Payers
-
HealthPartners Exec: The 5 Rules To Scale Value-Based Care in the Commercial Market
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.
-
Breaking Through Gridlock in the Mental Health Care System
For the gridlock in mental healthcare to be resolved, 100% of mental healthcare providers must practice measurement-based care, utilizing validated rating scales to monitor and measure longitudinal outcomes for every patient. And payers then must offer reimbursement that appropriately rewards providers for delivering high-quality, effective care, and incentivize proactive mental health management.
-
Payer’s Place: Don Antonucci
The CEO of Providence Health Plan visits the Payer’s Place and addresses the future of payment models.
-
Payer’s Place: Dr. Anil Singh, Highmark Health
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
-
Is Medicaid Expansion Still a Political Wedge Issue?
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.
-
What CVS Stands to Gain by Setting Up Biosimilar Subsidiary Cordavis
Pharmaceutical industry observers say CVS Health’s creation of Cordavis, a new biosimilar drugs company, is part of a strategy to make its move into this market as profitable as possible.
-
Solera Health Launches Weight Management Solution for Payers and Employers
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.
-
Report: MA Enrollment Has Quadrupled in Rural Communities Since 2010
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.
-
MA Beneficiaries With Cancer Spend Less on Healthcare Than Traditional Medicare Beneficiaries
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.
-
Payer’s Place: Don Antonucci, Providence Health Plan
The CEO of Providence Health Plan visits the Payer’s Place and addresses the future of payment models.
-
Two Value-Based Care Initiatives That Could Shift the Alternative Payment Model Landscape
The Centers for Medicare and Medicaid Services has announced two value-based care alternative payment models set to launch in July 2024, one focused on dementia and one on primary care.
-
Integrating Workers’ Comp and Medical Benefits Makes So Much Sense
The current dual-system model is inefficient, wasteful, and inconvenient. There is a clear need to integrate workers’ comp and medical benefits programs to cut down on costs and alleviate the hassle of dealing with separate care silos. It’s possible, and its time has come.
-
Report: About Half of MA Beneficiaries Leave Their Plan After 5 Years
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.
-
Amgen, FTC Settlement Allows $28B Horizon Acquisition to Move Forward
Amgen and the Federal Trade Commission are settling the lawsuit the regulator filed to block the pharmaceutical giant’s $28 billion Horizon Therapeutics acquisition. As part of the settlement, Amgen agrees not to “bundle” its products with Horizon’s drugs in negotiations with health plans.