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.