Category: Value-Based Care

  • THCB Spotlights: Maya Said, CEO, Outcomes4Me

    Today on THCB Spotlights, Matthew Holt talks with Maya Said, the CEO of Outcomes4Me, which works in the cancer patient empowerment space. Outcomes4Me is a patient empowerment platform that helps patients diagnosed or in active treatment for breast cancer understand their situation and treatment options, as well as connect better with providers to enable meaningful […]

  • It’s Time More Healthcare Companies Break Through Data Silos

    Derik Ciccarelli, a Healthcare Fraud Analyst at Codoxo Unifying health records remains a challenge, but the benefits of integrating disparate data could transform the industry Healthcare payers, providers and agencies have traditionally struggled with unifying health records, but no longer is that a viable reason to put off what can be achieved today. It’s time […]

  • How Healthcare Facilities Can Prepare for Expanded Inclusion Criteria for Telehealth and RPM Solutions in Value-Based Care Settings

    Dr. Nora Zetsche, co-founder of Veta Health As legislation, engagement and positive results continue to push digital patient care solutions forward, many healthcare organizations are not yet prepared for the increased adoption of these technologies. While general interest in telehealth remains somewhat lukewarm, the proof of viability for clinically-driven remote patient monitoring (RPM) is undoubtedly […]

  • Healthcare Data & Analytics Platforms: Shifting from Siloed Capabilities

    Bradley Hunter, Research Director at KLAS Research Ryan Pretnik, Research Director at KLAS Research Lois Krotz, Research Director at KLAS Research Historically, analytics capabilities for healthcare organizations have been offered in siloed solutions. These solutions provide quick insights but not the longitudinal patient, financial, and operational views organizations need to truly move the needle in […]

  • Providence St. Joseph, Anthem Accelerate Value-Based Care with Vim

    What You Should Know:  – Anthem Blue Cross and Providence St. Joseph Health are accelerating value-based care by using a new technology partner, Vim. The partnership enables the organizations to scale their tech solutions for better payer-provider collaboration to ultimately improve healthcare performance in California. – Vim offers an EHR-integrated application suite that includes Digital […]

  • Nemours Children’s Selects Innovaccer Health Cloud to Support Value-Based Whole-Person Care

    What You Should Know:  – Innovaccer Inc., the Health Cloud company, announced a partnership with Nemours Children’s Health, one of the nation’s largest clinically integrated pediatric health systems, to create a unified data platform designed to accelerate Nemours’ mission to transform children’s health through a holistic care model. – The partnership will integrate and activate […]

  • Healthcare at the Crossroads: Value-Based Care and Interoperability

    Michael Pattwell, Principal Consultant, Value-Based Care at Edifecs Amid the difficulties of the last year, a bright spot has emerged that may provide a strong indication of renewed movement toward the transformation of the healthcare industry that we know today. Value-based care, a model that rewards better patient health outcomes, has experienced a surge in interest amid heightened consumer […]

  • Why Family Caregivers Need Help from the Healthcare Establishment

    Claudia Fine, LCSW, MPH, Chief Professional Officer at eFamilyCare I recently spoke with a woman whose husband contracted a serious, chronic illness that requires long-term use of a peripherally inserted central catheter (PICC) line.  As her husband’s primary caregiver, this woman is responsible for cleaning and flushing the PICC line three times a day. And […]

  • axialHealthcare Rebrands as Wayspring, Raises $75M for Value-Based Care Solution

    – Wayspring, formerly axialHealthcare, announced today its new name and a $75M investment from Valtruis, Centene Corporation, CareSource, HLM Venture Partners, and existing investors Highmark Ventures, .406 Ventures, the Blue Venture Fund, and Oak HC/FT.  Wayspring will use the capital to scale its value-based care solution, a full-risk medical home model for substance use disorder […]

  • NANI Makes Equity Investment in Strive Health for Risk Payment

    What You Should Know: – Strive Health, the national leader in value-based kidney care, and Nephrology Associates of Northern Illinois and Northern Indiana (NANI), the nation’s largest independent nephrology group, today announced a strategic partnership to jointly pursue and manage global risk payment models. – This partnership will benefit people with chronic kidney disease (CKD) […]

  • Saint Luke’s Health System Deploys Innovaccer Health Cloud

    What You Should Know: – St. Luke’s Health System, one of the largest health networks in Kansas City, has adopted Innovaccer Health Cloud to support its initiatives around the Primary Care First and commercial value-based care models. – St. Luke’s Health System turned to the Innovaccer Health Cloud and it’s Data Activation Platform to unify […]

  • Reducing low-value care starts by understanding its drivers

    There is no single driver of low-value care — providers, systems, and patients all play a role. But with the right tools, stakeholders can work together to re-align incentives and transform our healthcare delivery system into one that prioritizes value, eliminates waste and leads to better overall patient outcomes.

  • Real-World Data Flow – The Only Way to Change Value-Based Care?

    Manan Sheth, Sr. Technical Product Manager at CitiusTech Healthcare interoperability issues have always been confusing, changing, and difficult to address. The reason why is not straightforward: we have a fragmented health system with a myriad of specialized applications that are not universally used. Instead, we have a system where each organization elects which technology tools […]

  • Akron Children’s, CareSource to launch ACO

    Dubbed the Akron Children’s Health Collaborative, the pediatric ACO will focus on improving care for the approximately 100,000 children in Ohio covered by Medicaid whose benefits are managed by CareSource.

  • Cricket Health Secures $83.5M to Expand Value-Based Kidney Care Model to Health Plans

    What You Should Know: – Cricket Health, a San Francisco, CA-based provider of value-based kidney care with a clinically-proven approach to managing chronic kidney disease (CKD) and end-stage kidney disease (ESKD), today announced it has raised $83.5 million in Series B funding round led by Valtruis with a strategic investment from Blue Shield of California. […]

  • PE Firm WCAS Launches $300M Value-Based Care Portfolio Company, Valtruis

    What You Should Know: Welsh, Carson, Anderson & Stowe (“WCAS”), a leading private equity firm focused exclusively on the healthcare and technology industries, announced that it is launching Valtruis, a unique portfolio company that will invest in and partner with value-based care driven healthcare companies. WCAS is committing an initial $300M to this platform. Founded […]

  • ACLC, Innovaccer Jointly Launch Value-Based Care Collaborative

    What You Should Know:  –  Innovaccer Inc., a San Francisco-based healthcare technology company, today announced its partnership with the Accountable Care Learning Collaborative (ACLC) to launch various initiatives promoting value-based care (VBC) in the industry. The ACLC is a nonprofit, peer-learning, member organization in which members work together to develop VBC competencies and build resources […]

  • Rescheduling COVID-deferred screening appointments with automated patient outreach

    More than 40% of patients surveyed skipped medical care in the early months of the pandemic, according to a recent study by researchers at the Johns Hopkins Bloomberg School of Public Health. Of those who needed care, 58% missed scheduled preventive care. Similar trends are observed in cancer screening, with appointments for breast, colorectal, and […]

  • Former CMMI director’s new company will focus on value-based rural healthcare

    Main Street Health, launched by former Center for Medicare & Medicaid Innovation Director Brad Smith, aims to provide value-based care solutions in rural America. The company’s first step will be to partner with primary care clinics, urgent care centers and independent pharmacies to implement a program that will coordinate care for seniors.

  • Humana Acquires Integrated Post-Acute Care Provider onehome – M&A

    What You Should Know: – Humana Inc. announced that it has signed a definitive agreement to acquire integrated post-acute care provider One Homecare Solutions (“onehome”) from WayPoint Capital Partners (WayPoint), the private equity affiliate of a New York-based family investment office. – The acquisition will further advance Humana’s strategy to build a value-based home health […]

  • Why Provider-Payer Collaboration is the Secret to Value-Based Success

    Rachael Jones is SVP, Performance Analytics and Quality, Cotiviti Emad Rizk, M.D.,President and CEO, Cotiviti Just before the COVID-19 pandemic emerged, 48% of healthcare providers surveyed said three-quarters of their organization’s payments were grounded in fee-for-service models of care. Fast forward a year and the financial aftershocks of the pandemic have highlighted some of the […]

  • Applying A Hedge Fund Mentality for Investing in Social Determinants of Health

    Matt Lambert, M.D., Chief Medical Officer – Curation Health While I am a practicing clinician, I am a firm believer that improvements in healthcare most often come from borrowing the best ideas from other business models. For example, I have sometimes borrowed from software company and payer colleague insights to describe value-based care (VBC) reimbursement […]

  • The Crucial Role of SDOH Data in Value-Based Care

    Rahul Sharma, CEO of HSBlox Roughly $4 trillion is spent on healthcare annually in the U.S.  Despite this massive expenditure, roughly 80% of health outcomes are attributed to social, behavioral and environmental factors, known as social determinants of health (SDOH).   What has been far less clear is how providers and payers can fully harness SDOH […]

  • One Medical Acquires Value-Based Primary Care Group Iora Health for $2.1B – Health M&A

    What You Should Know: – Today, One Medical (NASDAQ: ONEM) announced its intent to acquire Iora Health, a value-based primary care group for serving roughly 38,000 Medicare patients through digital health and 47 in-person medical offices in ten markets across the United States for about $2.1B in stock. – Iora Health’s relationship-driven primary care model […]

  • What Population Health Management Providers Need to Know About HITRUST CSF Certification

    Bob Dupuis, VP of Enterprise Architecture and Security at Arcadia Healthcare companies continue to implement value-based care and population health management initiatives to coordinate healthcare delivery and improve the quality and value of patient care. These initiatives depend on the ability to access, aggregate, and analyze massive amounts of patient data, often coming from hundreds […]

  • Finetuning Quality Measure Reporting to Perform Like Professional Athletes

    Kyle McAllister, IT and Analytics Strategist, Pivot Point Consulting Tyler Camp, EHR Practice Manager, Pivot Point Consulting Healthcare organizations deal with a seemingly endless list of demands, including expanding access to care, financial sustainability, staffing shortages, rigorous data security, government regulations and quality improvement initiatives. Many organizations can operate at full speed and still find […]

  • Zing Health Acquires Medicare Advantage Plan Provider Lasso Healthcare

    What You Should Know: – Zing Health Enterprises, a physician-founded and led provider of Medicare Advantage health plans, has signed definitive documents to acquire Harrisburg, PA-based Lasso Healthcare Insurance Co. – Lasso Healthcare offers Medicare Advantage (MA) plans in 34 states and the District of Columbia. Its insurance offerings currently cover over 6,000 members. Lasso […]

  • Why Healthcare Data Won’t Magically Create Value-Based Care

    Irv Lichtenwald, President & CEO of Medsphere Systems Corporation The conversation about transitioning the American healthcare system from fee for service (FFS) to value-based care (aka, pay for performance) has been going on for more than 15 years. Still, it felt like time travel to come across a Health Affairs book review from 2006 by the late […]

  • Groups Recover Together Nabs $60M for Value-Based Care Platform for Opioid Addiction Treatment

    What You Should Know: – Groups Recover Together (Groups), a national leader in value-based care for opioid addiction treatment, today announced it has raised $60 million in Series C financing. Oak HC/FT led the round, joining existing investors Bessemer Venture Partners, Transformation Capital, RRE Ventures, Optum Ventures and Kaiser Permanente Ventures. – The latest financing […]

  • Why the Digital Front Door is Critical to the Healthcare Revenue Cycle

    Joel French, EVP of Patient Experience at R1 RCM, Inc. The COVID-19 crisis has upended many of our traditional business procedures and processes. However, because digital transformations were well underway before the pandemic, the shift to remote work and contactless consumer self-service was swift. In healthcare, digital strategies that were expected to take 10 years […]

  • Privia Health launches IPO, aims to raise up to $370M

    The physician practice management company launched its IPO through which it plans to sell 19.5 million shares of common stock, priced between $17 and $19 per share. It will use the proceeds for general corporate purposes, like research and development, and to acquire complementary businesses or technologies.

  • 3 Strategies to Up-Level Medicare Advantage Enrollment Before it is Too Late

    Trey Keller, VP of Product Management at Edifecs Aaron Fulner, Sr. Director at Edifecs With a new administration looking to reshape healthcare policy and additional special enrollment periods already underway, now is the time to ensure Medicare enrollment systems are ready for the unpredictability, and potential opportunities, ahead. While Medicare is the fastest growing segment […]

  • What Will It Take for Hospitals to Survive the Pandemic?

    Dr. John Frownfelter, MD, FACP, Chief Medical Officer at Jvion In 1852, Mercy Hospital & Medical Center opened as Chicago’s first chartered hospital. In May, it will close, leaving residents of the surrounding South Side community — poor and mostly people of color — without a place to see a doctor. And it isn’t the […]

  • Q1 2021 Health IT/Digital Health PC/VE, M&A, IPOs/ SPACs Activity

    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 course of the quarter, we observed $7 billion in private […]

  • Does Telemedicine Impede or Help the Patient-Centered Medical Home?

    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 path of least resistance in obtaining care, such as opting […]

  • Cardinal Health and Deep Lens Collaborate for AI-based Oncology Clinical Trial Matching

    What You Should Know: – Today, Deep Lens and Cardinal Health announced a strategic collaboration that will integrate Deep Lens’ AI-based clinical trial matching solution, VIPER, into community-based oncology practices throughout the Cardinal network. VIPER will be a part of Cardinal Health’s new Navista advanced suite of technology solutions designed to help oncologists improve outcomes, […]

  • Firefly Health’s CEO & Exec Chairman on $40M Raise & Becoming a “Bloat-less Kaiser”

    By JESSICA DaMASSA, WTF HEALTH Virtual-first primary care company Firefly Health is becoming a health plan! Backed by a $40M Series B, CEO Fay Rotenberg and Executive Chairman Jonathan Bush stop by to explain how they’re providing “half-price healthcare that’s twice as good.” (Or, as only Jonathan can put it: “we’re a bloat-less Kaiser.”) All […]

  • Boost Operational, Clinical and Financial Performance with Good Data

    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 impact of the pandemic, there’s a renewed urgency among hospitals […]

  • How the Pandemic is Accelerating the Shift to Alternative Care Delivery Models

    Mark Prather MD, MBA, CEO & Co-founder at DispatchHealth The COVID-19 pandemic has transformed how we interact with one another, with businesses, and with the world around us. From social distancing to hand sanitation to remote working, its impact on society is immense. And among the various industries that are experiencing significant change as a […]

  • Strive Health Raises $140M for Value-Based Kidney Care Platform

    What You Should Know: – Strive Health, a Denver-based provider of value-based kidney care today announced $140 million in Series B funding with Alphabet’s independent growth fund, CapitalG, as the lead investor. Strive has more than doubled its presence in regional markets and grown its employee base by more than 600% in the last year. This funding will further increase that momentum.  […]

  • Kelsey Mellard, CEO Sitka

    By MATTHEW HOLT Kelsey Mellard is CEO of Sitka, one of the emerging companies that’s providing specialty consults online to primary care docs. They’ve been building a specialty care network that can be accessed by asynchronous video, slightly different to some of their competition. Most of their customers are capitated medical groups, like ChenMed, trying […]

  • Wellstar Invests $10M to Become First Sharecare-Enabled Health System

    Wellstar Health System, one of Georgia’s largest and most integrated healthcare systems, and Sharecare, the digital health company that helps people manage all their health in one place, announced a strategic partnership to collaborate on unique, market-leading innovations in personalized care delivery, population health, and consumer engagement. Through this partnership, Wellstar also will become the […]

  • 11 Best Practices of a Successful Care Model Transformation Plan

    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 resurgence in cases has led to further decreases. The public […]

  • Vytalize Health Acquires Patient Financial Experience Platform MedPilot

    What You Should Know: – Vytalize Health acquires patient financial experience platform MedPilot to accelerate data-driven engagement technology to its ACO’s Medicare population. – An alumnus of the Cedars-Sinai Accelerator, MedPilot’s platform has already helped over 1 million patients to date and boasts a 97% patient satisfaction score.   Vytalize Health, a leading provider of value-based […]

  • Signify Health goes public in upsized IPO

    Signify Health, a company that provides services for value-based care programs, went public on Thursday in an upsized IPO. The company’s stock began trading at $24 per share, above its expected range of $20 to $21 per share.

  • Signify Health Shares Soar More Than 33% in IPO, Valuing Company at Over $7.12B

    What You Should Know: – Shares of Signify Health, a value-based care billing platform for in-home and bundled health services jumped more than 33% in its initial public offering (IPO), valuing the company at over $7.12B. – Today, Signify Health’s CEO Kyle Armbrester will also join the ranks among the youngest CEOs to ever take […]

  • Mercy, Anthem ink agreement to enhance care, drive down costs

    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 and Anthem.

  • UPMC Spinout Astrata Launches NLP Platform to Improve Value-Based Care

    What You Should Know: – UPMC spinout company Astrata launches a natural language processing (NLP) technology platform that allows health insurers to more efficiently analyze unstructured clinical data. UPMC Enterprises, the innovation and commercialization arm of UPMC has incubated and launched Astrata, a digital healthcare quality company. Astrata uses advanced analytics and natural language processing […]

  • Anthem Acquires Puerto Rico’s Largest Medicare Advantage Plan

    What You Should Know: – Anthem, Inc. has entered into an agreement with InnovaCare Health, L.P., to acquire its Puerto Rico-based subsidiaries, including MMM Holdings, LLC (“MMM”) and its Medicare Advantage (MA) plan MMM Healthcare, LLC as well as affiliated companies and Medicaid plan.   – MMM is Puerto Rico’s largest MA plan and one […]

  • Epic, Galen Healthcare, Chartis Group Named 2020 Overall Best in KLAS Awards

    What You Should Know: – Epic was named the top Overall Software Suite for the eleventh consecutive year in the Best in KLAS 2021 Software & Services report, released today, which reports on the top vendors for 2020. Epic was also named the top Overall Physician Practice Vendor. Galen Healthcare Solutions was named the top Overall IT Services Firm. […]

  • Why CMS Will Lead the 2021 Kidney Care Revolution

    Chris Riopelle, CEO of Strive Health After an unprecedented year, kidney care providers, including nephrologists, dialysis facilities, and care extenders are expecting 2021 to follow suit. We will see an overhaul in reimbursement and major industry shifts, partly led by CMS, that will require providers to advance their capabilities in a way that will usher […]

  • Value-based care platform Signify Health files for IPO

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

  • Aledade Secures $100M for Value-Based Primary Care, Reaching $2.1B Valuation

    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 Medicare Advantage Contracts. Aledade, a Bethesda, MD-based provider of value-based […]

  • Healthcare PE Firm Heritage Group Launches $317M Health Tech Fund

    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 in the nation, including large provider systems, payers, and healthcare […]

  • Modernizing Medicine Acquires Orthopedic EHR Platform Exscribe – M&A

    What You Should Know: – Modernizing Medicine announced it has acquired orthopedics EHR vendor Exscribe bringing together two of the healthcare industry’s leading, all-in-one orthopedic EHR vendors. – As part of the acquisition, Exscribe Founder and CEO, Dr. Sachdev and other members of the Exscribe team will be joining Modernizing Medicine. Specialty-specific EHR provider Modernizing […]

  • NeuroFlow Secures $20M for Tech-Enabled Behavioral Health Integration Platform

    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 bridge the gap between mental and physical health in order […]

  • Central Logic Acquires Acuity Link for Intelligent Transport Capabilities – M&A

    What You Should Know: – Central Logic acquires Acuity Link to power the company’s Intelligent Transport capabilities, speeding time to care in the best setting. – In addition, the company rolls out a new interoperable Bed Visibility capability that offers a real-time snapshot into available beds across the enterprise for improved access and enhanced revenue […]

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

    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 it has acquired PointRight Inc., a leading provider of analytics […]

  • VBC Expert Talks Best Practices to Optimize Value-Based Contracts for Providers

    Spencer Lilly, VBC Reimbursement Expert & Consultant at abeo In a bid to shift the foundation of healthcare reimbursement, CMS is pushing for significantly more reimbursements for Medicare and Medicaid services to be tied to value-based care (VBC) contracts. To accomplish this, tackling the biggest healthcare cost line items, such as anesthesia, will be at […]

  • 12 Telehealth & Virtual Care Predictions and Trends for 2021 Roundup

    Dr. Paul Hain, Chief Medical Officer of GoHealth Telehealth is Here to Stay in 2021 Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of […]

  • 30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

    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 institutions, geographies, patient demographics, and medical scanners. The sensitivity and […]

  • 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 better health outcomes to members at lower costs while simplifying […]

  • Highmark Inks 6-Year Partnership with Google Cloud to Power Living Health Model

    What You Should Know: – Highmark Health signs six-year strategic partnership agreement with Google Cloud to transform the health experience for patients and caregivers through the development of Highmark Health’s new Living Health Model – The Living Health model is designed to eliminate the fragmentation in health care by re-engineering the healthcare delivery model with […]

  • Despite COVID-19: Providers Should Not Lose Sight of MIPS Compliance

    Courtney Tesvich, VP of Regulatory at Nextech When 2020 began, no one anticipated that complying with the Merit-based Incentive Payment System (MIPS)—the flagship payment model of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)—would look so different halfway through the year. Like many other things, the COVID-19 crisis has delayed, diverted, […]

  • Cityblock Health Reaches $1B Valuation, Raises $160M to Address Systemic Healthcare Inequity

    What You Should Know: – Cityblock Health, a transformative, value-based healthcare provider focused on improving healthcare outcomes for marginalized communities, today announced a $160M Series C round, bringing its total raised to $300M. – Cityblock is a care delivery trailblazer working to right the injustices of a healthcare system that cycles vulnerable communities through frequent […]

  • Elation Health Nabs $40M for Clinical-First Solution to Power Independent Primary Care

    What You Should Know: – Elation Health, which provides an easy-to-use and affordable clinical technology platform for more than 7 million independent primary care clinicians serving 14M+ patients – including an EHR raises $40M in Series C funding from Al Gore’s sustainable investment firm, Generation Investment Management. – Elation’s API-enabled platform also allows organizations to […]

  • CMS’ new Geo care delivery model: 5 things to know

    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.

  • PointClickCare Acquires Collective Medical for $650M to Create to Largest Combined Acute and Post-Acute Care Network

    What You Should Know: – PointClickCare announces its intent to acquire Collective Medical to create the largest combined acute and post-acute care network in North America for $650M. – Collective Medical’s platform connects more than 1,300 hospitals, thousands of ambulatory practices and long-term post-acute care (LTPAC) providers, as well as accountable care organizations (ACOs) and […]

  • 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 firm Greycroft, most recently served as chief executive officer of […]

  • Well Health Nabs $45M to Expand Intelligent Communications Hub

    What You Should Know: – WELL Health raises $45M in Series C funding to transform patient communication for healthcare providers, payers, and ACOs. – WELL Health enables conversations between patients and healthcare organizations through secure, multilingual messaging in the patient’s preferred communications channel: texting, email, telephone, and live chat. Well Health Inc., a Santa Barbara, CA-based […]

  • Signify Health Acquires Healthcare Payment Blockchain Company PatientBlox

    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 of care, supporting the company’s commitment to advance value-based care […]

  • Intermountain Adds Omada’s Diabetes Prevention Program to At-Risk Patients

    What You Should Know: – Omada’s diabetes prevention program will be available to Intermountain’s at-risk patient population as part of a limited engagement in 2020 and 2021. – Omada’s diabetes prevention program is personalized to meet each participant’s unique needs as they evolve, ranging from diabetes prevention, type 2 diabetes management, hypertension, behavioral health, and […]

  • Lean on Your Connected Community of Care in Times of Crisis

    Dr. Keith Kosel, Vice President at Parkland Center for Clinical Innovation (PCCI) We’ve all experienced crises in our lives. They may be personal in nature (e.g., involving our interpersonal relationships), organizational (e.g., relating to our employment or retirement income), or nature-made (e.g., floods, tornados, or the COVID-19 pandemic). When crises hit our communities, the impacts […]

  • Addressing Social Determinants of Health: IT Solutions to Engage Community Resources

    What You Should Know: – The latest report from Chilmark Research examines the new approaches and tools for utilizing community resources that can address social determinants of health, giving providers the ability to extend care beyond the confines of the clinic. – This research indicates that the next two years will largely bring an expansion […]

  • Innovaccer, Surescripts Integrate to Leverage Medication Data for Patients

    What You Should Know: – Innovaccer partners with Surescripts to power its data activation platform with the most comprehensive medication data. – The partnership will enable the company to conduct smart medication reconciliation and ensure that patients are complying with their care protocols. Innovaccer, Inc., a San Francisco, CA-based healthcare technology company, announced its partnership […]

  • CMS Direct Contracting Model Options for Value-Based Care

    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 new model is to create the next generation of risk-sharing […]

  • Humana Taps Cohere Health to Modernize Prior Authorizations for Musculoskeletal Treatment

    What You Should Know: – Cohere Health partners with health insurer Humana to modernize the prior authorization process for musculoskeletal treatment across 12 states. – In addition, the company has closed an additional $10M in funding led by Flare Capital Partners and Define Venture, bringing the company’s total funding to $20M. Health insurer Humana has […]

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

    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 these expectations. Health systems must be aware of current trends […]

  • Patient Leakage & Keepage: State of the Industry Report

    What You Should Know: – “The Patient Keepage & Leakage Report” offers an in-depth, state of the industry look at health system executives’ views on the challenge of patient leakage, in which patients seek care beyond their networks. Although 96% of health system execs surveyed said that addressing patient leakage is a top priority, very […]

  • WellSky Acquires CarePort Health from Allscripts for $1.35B

    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 increase patient satisfaction. WellSky, a global health, and community care […]

  • Thriving in a Value-Based Care Environment: Impacting Outcome-to-Cost Ratio

    Jerry Carlson, Product Support Manager, BG DI BU IC Sales, Dunlee As the COVID-19 pandemic creates surges in acute care, many imaging departments are experiencing a decrease in volume, due to patients deferring or canceling non-urgent appointments and surgeries. The impact of this makes it painfully obvious that — because imaging departments rely on a […]

  • Value-based care – no progress since 1997?

    By MATTHEW HOLT Humana is out with a report saying that its Medicare Advantage members who are covered by value-based care (VBC) arrangements do better and cost less than either their Medicare Advantage members who aren’t or people in regular Medicare FFS. To us wonks this is motherhood, apple pie, etc, particularly as proportionately Humana […]

  • Value-based care – no progress since 1997?

    By MATTHEW HOLT Humana is out with a report saying that its Medicare Advantage members who are covered by value-based care (VBC) arrangements do better and cost less than either their Medicare Advantage members who aren’t or people in regular Medicare FFS. To us wonks this is motherhood, apple pie, etc, particularly as proportionately Humana […]

  • Curation Health Raises Series A Funding for Clinical Decision Support Platform

    What You Should Know: – Curation Health raises an undisclosed Series A round of funding to accelerate the adoption of its advanced clinical decision support platform. – Curation Health provides an advanced clinical decision support platform for providers and health plans that aids in managing risk contracts and improving quality performance. Curation Health, an Annapolis, […]

  • Digital Behavioral Health: Addressing The COVID-19 Behavioral Health Crisis

    Victor Siclovan, Director of Medicaid Transformation Project at AVIA Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, […]

  • Value-Based Reimbursement Contracts Now Account for 26% of Hospital Revenue, KLAS Finds

    What You Should Know: – Value-based reimbursement (VBR) contracts now account for 26% of hospital revenue, according to a new report from KLAS research and CHIME. – Report reveals providers are looking first to their electronic health record (EHR) systems to drive PHM, and are most interested in investing in new healthcare information technology (HIT) […]

  • Molina Healthcare Acquires Affinity Health Plan for $380M

    What You Should Know:  – Molina Healthcare acquires New York-based Medicaid managed care organization Affinity Health Plan for $330M in cash serving members in New York City, Westchester, Orange, Nassau, Suffolk, and Rockland counties.  – As of August 31, 2020, Affinity served approximately 284,000 Medicaid members. Affinity’s premium revenue for the trailing twelve months ended […]

  • Revel, NovuHealth Merge to Create Largest Healthcare Member Engagement Platform

    What You Should Know: – NovuHealth and Revel merge to bring together NovuHealth’s personalized healthcare loyalty programs with Revel’s applied behavioral research and health action technologies.  – Together, Revel and NovuHealth work with more than 50 healthcare organizations, including seven of the top 10 largest health insurers in the United States representing more than 65 […]

  • Independence Blue Cross, Signify Launches Social Determinants of Health Network in Philly

    What You Should Know: – Independence Blue Cross and Signify Health launches social determinants of health network, CommunityLink to connect data from multiple CBOs to integrate social directly into medical care in the Philadelphia area. – CommunityLink represents one of the first examples nationwide of combining in-home health with social care. Independence Blue Cross (Independence) […]

  • Obstacles to Value-Based Care Can Be Overcome

    By KEN TERRY (This is the seventh in a series of excerpts from Terry’s new book, Physician-Led Healthcare Reform: a New Approach to Medicare for All, published by the American Association for Physician Leadership.) Even in a healthcare system dedicated to value-based care, there would be a few major barriers to the kinds of waste […]

  • Slow Walking to Value Based Care: Why Fee for Service Still Rules

    By KEN TERRY (This is the second in a series of excerpts from Terry’s new book, Physician-Led Healthcare Reform: a New Approach to Medicare for All, published by the American Association for Physician Leadership.) In January 2015, then Health and Human Services Secretary Sylvia Burwell announced lofty goals for the government’s value-based payment program. By […]

  • The Coronavirus Crisis’ Silent Death Toll: Chronically Ill Patients

    Dr. Kayur Patel, Chief Medical Officer of Proactive MD The impact of the coronavirus crisis is shining a bright light on many of the challenges facing the U.S. healthcare system.  So much more than a lack of primary care physicians and hospital beds, the all-hands-on-deck approach to combating the spread of COVID-19 has forced patients […]

  • Report: Modern Revenue Integrity Solutions Driving Payment Performance

    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 clearer. Revenue cycle has and continues to be one of […]

  • What would post-Covid value-based care look like?

    As virtual care is only going to grow in the coming months as a solution to pent-up demand for care that has resulted from the pandemic, focused attention is needed to address these operational and reimbursement issues.

  • Primary care startup Oak Street Health goes public for $328M

    Oak Street Health, which operates primary care centers for Medicare patients, went public on Thursday for $328 million. Its capitation payment model has helped the company continue on where many clinics have struggled during the Covid-19 pandemic.

  • How Times of Crisis Spur Needed Change in Healthcare Delivery

    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 healthcare system, such as optimizing operational efficiency. Organizations and individuals […]

  • The Adoption of Telehealth During the Pandemic will Shape Healthcare’s New Normal

    Abhinav Shashank, CEO and Co-founder of Innovaccer Inc. COVID-19 has presented healthcare with a challenge like no other, with nearly nine million cases all over the world and over 470,000 lives lost. The speed of the outbreak and the disruption caused by it has created unforeseen challenges for communities and economies, and it’s especially apparent in […]

  • Greenway Health Taps AWS to Develop Cloud-Based, Data Services Platform

    What You Should Know: – To help meet the needs of ambulatory care practitioners in a post-COVID environment, Greenway Health, a leading health information technology, and services provider, today announced a new strategic partnership with Amazon Web Services (AWS). – Leveraging AWS cloud services, Greenway is developing a new cloud-based, data services platform, Greenway Insights, […]

  • W2O Acquires Discern Health to Strengthen Value-Based Care Capabilities

    What You Should Know: – W2O announced today the acquisition of Discern Health, a leading healthcare consultancy based in Washington, DC, and Baltimore, to strengthen its strategic capabilities in assisting clients with critical healthcare policy trends and value-based reimbursement models. – Discern Health brings experts with decades of experience in quality, health care measurement, and payment […]

  • Holon Integrates with Cerner’s HealtheIntent PHM Platform for Value-Based Care Insights

    What You Should Know: – Holon and Cerner announced a partnership to advance the delivery of relevant patient insights to providers when they need it most.  – Holon and Cerner will deploy patented technology that automatically delivers contextually relevant patient information from Cerner’s HealtheIntent® population health platform, which is EHR-agnostic, directly to clinicians in their workflow to inform care decisions.  Holon Solutions, one […]

  • Top 3 Priority Areas for Healthcare CIOs in the Age of COVID-19

    What You Should Know: – In the age of COVID-19, healthcare CIOs cite interoperability, cybersecurity, and operationalizing SDOH data priorities as top three priority areas, according to the third annual LexisNexis focus group of CHIME executives. – The survey results also highlighted the importance of a team approach with support across the organization in helping CIOs […]

  • Cohere Health Launches with $10M to Increase Transparency Across Care Journey

    What You Should Know: – Boston-based health IT start-up Cohere Health announced the official launch of its company with a $10 million Series A funding round led by Flare Capital Partners. – The company’s patient journey-focused platform improves the notoriously difficult prior authorization process and replaces an existing patchwork of legacy, siloed processes, and antiquated […]

  • Oak Street Health files for IPO

    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.

  • Healthcare Headlines: October 2019

    <h2 class="heading-medium">Does Value-Based Pay Have A Future?</h2> While just about everyone in healthcare likes the idea of paying for outcomes, there still remains a challenge on how to fairly implement it. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was a major step away from fee-for-service for physicians; subsequently, private payers began to […]