The commercial market has struggled to adopt value-based care, but HealthPartners has had some success, according to Mark Hansberry, senior vice president and chief marketing officer of the company. During a conference, he shared five rules for scaling value-based care, including creating trust and providing real-time data.

The Federal Trade Commission only gets notified when a merger/acquisition deal value is above $100-$110 million, so smaller deals nonetheless lead to a slow consolidation of the market. In conference remarks, FTC Chair Lina Khan outlined the ways in which the agency is trying to counter this phenomenon.

CardioOne, a startup built at Redesign Health, partners with independent cardiology practices to help them transition to value-based care. On Monday, the company announced it has raised $8 million in seed funding and has three new partners.

MedCity News is launching a new podcast called MedCity FemFwd, which will discuss the breakthroughs and challenges in the women’s health space. In the inaugural episode, Michelle Long of KFF examines whether Opill — the first daily oral contraceptive approved for nonprescription use in the U.S. — will be covered by insurance.

More than a dozen civil rights organizations alleged in a new complaint that Florida uses administrative practices that are preventing underserved communities from renewing their Medicaid coverage.

MedImpact and GoodRx are teaming up to lower costs for MedImpact members. When eligible MedImpact members refill a generic prescription, the companies’ savings solution will compare the member’s benefit to GoodRx’s price and will automatically apply the lowest one.

When Medicaid expansion was first enacted, it was a hot topic debate between Democrats and Republicans. But more and more states are starting to expand Medicaid, including several conservative states.

Solera Health recently launched a program that aims to help patients who are interested in GLP-1s gain access to lifestyle change support. It also provides educational materials on GLP-1s.

Through a new partnership with Walgreens, Pearl Health will work with primary care providers by offering its technology and data insights to help them better their care and transition to value-based payment models. Walgreens is then providing prescription fulfillment, medication adherence, immunization and diagnostic testing services.

Talkiatry, Array Behavioral Care, Iris Telehealth and Quartet Health sent a letter to the DEA asking for a special registration process that would allow for the prescribing of certain controlled medications via telemedicine.

Pumpspotting’s funding round was led by Sincere Corporation and Maine Venture Fund and included participation from Unum Business Ventures and Maine Technology Institute. In total, pumpspotting has raised more than $3.3 million.

In rural areas, the share of eligible beneficiaries enrolled in MA plans nearly quadrupled from 11% in 2010 to 40% in 2023, according to new research from KFF. This represents 400,000 rural MA beneficiaries in 2010 and 1.8 million in 2023.

Employers expect health benefit costs to increase 5.4% per employee on average in 2024, new data from Mercer shows. This is due to inflationary pressures and health system consolidation.

A new survey from Alignment Health found that economic instability, food insecurity, lack of support and transportation access are the biggest social barriers for seniors.

Medicare Advantage beneficiaries with a cancer diagnosis spend $3,996 on out-of-pocket costs and premiums annually, versus $6,091 for traditional Medicare beneficiaries with cancer, a new report found.

After five years of enrolling in a Medicare Advantage plan, 48.3% of non-dually enrolled beneficiaries left their contract and 53.4% of dually enrolled beneficiaries did, a new study found.

Through a new partnership, Bicycle Health providers can prescribe patients buprenorphine extended release injections (otherwise known as Sublocade), which can be administered by a pharmacist at an Albertsons pharmacy.

Through a new partnership, Castell will be able to refer members of its Utah health plan customers to Headspace for behavioral health coaching and therapy.

Mental health company Two Chairs launched two new solutions Tuesday: group therapy and care navigation. The offerings will help improve access to mental health care and lead to better clinical outcomes, said Alex Katz, CEO and founder of the company

Some states may not be following federal requirements for the Medicaid renewal process, resulting in many individuals being wrongly removed from coverage, CMS said. Children may especially be affected.

Kidney care company Strive Health announced last week that it is collaborating with primary care company Oak Street Health to serve Medicare members with stage 4 chronic kidney disease and end-stage kidney disease.

A study on BeMe Health, a behavioral health platform for teens, found that users engaged with the platform eight times on average over a month. The study was done in collaboration with Stanford University.

HHS released the first 10 drugs selected for the Medicare Drug Price Negotiation Program. These drugs include Eliquis, Jardiance and Xarelto. Under the program, the federal government will be able to negotiate the price for selected drugs for the first time.

Although many employers and consumers don’t understand the difference between value-based care and fee-for-service, most are in favor of value-based care after being given the definition, a new survey found.

In a new lawsuit, Bon Secours Mercy Health Virginia alleges that Anthem Health Plans of Virginia owes the health system more than $93 million in outstanding unpaid and underpaid claims.

A new study found that between 16.2% and 17.7% of Medicare Advantage enrollees reported using post-acute care services, compared to 22.4% to 24.1% of traditional Medicare enrollees.

Cigna removed 25% of medical services from prior authorization requirements. This represents more than 600 codes, and includes 100 surgical codes, nearly 200 genetic testing codes, durable medical equipment, orthoses and prosthetics and other services, said Dr. Scott Josephs, chief medical officer of Cigna Healthcare.

For the sixth year in a row, the Medicare Shared Savings Program created overall savings, CMS announced. When compared to clinician groups of a similar size not participating in the program, participating ACOs performed better on quality measures, including measures for diabetes, breast cancer and colorectal cancer screenings, tobacco screenings and depression screenings.

In a new agreement, Interwell Health will provide care to Humana Medicare Advantage HMO and PPO members with chronic kidney disease in 13 states. It will also serve patients with end-stage kidney disease across the country.

Employers’ healthcare costs are anticipated to rise by 8.5% in 2024, according to Aon. The projected increase is nearly twice the 4.5% increase that employers saw from 2022 to 2023. Inflation is a major factor for the increase.