MA-Home Care Referrals Skyrocketing, healthAlign Data Reveals
The convener platform healthAlign has a front-row seat to see how home care is being utilized in Medicare Advantage (MA). Andy Friedell, the company’s founder […]
The convener platform healthAlign has a front-row seat to see how home care is being utilized in Medicare Advantage (MA). Andy Friedell, the company’s founder […]
Ashish Kachru, CEO at DataLink Approximately 42% of Medicare beneficiaries are enrolled in Medicare Advantage plans—a segment projected to reach 46% by 2025. Due to […]
More than ever, Medicare Advantage (MA) plans are stepping up and responding to the demand for more access to care in the home setting. This, […]
With the expansion, pending CMS approval, Long Beach, California-based SCAN will reach nearly 7 million potential customers across four states, including California and Arizona.
FAIR Health Monthly Telehealth Regional Tracker, May 2022, United States What You Should Know: – In May 2022, for the second straight month, telehealth utilization, as […]
Retail and technology giant Amazon (Nasdaq: AMZN) last month announced plans to acquire primary care innovator One Medical for an astounding $3.9 billion. The transaction […]
What You Should Know: – Homeward raises $50M Series B funding round co-led by ARCH Venture Partners and Human Capital. – The funding round also […]
Along with achieving better health outcomes, Medicare Advantage (MA) checks in at annual consumer savings of roughly $2,000. That’s according to a new report from […]
What You Should Know: – Today, Innovaccer Inc., the Health Cloud company, announced that Curana Health is partnering with Innovaccer to build a leading edge […]
CVS Health (NYSE: CVS) is one of the most influential health care entities in the United States. It having the health insurance giant Aetna underneath […]
What You Should Know: – Today Geisinger Health Plan (GHP) and Cohere Health, a provider of utilization management (UM) technology, announced they are joining forces to streamline the prior authorization process for […]
Siddharth Thakkar, VP, Product and Marketing at IKS Health For the better part of a decade, the shift toward value-based care in the U.S. has […]
Seniors’ demand for Medicare Advantage plans shows no signs of slowing down any time soon, and that means CMS is likely to continue accelerating its […]
The relationship between Medicare Advantage plans and home health care agencies has not changed much over the last few years. They are often filled with […]
House lawmakers are pushing for more oversight of Medicare Advantage (MA) plans in light of concerns over higher spending, improper claim denials and access to […]
Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars […]
Most Medicare Advantage enrollees are satisfied with their plan and prefer it to other forms of Medicare insurance like Medigap, according to a report released […]
As home-based care providers struggle to gather quality and reliable data across their platforms, Signify Health (NYSE: SGFY) feels like it is positioned to keep […]
Michael Gardner, Chief Strategy Officer at Virsys12 As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a […]
Shifting health care payer trends have home-based care providers stuck between two battling business decisions: “adapt or die,” or sustainability. Those two decisions may look […]
Aledade, a startup that partners with independent practices to establish accountable care organizations, raised $123 million in a Series E funding round. The company plans […]
What You Should Know: – Homeward, the comprehensive rural care provider network launched by former Livongo titan, Dr. Jenny Schneider, has announced a partnership with […]
What You Should Know: – CareMax, a tech-enabled provider of value-based care to seniors announced an agreement to acquire the Medicare value-based care business of […]
Home health and personal care services provider Amedisys Inc. (Nasdaq: AMED) is experimenting with a new model that better fits the Medicare Advantage-heavy environment of […]
Home health care providers and Medicare-for-all advocates certainly agree on their general disliking of Medicare Advantage (MA). The one problem is that these advocates are […]
What You Should Know: – Olive, the automation company creating the Internet of Healthcare, today announced its partnership with Magenta Care Continuum, a HIPAA-compliant health records […]
With the nationwide rollout of the Home Health Value-Based Purchasing (HHVBP) Model inching closer, home health agencies are feeling confident about their ability to adapt. […]
One way MA plans can stand out in an increasingly competitive market is by making members aware of the benefits they may not even know […]
The home health industry’s battle with Medicare Advantage (MA) plans for fair rates has gone from a few stakeholders saying “the quiet part out loud” […]
The highly fragmented home health industry has turned providers into commodities, at least in the eyes of Medicare Advantage (MA) organizations. Because there are so […]
CVS Health (NYSE: CVS) recently floated the idea of home health acquisitions and partnerships. Mostly, it has repeatedly doubled down on the idea that it […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Home-based palliative care is an untapped business opportunity for many home health and hospice providers in the U.S., but multiple factors continue to hinder near-term […]
What You Should Know: – Three leading organizations that provide healthcare services to senior living communities – Elite Patient Care, Provider Health Services, and AllyAlign Health […]
Anne Davis, VP of Government Markets & Strategy at Wellth Structural racism and poverty are correlated with a higher incidence of obesity among Black Americans […]
Medicare Advantage (MA) organizations have limited beneficiaries’ access to necessary care. They have also denied payments to providers for services that are covered under Medicare […]
Encompass Health reported a strong financial first quarter for 2022 despite continued staffing constraints in its home health business. On Wednesday, Encompass Health reported total […]
Medicare Advantage Organizations (MAOs) delayed or denied payments and services to patients, even when these requests met Medicare coverage rules, according to a report released […]
Humana Inc. (NYSE: HUM) has been vocal about its plan to develop its health care services capabilities in three phases. The first phase is building […]
What You Should Know: – Blue Cross Blue Shield of Michigan (BCBSM) today announced a joint venture with Nashville-based Honest Medical Group to offer physicians comprehensive operational, clinical, […]
Compared to fee-for-service Medicare, seniors save close to $2,000 on average in total annual health care spending with Medicare Advantage (MA). That’s according to a […]
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Shahyan Currimbhoy, VP at Edifecs Aaron Fulner, Sr. Director at Edifecs Up until now, risk adjustment has been addressed as a mechanism to accurately represent the overall risk profile of […]
The Series B funding round was led by Enhanced Healthcare Partners. Hoboken, New Jersey-based Vytalize has grown its patient base 150% year-over-year and is now […]
What You Should Know: – Vytalize Health raises over $50 million to advance its value-based care platform for seniors helping primary care doctors strengthen relationships […]
When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several […]
With more than two years having passed since the COVID-19 pandemic began in early 2020, questions are being raised about when to end the public […]
New data relating to Special Supplemental Benefits for the Chronically Ill (SSBCI) has been released. And while there are plenty of kinks to work through […]
By GEORGE HALVORSON This is the third part of former Kaiser Permanente CEO George Halvorson’s critique of Medpac’s new analysis of Medicare Advantage. Part 1 […]
Though home health admissions have begun to stabilize, providers are still seeing admissions that are lower than pre-pandemic levels. That’s according to the 2021 post-acute […]
By GEORGE HALVORSON This is the second part of former Kaiser Permanente CEO George Halvorson’s critique of Medpac’s new analysis of Medicare Advantage.Part 1 is […]
By GEORGE HALVORSON This is the first part of former Kaiser Permanente CEO George Halvorson’s critique of Medpac’s new analysis of Medicare Advantage. The rest […]
Fierce Healthcare reports that in 2022 Medicare Advantage enrollment is continuing to grow at the expense of traditional fee-for-service Medicare. They write that: Medicare Advantage […]
Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign […]
In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several […]
Widowed and usually living alone, Gloria Bailey walks with a cane after two knee replacement surgeries and needs help with housekeeping. So she was thrilled […]
A report detailed how Medicare Advantage grew again, gaining some of its numbers from new members and poaching others from Original Medicare, which is declining […]
What You Should Know – Homeward, a new company focused on improving access to high-quality, affordable primary and specialty care in rural communities launches with an initial […]
A lot changed for Signify Health Inc. (NYSE: SGFY) throughout 2021. One thing that has remained constant, though, is the organization’s push towards a value-based […]
As a parting gesture to a pandemic-ravaged city, former New York Mayor Bill de Blasio hoped to provide the city with a gift that would […]
BY NIRBAN SINGH AND AMY HELBURN Introduction Medicare Advantage (Advantage), originally conceived in 1997 during the Clinton Administration as ‘Medicare + Choice’, has progressively grown […]
Medicare Advantage (MA) supplemental benefits adoption has been slow by some measures and rapid by others. A new report from the consulting firm Milliman offers […]
A trip to the Home Care 100 conference in Phoenix, Arizona, this past week was refreshing. It was an escape from the frigid Chicago temperatures. […]
By RICHARD ISSACS You’ll recall that we ran a long piece (pt 1, pt 2) about Medicare Advantage from former Kaiser Permanente CEO George Halvorson […]
What You Should Know: – NourishedRx, a digital health company raises $6M in seed funding led by S2G Ventures with additional investors Route 66 Ventures, […]
Suzanne Cogan, General Manager, SPH Analytics, a Press Ganey Solution Healthcare organizations are increasingly eager to leverage analytics technologies, including machine learning and artificial intelligence […]
Coming off a major expansion that took place last year, Zing Health has now set its sights on reducing social isolation. The Medicare Advantage (MA) […]
The Biden Administration’s requirement for private insurers to cover the cost of at-home rapid COVID-19 tests for their enrollees does not apply to Medicare. Medicare […]
Anthem Inc. (NYSE: ANTM) believes that its dedication to supplement benefits – including at-home care offerings – is strengthening its value proposition among other health […]
What You Should Know: – RecoveryOne, a digital health innovator dedicated to improving health outcomes for recovery from musculoskeletal (MSK) injuries of all types and reducing costs, announced […]
RecoveryOne will now offer their virtual physical therapy app for musculoskeletal (MSK) injuries as an in-network benefit to some Cigna Medicare Advantage Customers.
Many of the in-home supplemental benefits offered by Medicare Advantage (MA) plans are new. But whether they are through the primarily health-related pathway, which began […]
UnitedHealth Group (NYSE: UNH) was the first health care titan to report its 2021 year-end results, doing so Wednesday morning. The Minnetonka, Minnesota-based company showed […]
Medicare Advantage (MA) has been viewed over the last few years as a new space for home-based care providers to generate revenue. Changes have allowed […]
By GEORGE HALVORSON Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably with his proposal for Medicare Advantage for […]
If 2020 was the year home care finally entered the spotlight, then 2021 was the year the industry solidified that star power while gaining powerful […]
New data relating to Medicare Advantage (MA) benefits is on its way out for the new year. And finally, it looks as if optimistic home-based […]
In December, CVS Health (NYSE: CVS) shared its strategy for “revolutionizing” the consumer experience through its primary care, payer, digital and omnichannel health services offerings, […]
By GEORGE HALVORSON Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably with his proposal for Medicare Advantage for […]
CareLinx, now a part of Sharecare, has had an eye on Medicare Advantage (MA) opportunities ever since in-home care services became a benefit under MA […]
Regence is partnering with Strive Health to deliver comprehensive kidney care to 16,000 Regence Medicare Advantage and commercially insured plan members in several Western states.
What You Should Know: – Medicare Advantage provider Zing Health raises $25M from Town Hall Ventures and Leavitt Equity Partners, two leading investors focused on growing […]
SCAN Health Plan and MedArrive are teaming up to provide COVID-19 booster and flu shots to homebound seniors throughout California’s Los Angeles and Orange counties. […]
With Medicare Advantage (MA) enrollment on the rise, home health providers need to be primed to adapt to the changing market. MA has played a […]
Home care has become a crucial part of care plans for primary care providers (PCPs), according to a new value-based care report conducted by Humana […]
In-home support services are the most popular — and arguably impactful — supplemental benefit offered by Medicare Advantage (MA) plans under the primarily health-related category. […]
What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best […]
More Medicare Advantage (MA) plans are offering in-home support services as supplemental benefits. That’s according to a new report from Washington, D.C.-based research and advisory […]
Encontrar el mejor plan médico privado, o de medicamentos, de Medicare entre docenas de opciones es lo suficientemente difícil sin incluir estrategias de venta engañosas. […]
Switching seniors to Medicare Advantage plans has cost taxpayers tens of billions of dollars more than keeping them in original Medicare, a cost that has […]
Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. […]
Signify Health Inc. (NYSE: SGFY) believes that it will be more suited to deal with workforce shortages than other, more traditional home-based care providers. In […]
According to a survey of hospital finance leaders by Guidehouse, 60% of them are looking to advance into Medicare Advantage models next year. They still […]
In its earnings statement, the company disclosed that it received a civil investigative demand from the Department of Justice. Specifically, the agency was looking for […]
A record 3,834 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare for 2022, a new KFF analysis finds. That’s […]
For 2022, the average Medicare beneficiary has access to 39 Medicare Advantage plans, the largest number of options available in the last decade, and can […]
This issue brief provides an overview of the Medicare Part D prescription drug benefit market for 2022, with a primary focus on stand-alone drug plans. […]
Insurtech company The Helper Bees recently launched an aging-in-place provider marketplace. With the rollout of this new platform, the company is positioning itself as a […]
“Did you think we wouldn’t notice?” an older woman says, speaking into the camera. “You thought you could sneak this through?” an older man later […]
The California-based health system and insurer has bilked CMS out of “hundreds of millions of dollars” by submitting claims that were altered to make patients […]
Patina Health – a primary care startup focused on delivering care in the home – announced a Series A funding round of $57 million early […]
The bill, if enacted into law, will establish an electronic prior authorization process and require Medicare Advantage plans to report on their use of prior […]
Kaiser Permanente is one of the largest health systems and health plans in the entire U.S. And while home-based care has always been a part […]
Close to 90% of older adults want to receive care in their homes as they age, according to a study conducted earlier this year by […]
Two weeks ago, Home Health Care News hosted our flagship FUTURE Conference in downtown Chicago. Since then, I’ve been reflecting on the event’s panels as […]
With enrollment up and more plans launching each year, Medicare Advantage (MA) organizations have had to figure out how to differentiate themselves in an increasingly […]
Though the Medicare Advantage-focused insurance technology startup is smaller than rivals like Clover Health in terms of membership and revenues, this latest financing round places […]
SCAN Health Plan is launching a new care delivery model that it hopes will set a new standard within the Medicare Advantage (MA) space. A […]
CMS is lowering the average premium for MA plans to $19 per month in 2022 from about $21 this year. The news comes as several […]
Newer supplemental benefits like access to in-home support services or a personal care helper have helped Anthem Inc. (NYSE: ANTM) attract and retain Medicare Advantage […]
October is normally a pretty eventful time for home health and home care operators. This year will certainly be no different, particularly when it comes […]
Overall, MA companies generated an estimated $9.2 billion in risk-adjusted payments for diagnoses listed only on chart reviews and health risk assessments, with the top […]
The Helper Bees (THB) announced Wednesday the launch of its aging-in-place provider marketplace. Austin, Texas-based THB is a full-service insurtech company that works to create […]
Many Medicare beneficiaries face high annual out-of-pocket costs for dental and hearing care — services that generally aren’t covered in traditional Medicare, but typically are […]
This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and […]
As of Friday, nearly 55% of the U.S. population was fully vaccinated against the COVID-19 virus. Despite a strong start, that figure now puts the […]
The agency has suspended enrollment in three UnitedHealthcare plans and one Anthem plan for 2022 because the plans did not spend enough of their premium […]
SCAN Health Plan has been serving numerous counties across California for decades. Now, the Medicare Advantage insurer plans to expand its footprint to two additional […]
The Justice Department has accused an upstate New York health insurance plan for seniors and its medical analytics company of cheating the government out of […]
Through the partnership, Ochsner Health’s Medicare Advantage patients will gain access to Bold’s platform, which assesses current fitness levels to create a personalized exercise program […]
What You Should Know: – Ochsner Health and innovationOchsner (iO) have partnered with Bold, an evidence-based, digital exercise platform for older adults aimed at reducing […]
The California-based health system will pay a hefty price to resolve allegations that it knowingly submitted inflated diagnosis codes for certain Medicare Advantage beneficiaries to […]
In a wide-ranging interview, Dr. Scott Weingarten, the payer’s inaugural chief innovation officer, discussed his priorities in his new role, including the new payer-agnostic geriatric […]
Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you […]
Overturning a district court’s decision that had earlier vacated the Medicare Advantage Overpayment Rule, the DC Circuit opened a Pandora’s Box of DOJ False Claims […]
The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap […]
This analysis finds that Medicare spending for Medicare Advantage enrollees was $321 higher per person in 2019 than if enrollees had instead been coverage by […]
Sorry, Joe Namath. Despite what you keep saying in those TV ads, under Medicare, seniors are not “entitled to eliminate copays and get dental care, […]
In recent years, Medicare Advantage (MA) plans have increasingly turned their attention to addressing members’ social determinants of health (SDoH), with the home playing a […]
The insurtech company, which went public in March, is planning to expand to 16 new markets across Nevada, North Carolina and Arizona next year. It […]
CMS has finalized its 2022 inpatient payment rule, which will not only repeal part of the price transparency requirements related to Medicare Advantage rates and […]
A little over half (55%) of Medicare Advantage plan members actively managed their care in the past year — a nine-percentage-point drop from 2019, according […]
The government has intervened in complaints alleging Kaiser Permanente entities defrauded Medicare out of “tens of millions of dollars” by knowingly submitting false diagnoses for […]
With the right kinds of MA partnerships, physicians can more fully engage, collaborate, and capture the value they create.
Despite still reeling from COVID-19-related headwinds, Humana Inc. (NYSE: HUM) experienced better-than-expected results in its home and provider businesses during the second quarter of 2021. […]
Many people enrolled in Medicare go without dental care, especially beneficiaries of color, according to a new KFF analysis of dental coverage and costs for […]
Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other […]
Anthem Inc. (NYSE: ANTM) continues to tout its positioning when it comes to home-based care. The Indianapolis-based insurer acquired myNEXUS — a convener that manages […]
UnitedHealth Group (NYSE: UNH) leaders highlighted key growth drivers for the company during a Thursday morning conference call on Q2 2021 financial results. Execs honed […]
Enrollment in Medicare Advantage plans grew rapidly between 2009 and 2018, with the largest increases seen among Black, Hispanic and dual enrollee — that is […]
The startup, called Medorion, raised $6 million in a Series A funding round. The company provides tools to create a database of “electronic behavior records” […]
Senior-focused primary care provider Cano Health acquired Doctor’s Medical Center for $300 million, which adds around 54,000 new members and 18 medical centers to its […]
Health plans — and the entities that own them — continue to invest heavily around in-home care. The latest example is GuideWell Mutual Holding Corporation, […]
Cano Health, which provides primary care services for seniors, bought Miami-based University Health Care for $600 million. University Health Care serves approximately 24,000 Medicare Advantage […]
Home care companies looking to lean into Medicare Advantage (MA) opportunities in their markets will have to plan prudently. That planning must be pretty comprehensive, […]
The Medicare Advantage (MA) opportunity isn’t one that has happened overnight for home care providers, with some industry insiders even describing it as a “slow […]
AllyAlign Health, which offers health plans for seniors like Medicare Advantage and institutional special needs plans, has raised $300 million in funding. It will use […]
What You Should Know: –Innovaccer Inc., a leading healthcare technology company, recently launched its Health Plan Analytics tool, which provides a comprehensive view of health […]
Clover Health (Nasdaq: CLOV) announced Wednesday that it plans to scale its in-home primary care program, “Clover Home Care,” through the new direct-contracting model from […]
Medicare Advantage has grown over time. In 2020, nearly four in ten (39%) of all Medicare beneficiaries – 24.1 million people out of 62.0 million […]
The Medicare Advantage (MA) market is controlled mostly by big payers, as the top 10 plans control over 75% of the market. Then there is […]
The Medicare Advantage (MA) program has carved out a larger role in the general Medicare universe over the last several years. The MA piece of […]
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private […]
The COVID-19 public health emergency has solidified the home as a viable and effective care setting. That, in turn, has led to meaningful opportunities for […]
While the insurance industry, and especially the Medicare program, continues to expand benefits there remains a lot of opportunity for improvement surrounding alternative medicine coverage.
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, […]
Payers appeared to have a profitable 2020, with gross margins per member per month increasing, and administrative costs and medical loss ratios decreasing, a new […]
When it planned to go public through a SPAC merger, insurance startup Clover Health told investors that it already had 200,000 direct contracting lives under […]
The health insurance startup and transportation service company are joining forces to offer Medicare Advantage members access to non-emergency medical transportation. With transportation being a […]
Is your “marketing to seniors” an audience turn-off? Are you inadvertently alienating the mature audience that you want to attract? Many people get genuinely upset—insulted, […]
This analysis examines insurers’ financial data across markets through the end of 2020. It finds that average margins remained relatively high compared to recent years, […]
As the breadth and depth of what Medicare Advantage (MA) plans can offer has grown, the actual management of supplemental benefits has gotten more complex. […]
The greatest uncertainty is members’ health status, which could impact MA organizations’ bidding submission process for 2022. Fortunately, fully vaccinated members are likely to resume […]
Humana Inc. (NYSE: HUM) believes it can deliver home health services better than traditional providers do today. More than any other reason, that’s fundamentally why […]
Votive Health — a technology startup that facilitates payer-provider integration — formally announced its launch and first funding round on Wednesday. The company raked in […]
Just as other industries are rolling back some consumer-friendly changes made early in the pandemic — think empty middle seats on airplanes — so, too, […]
A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to […]
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 […]
Medicare Advantage (MA) has provided tailwinds for home-based care providers, as the overall MA member population has grown substantially over the last decade. In 2020, […]
onehome — a home-focused post-acute care company that operates under a full-risk model — is gearing up for a major expansion push. And it’s doing […]
Accra executive lands promotion Accra has promoted Susan Morgan to the role of chief operating officer. The Minnetonka-based Accra is the largest provider of home […]
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 […]
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 […]
A new report from Washington, D.C.-based health care consulting firm Avalere Health is shining a brighter light on home-based care and its ability to drastically […]
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 […]
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 number of health plans offering some kind of innovative supplemental benefit skyrocketed in the past year, reflective of health care’s increasingly strong focus on […]
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 […]
Two in-home care providers — ConcertoHealth and Perfect Health — announced Wednesday that their organizations have merged. Together, the companies will operate under the name […]
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, […]
Humana Inc. (NYSE: HUM) continues to make significant investments when it comes to building a home-based care strategy. Currently, the Louisville, Kentucky-based company’s in-house home-based […]
To better care for its members with multiple chronic conditions, health insurance giant Humana Inc. (NYSE: HUM) is teaming up with DispatchHealth to offer advanced […]
In September, the U.S. Centers for Medicare & Medicaid Services (CMS) released high-level data suggesting a huge expansion of new Medicare Advantage (MA) supplemental benefits […]
All eyes have been on Encompass Health Corp. (NYSE: EHC) since the company first announced it would be “exploring strategic alternatives” for its home health […]
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 […]
It appears some health care companies are still opting to go public the old-fashioned way. Signify Health — a value-based care platform that uses advanced […]
The company partners with independent practices, health centers and clinics to establish primary care-focused accountable care organizations.
What You Should Know: – Aledade raises $100 Million in Series D funding to help more primary care practices thrive in value-based care. – The […]
What You Should Know: – Today, CVS Health announced Symphony, a medical alert system designed to keep seniors safe and connected at home. – Symphony […]
Medicare Advantage enrollment has grown rapidly over the past decade, and Medicare Advantage plans have taken on a larger role in the Medicare program. More […]
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 […]
The majority of health care financial leaders view home care as a key area of investment. That’s according to a recent survey from BDO, a […]
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 […]
Under the Trump administration, federal health care policymakers have long been vocal about the ability of Medicare Advantage (MA) to lower costs and improve outcomes […]
On the heels of a $140 million funding round, insurance startup Oscar Health confidentially filed for an IPO.
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 […]
In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average […]
Anne Davis, Director of Quality Programs & Medicare Strategy at HMS A global health crisis has thrust us into a scenario in which lives quite […]
Shanti Wilson, Consultant, Freed Associates As if 2020 couldn’t be any more challenging for healthcare providers, new federal rules on interoperability and patient access, granting patients […]
As mission-driven organizations, SCAN Group and SCAN Health Plan have leaned into trying to solve some of health care’s biggest problems. In particular, keeping seniors […]
The public comment period has just closed for the calendar year (CY) 2022 Medicare Advantage (MA) and Part D Advance Notice recently released by the […]
Home-based care company Prospero Health announced Tuesday it is expanding into 16 additional states to serve 8,000 new patients in 2021. That vastly increases the […]
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. […]
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 […]
A number of major Medicare Advantage (MA) carriers are expanding their supplemental benefit offerings shaped around in-home care next year. UnitedHealthcare, the insurance arm of […]
Humana Inc. (NYSE: HUM) continues to shift its operations toward value-based care payment models, both with internal service lines and with external provider partnerships. The […]
The ongoing expansion of Medicare Advantage (MA), a federal minimum-wage hike and additional support for front-line health care workers during the COVID-19 public health emergency. […]
For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can […]
This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2021, with a focus on stand-alone drug plans. […]
With hundreds of plans reportedly offering in-home support services in 2021, the coming year is certain to bring more Medicare Advantage (MA) opportunities for home […]
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 […]
This analysis shows that more than half of Medicare beneficiaries do not compare coverage options annually during the open enrollment period, despite the fact that […]
As Medicare Advantage (MA) enrollment explodes and plans begin to offer more benefits to members, home health and home care agencies alike need to prove […]
In-home care providers with a mission to serve particularly vulnerable populations often target “dual eligibles,” or individuals signed up for both Medicare and Medicaid benefits. […]
The U.S. Centers for Medicare & Medicaid Services (CMS) last month released new Medicare Advantage (MA) figures highlighting a massive expansion of plans offering home-focused […]
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 […]
Today on Health in 2 Point 00, Jess and I gossip about the wild rumor that UnitedHealthcare is acquiring Amwell. On Episode 157, we discuss […]
What You Should Know: – Humana Inc. and Fresenius Medical Care North America (FMCNA) today announced an agreement to broaden their collaboration toward improving the […]
Clover Health recently announced that it will go public through a merger with a special purpose acquisition company (SPAC), Social Capital Hedosophia Holdings Corp. III. […]
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.
What You Should Know: – Walmart announced it will begin selling Medicare insurance plans during this year’s annual enrollment period, Oct. 15 through Dec. 7. […]
People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu […]
The insurer plans to increase the footprint for its Medicare Advantage plans by 50%, adding plans in 300 additional counties.
What You Should Know: – Independence Blue Cross and Signify Health launches social determinants of health network, CommunityLink to connect data from multiple CBOs to […]
What You Should Know: – Cone Health has signed a letter of intent to merge with Norfolk, Virginia-based Sentara Healthcare for a combined $11B in assets. […]
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 […]
Irv Lichtenwald, President & CEO of Medsphere Systems Corporation In the late 1940s, the United Kingdom was busily reassembling country and what remained of the […]
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 […]
Humana’s (NYSE: HUM) long-standing home- and community-based focus served the insurer well in Q2 2020 — a quarter dominated by the COVID-19 emergency. The coronavirus […]
Home health admissions saw a slight decline in volume during the fourth quarter of 2019. Meanwhile, referral trends appear to be holding steady. That’s according […]
While the Medicare Advantage (MA) home care opportunity continues to expand, cynics have been quick to criticize it. Some say the opportunity is too small […]
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 […]
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 […]
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 […]
Securing stockpiles of personal protective equipment (PPE), doubling down on company-wide training efforts and implementing educational initiatives are just some of the responsibilities that home […]
Walmart quietly launched a new health insurance business. The company, called Walmart Insurance, was filed with the Arkansas Secretary of State last month.
The coronavirus could be the match that finally sparks the Medicare Advantage (MA) boom for home care. The explosion has been a long time coming. […]
Copyright © 2024 | WordPress Theme by MH Themes