged as a major health threat, virtual care has taken off. As many as 46% of patients reported in late April that they had used telehealth to replace a canceled healthcare visit in 2020, while 48% of… Read More »Getting Beyond the Telehealth ‘Stop-Gap’ Mentality
Chance Scott, a Director in life sciences at Guidehouse, talks about some of the challenges digital health innovators face, from reimbursement by private plans to the future of reimbursement for other telehealth tools and digital therapeutics.
The insurer plans to increase the footprint for its Medicare Advantage plans by 50%, adding plans in 300 additional counties.
What You Should Know: – Amwell ranks highest among direct to consumer brands and Cigna ranks highest among health plans for telehealth patient satisfaction, according to the J.D. Power 2020 U.S. Telehealth Satisfaction Study – Though telehealth has been pitched as a solution to improve… Read More »Amwell and Cigna Ranks High in Telehealth Patient Satisfaction, J.D. Power Finds
The plans will include zero-dollar premiums and will give patients access to free primary care visits, dental exams and lab tests at Walmart Health centers across the state.
The company, which was a winner of the MedCity INVEST Digital Health Pitch Perfect contest, was founded with the aim of using digital technology to improve the experience and efficiency of prior authorizations, in particular determining whether they are needed.
In the latest video installment from INVEST Digital Health, venture capitalist Michael Yang, Managing Partner, OMERS Ventures, and healthcare entrepreneur Shawn Wagoner, Chief Revenue Officer, Bind Benefits, go head to head to debate the future of health insurance.
Although the deadline for compliance with the FHIR patient access rules is fast approaching, most payers are not prepared,
Anthem will pay $39.5 million in a settlement related to a cyberattack in 2015. The settlement, reached with a group of state attorneys general, is separate from a class action case over the breach that Anthem settled in 2018.
What You Should Know: – CorroHealth – a newly-formed entity – combines the services and technologies of TrustHCS, Visionary RCM, T-System, and RevCycle+. – Under this new entity, CorroHealth is committed to helping clients navigate regulatory compliance complexities, ease physician burdens and improve financial outcomes.… Read More »TrustHCS, Visionary RCM, T-System, RevCycle+ Merge to Form New Entity CorroHealth
Molina announced it will acquire the assets of Affinity Health Plan, a New York-based Medicaid managed care organization. It’s one of several Medicaid MCO purchases the insurer has announced this year.
The INVEST Digital Health Virtual conference Pitch Perfect competition, from September 21-25, had some intense competition between the healthcare startup participants. Thanks to all the entrepreneurs, judges and sponsors who took part.
Premera will pay nearly $7 million in a settlement related to a security breach in 2014 affecting more than 10 million people. It will be the second-largest HIPAA fine to date.
The two companies had been negotiating a six-year value-based contract prior to the start of the pandemic. Allina and BCBS of Minnesota expect the agreement will affect roughly 130,000 patients.
How do we improve behavioral health in meaningful ways? Join the conversation at INVEST Digital Health.
A panel discussion at the conference will examine what is being done to address behavioral health needs from social isolation, accentuated by the public health crisis, to the stress experienced by healthcare professionals.
A survey of consumers with health insurance spells out how they want payers to communicate with them and how frequently. It also touches on the impact of Covid-19 on care delivery.
Alphabet’s healthcare subsidiary, Verily, will partner with Swiss Re Corporate Solutions to create a new stop-loss insurance company. The new entity, called Coefficient, will use data analytics to help self-funded companies manage unexpected areas of cost.
What You Should Know: – Dignity Health Management Services (DHMSO), the largest health system in the state of California to transform their network health data into actionable insights. – With this partnership, the organization will leverage Innovaccer’s FHIR-enabled Data Activation Platform to better manage healthcare… Read More »Dignity Health Management Services to Leverage Innovaccer’s FHIR-enabled Data Activation Platform
The upcoming INVEST Digital Health virtual conference September 21-25 will offer a spotlight for this debate to continue. It will also include conversations spanning behavioral health and how hospitals are addressing the pandemic as well as healthcare startup pitches.
Some healthcare startups that offer at-home prescription deliveries and test kits have experienced delays with the USPS. They shared how they’re navigating the changes.
The Cleveland Clinic struck a partnership with CVS Health subsidiary Aetna to form a new accountable care organization (ACO). The two companies plan to launch a co-branded insurance plan this fall.
What You Should Know: – New Chilmark Research report on revenue integrity in healthcare reveals a transitional market making strides to address the new burdens of modern care economics. – The ongoing COVID-19 public health emergency underscores the imperative need for automation and reduced administrative costs even… Read More »Report: Modern Revenue Integrity Solutions Driving Payment Performance
What You Should Know: – Bridge Connector raises $25.5 million in Series B funding to advance interoperability layer for healthcare organizations as demand for integrated health data intensifies during COVID-19 pandemic. – The investment will support the growth of Destinations, the company’s new integration-platform-as-a-service (iPaaS)… Read More »Bridge Connector Lands $25.5M to Expand Healthcare Integration Platform
During the height of the Covid-19 pandemic, all of the seven largest commercial insurers saw their profits rise, with some seeing their profits double. Will they have to pay some of it back?
We need to keep in mind three key elements to successfully implement the final interoperability rules from CMS that require private payers to provide longitudinal claims data to members as well as the use of open APIs so a range of third-party applications can be… Read More »How payers and providers can address the CMS interoperability mandate
Check out news from healthcare startups including Bind, Reify Health, Bodyport and more.
What You Should Know: – Revenue cycle management provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue cycle management, workflow automation, and data analytics tools at a $1.3B valuation. – The acquisition will create the first unified healthcare payments platform with both commercial… Read More »Waystar Acquires Medicare RCM Company eSolutions at $1.3B Valuation
UnitedHealthcare sent a notice to plan members stating that it would no longer cover Descovy to prevent HIV, while Truvada – after it goes generic next month – will be covered for free. Gilead reported that Descovy for PrEP had offset a second-quarter fall in… Read More »Gilead got a boost from a newly approved PrEP drug. Now, a major insurer is dropping coverage
Mitzi Amon, Director of Healthcare Marketing at Vertiv If you’ve been to a big-brand grocery or department store recently, you probably noticed some form of healthcare outlet – or maybe you didn’t. These in-store pharmacies and clinics have become so omnipresent, right there next to… Read More »Envisioning a 5G-Powered Retail-Healthcare Hub
Brian Robertson, CEO at VisiQuate, There have been many memorable “where were you?” events since the 21st century began. But few can match the COVID-19 pandemic, at least from a healthcare perspective. The effect on healthcare (and healthcare executives) has been particularly profound since our industry… Read More »Top 5 RCM Challenges for Healthcare Executives in the COVID-19 Era and Beyond
For the quarter ending on June 30, when many health systems face a rising number of Covid-19 cases, the Kaiser Foundation Health Plan more than doubled its net income to $4.5 billion. The nonprofit managed care plans attributed the increase to reduced operating expenses and… Read More »Kaiser sees Q2 net income more than double to $4.5B
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– Healthcare Growth Partners’ (HGP) summary of Health IT/digital health mergers & acquisition (M&A) activity, and public company performance during the month of July 2020. While a pandemic ravages the country, technology valuations are soaring. The Nasdaq hit an all-time high during the month of… Read More »Analysis: July Health IT M&A Activity; Public Company Performance
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.
What You Should Know: – Ginger announces $50 Million in Series D funding to expand access to its on-demand mental healthcare system led by Advance Venture Partners and Bessemer Venture Partners; joined by Cigna Ventures and existing investors. – Company has more than tripled revenue… Read More »Ginger Lands $50M to Expand On-Demand Mental Health Support Platform
A webinar from HealthSparq offers analysis on a consumer sentiment study on health plans. It offers some useful insights on how the public health crisis has laid bare the trust issues consumers have and how insurers can address them to the benefit of both.
As the COVID-19 pandemic continues to change healthcare operations in the world, foundational systems are being adapted to meet these new demands. Sometimes it takes extreme circumstances to see the cracks in a system. COVID-19 has exposed areas with more room for improvement in the… Read More »How Times of Crisis Spur Needed Change in Healthcare Delivery
GoodRx, a startup that makes tools for comparing the price of prescription drugs, is looking to go public, according to a report by Reuters. The company reportedly submitted paperwork to the Securities and Exchange Commission.
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Insurance startup Oscar Health plans to expand to 19 new markets next year, pending regulatory approval. The company will offer individual and family health plans in four new states, and will expand its presence in existing states.
Telehealth has quickly transformed the healthcare industry. Rather than scheduling an appointment, waiting up to a few weeks, and going to a doctor’s office or another healthcare facility, we can now access many types of care from the convenience of our smartphones. However, telehealth has… Read More »Telehealth and COVID-19: Overcoming New Challenges for Providers and Payers
CVS Caremark added five new companies to its Point Solution Management Service, which it launched last year to make it easier for businesses to implement digital health tools. CVS Caremark CMO Sree Chaguturu shared more about the PBM’s plans for digital health.
In-home primary care startup Heal raised $100 million in funding, led by Humana. Heal plans to use the funds to expand into new markets and expand the breadth of services that it offers.
What You Should Know: – The latest Chilmark Research report examines how data-oriented APIs are contributing to development and integration efforts across healthcare from the perspective of the developer. – Reeling from the impact of the COVID-19 pandemic and seeking more effective ways to implement… Read More »Open APIs in Healthcare: The Future of Data Integration Report
Kim Babberl, Product Consulting Group Director at MedeAnalytics COVID-19 models are being used every day to predict the course and short- and long-term impacts of the pandemic. And we’ll be using these COVID-19 models for months to come. While many of us in healthcare are… Read More »Avoid COVID-19 Modeling Pitfalls by Eliminating Bias, Using Good Data
Kaiser Permanente opened its first medical school in Pasadena, California. Its first class of 50 students will have a mixture of in-person and virtual classes this year.
What You Should Know: – Sharecare acquires WhiteHatAI to provide health plan and provider clients with additional capabilities to ensure healthcare payment integrity – WhiteHatAI’s ability to detect erroneous claims before they are paid will help Sharecare’s health plan partners reduce costs associated with FWA.… Read More »Sharecare Acquires WhiteHatAI to Enhance Healthcare Payment Integrity
Healthcare mergers decreased in the first half of 2020, but not to the extent expected as a result of the Covid-19 pandemic. Reports by Pricewaterhouse Coopers and Kaufman Hall showed a decline in mergers and acquisitions, but still reported sustained interest from buyers
What You Should Know: – A new Accenture report called “Breakthrough Behavioral Health Access: Think Virtual” finds that the use of virtual behavioral health could expand care for more than 53 million Americans facing these conditions. – Demand for behavioral health specialists significantly outweighs current… Read More »Virtual Behavioral Health Could Reduce Costs, Improve Patient Outcomes, Report Finds
Humana will send 1 million screening kits to its members for managing diabetes and screening for colorectal cancer. The at-home tests are intended to offset screenings and other preventive care being pushed back due to Covid-19.
Executives with Kaiser Permanente, Houston Methodist, Providence St. Joseph Health and Highmark Health shared their thoughts on the future of digital health and how they used technology to care for their patients at the start of the Covid-19 pandemic.
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.
Kaia Health, a startup making an app to help users manage back pain, touted the results of a large, randomized controlled trial using its app. The company currently markets its system to employers, but hopes to make it available as a covered benefit in the… Read More »Digital health startup Kaia hopes to win over insurers with results of back pain study
What You Should Know: Healthify, a social determinants of health company (SDOH), announced a national partnership with Ride Health to offer transportation to medical and non-medical services for people faced with transportation barriers. – Each year, an estimated 3.6 million Americans do not obtain medical… Read More »Healthify, Ride Health Partner to Offer SDOH-Driven Transportation to Vulnerable Populations
Molina will acquire Passport Health Plan’s Medicaid and dual-eligible business for $20 million. The Kentucky-based company is a long-standing provider of Medicaid managed care plans, but lost a bid with the state earlier this year.
Centene will expand its partnership with behavioral health startup Quartet Health to 32 states. The insurer became an investor in Quartet last year.
Payers have a greater role to play to help members navigate the Covid-19 public health crisis and their future healthcare, according to a new report.
UnitedHealth Group saw its earnings nearly double to $6.6 billion during the second quarter, as fewer patients sought out appointments or non-essential procedures due to the pandemic.
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.”
Curavi Health, CarePointe, U.S. Health Systems Merge to Form Arkos Health to Power Virtual Care for Seniors
Curavi Health, CarePointe, U.S. Health Systems announced a merger agreement to form Arkos Health. Arkos Health will provide virtual care solutions and health insights to vulnerable populations across the United States. These three entities will become wholly-owned subsidiaries of Arkos Health, and the executive leadership… Read More »Curavi Health, CarePointe, U.S. Health Systems Merge to Form Arkos Health to Power Virtual Care for Seniors
Researchers at the Urban Institute found that up to 10 million people could lose their job-based insurance due to Covid-19 by the end of the year.
What You Should Know: – Emtiro Health, an innovative population health company in North Carolina has selected Innovaccer to deliver data-powered solutions to enhance the efficiency and effectiveness of care delivery. – Powered by Innovaccer’s FHIR-enabled Data Activation Platform, Emtiro Health will create unified patient… Read More »Emtiro Health Taps Innovaccer to Leverage the FHIR-Enabled Data Activation Platform
With public and private healthcare spending significantly outpacing that of other countries, U.S. hospitals face intense pressure to find new ways to capture greater value. More and more, organizations are finding that partnerships with existing vendors can help unlock next-level performance gains in a transformative… Read More »4 Ways Healthcare Organizations Can Establish Partnerships to Drive Innovation
The company is rolling out Level2, a digital health program for patients with type 2 diabetes. It uses wearable devices and coaches to help users manage their health.
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.
What You Should Know: – 8 in 10 consumers said COVID-19 made telehealth “an indispensable part of the healthcare system, according to a new study commissioned by Change Healthcare. – 2020 Change Healthcare – Harris Poll Consumer Experience Index reveals 65% said they plan to… Read More »8 in 10 Consumers Stated COVID-19 Made Telehealth “Indispensable” in Healthcare Delivery
Walmart quietly launched a new health insurance business. The company, called Walmart Insurance, was filed with the Arkansas Secretary of State last month.
A proposed rule by the Centers for Medicare and Medicaid Services would expand payments for new dialysis machines when used at-home.