Payers

5 Trends Driving The Future of Healthcare Real Estate in 2020 & Beyond

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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

FDA Grants AppliedVR Breakthrough Designation for Virtual Reality Chronic Pain Treatment

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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

Nebraska gets approval to add work requirements to Medicaid expansion

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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.

CMS promises a plan for Medicare to cover coronavirus vaccine

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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.

TrustHCS, Visionary RCM, T-System, RevCycle+ Merge to Form New Entity CorroHealth

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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 buys another Medicaid plan for $380M

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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.

Premera to pay $6.85M fine for data breach

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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.

Verily launches stop-loss health insurance subsidiary

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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.

Dignity Health Management Services to Leverage Innovaccer’s FHIR-enabled Data Activation Platform

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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

Report: Modern Revenue Integrity Solutions Driving Payment Performance

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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

Bridge Connector Lands $25.5M to Expand Healthcare Integration Platform

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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

Big profits put insurers on awkward footing 

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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? 

Top 5 RCM Challenges for Healthcare Executives in the COVID-19 Era and Beyond

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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

Why MedCity News should be your go-to advertising partner

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MedCity News has the most engaged healthcare business audience in the industry. We can collaborate with you to develop customized content or provide a platform for your business to present sponsored thought leadership content highlighting from executives in healthcare and life sciences.

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.

Report: GoodRx files for IPO

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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.

CVS builds out digital health program with five more companies

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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.

Healthcare deals dip in 2020, but not as much as expected

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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

Virtual Behavioral Health Could Reduce Costs, Improve Patient Outcomes, Report Finds

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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

Healthify, Ride Health Partner to Offer SDOH-Driven Transportation to Vulnerable Populations

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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

Curavi Health, CarePointe, U.S. Health Systems Merge to Form Arkos Health to Power Virtual Care for Seniors

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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

Emtiro Health Taps Innovaccer to Leverage the FHIR-Enabled Data Activation Platform

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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

4 Ways Healthcare Organizations Can Establish Partnerships to Drive Innovation

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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

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.

8 in 10 Consumers Stated COVID-19 Made Telehealth “Indispensable” in Healthcare Delivery

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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