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Payers and Providers

UnitedHealth Group Plans to Unveil Health Record for Members, Providers in 2019

October 17, 2018  |  Rajiv Leventhal, Managing Editor
news
Health insurer UnitedHealth Group will be unveiling a “fully integrated and fully portable individual health record,” CEO David Wichmann said on the on the company’s third-quarter earnings call yesterday.

Nemours Children’s Health’s New CEO: “The Most Exciting Time in Healthcare”

October 12, 2018  |  Mark Hagland
article
R. Lawrence Moss, M.D., who joined Nemours Children’s Health as CEO on Oct. 1, discusses the challenges and opportunities facing children’s hospitals and healthcare in the current environment

DOJ Approves CVS-Aetna $69B Merger, On Condition Aetna Divest Part D Business

October 10, 2018  |  Heather Landi, Associate Editor
article
The Justice Department has approved a $69 billion merger between mega-pharmacy retailer CVS Health and health insurer Aetna, on condition that Aetna divest is Medicare Part D prescription drug plan business.

At the HIT Summit in Raleigh, a Health Plan Executive Points to the Future of Value-Based Care

October 8, 2018  |  Mark Hagland, Editor-in-Chief
article
Speaking at the HIT Summit in Raleigh last month, Humana’s Ben Lunsford offered attendees insights into the future of value-based healthcare, and his health plan’s future intentions

On the Road to Risk, Summit Medical Group is Driving in the Fast Lane

October 2, 2018  |  Rajiv Leventhal, Managing Editor
article
In a recent interview with Healthcare Informatics, Jeffrey Le Benger, M.D., outlined the progress and evolution of his organization and how it’s continuing to plunge ahead into the world of risk and value-based care.

Climbing Up the Risk Ladder: How National ACO Has Built a Winning Value-Based Care Infrastructure

September 27, 2018  |  Rajiv Leventhal, Managing Editor
article
National ACO—headquartered in Beverly Hills, Calif., but with providers in multiple states—has progressed through the federal ACO ranks in a way that could set the path for others

Study: Health Plans Account for Majority of Breached Patient Records

September 25, 2018  |  Heather Landi, Associate Editor
news
Health plans accounted for the greatest number of patient records breached over the past seven years, according to an analysis of U.S. health care data conducted by two Massachusetts General Hospital physicians.

With $6.3M PCORI Contract, UPMC Health Plan to Study Tech-Based Approach to Chronic Disease

September 25, 2018  |  Heather Landi, Associate Editor
news
The UPMC Center for High-Value Health Care was recently awarded a $6.3 million contract from the Patient-Centered Outcomes Research Institute (PCORI) to study different care delivery models to improve outcomes for patients with chronic disease and a co-existing...

Premier Inc. Executives: Time to Unpack Some of the Challenges and Opportunities Inherent in the Path Into Risk

September 24, 2018  |  Mark Hagland
article
Shawn Griffin, M.D. and Steve Valentine of Premier Inc. discuss the challenges involved in the path into risk-based contracting, and the potential upending of the landscape by new disruptors

Is the Discourse Over the MSSP Program Teetering Towards Potential Conflict?

September 21, 2018  |  Mark Hagland, Editor-in-Chief
commentary
The joint statement by nine associations challenging CMS Administrator Seema Verma around her plans to insert more rigor into the MSSP program, feels like a teeter-totter moment for CMS

Town Hall Ventures Close First Fund at $115 Million

September 20, 2018  |  David Raths, Contributing Editor
news
Town Hall Ventures, an investment firm built to address the healthcare challenges of the most vulnerable Americans, has closed its first fund at $115 million.

The CEO of a Nationwide Association of MD Groups Sees the Future—and It’s Not in Fee-For-Service

September 18, 2018  |  Mark Hagland
article
Don Crane, CEO of APG, a nationwide association of medical groups working in risk-based contracting, shares his perspectives on the future of medical groups in a shifting landscape

On Staten Island, a Highly Innovative Program That's Redefining What’s Possible Under Medicaid

September 17, 2018  |  Mark Hagland, Editor-in-Chief
article
Healthcare leaders on New York City's Staten Island have been achieving exciting success in population health management in their community’s Medicaid and uninsured populations

Cigna to Invest $250M in Venture Fund with Eyes on Healthcare Startups

September 17, 2018  |  Rajiv Leventhal, Managing Editor
news
Cigna, the Connecticut-based health services company, has announced the launch of Cigna Ventures, a corporate venture fund focused on investing in promising healthcare startups and growth-stage companies.

Humana’s CMO Speaks of the “Bold Goal” Embedded in the Company's Population Health Work

September 14, 2018  |  Heather Landi, Associate Editor
article
Roy Beveridge, M.D., Humana’s chief medical officer, shares his perspectives on the drive to value-based care, population health and addressing social determinants of health.

New Healthcare Alliance Launches APM for Addiction Recovery

September 12, 2018  |  Rajiv Leventhal, Managing Editor
news
A national multi-sector alliance of healthcare stakeholders has announced the creation of the Addiction Recovery Medical Home (ARMH) model.

Putting Social Determinants of Health Data into Action

September 10, 2018  |  Heather Landi, Associate Editor
article
Leading hospitals, medical groups, and health systems, as well as ACOs and health insurers are moving forward to address social factors impacting health with a number of different approaches.

In the Emerging World of Risk-Based Contracting, Data Analytics Is a Foundational Necessity

September 7, 2018  |  Mark Hagland, Editor-in-Chief
article
With the emergence of more risk-based contracting, including two-sided risk, data analytics has now become fundamental to patient care organizations’ operational and financial success.

Top Ten Tech Trends 2018: Markets and Medicine—Where Do Physicians Land, in the Emerging World of U.S. Healthcare?

September 5, 2018  |  Mark Hagland, Editor-in-Chief
article
Even as the purchasers and payers of healthcare push hard on physicians to embrace value-based care delivery and payment, doctors remain conflicted and ambivalent about the new healthcare.

Humana to Launch Digital Health and Analytics Center in Boston

September 5, 2018  |  Rajiv Leventhal, Managing Editor
news
Humana will establish a center for digital health and analytics in Boston, the Louisville-based health insurer announced last week.

Top Ten Tech Trends 2018: A Social Determinants of Health Technology Market is Slowly Emerging

September 4, 2018  |  Heather Landi, Associate Editor
article
The IT market for social determinants of health data is currently a nascent field with many providers using homegrown solutions, but adoption of SDoH technology is expected to grow quickly.

Top Ten Tech Trends 2018: Are the Lines Between Provider and Payer Organizations Beginning to Blur? To Some, That Would be Progress

September 4, 2018  |  Mark Hagland, Editor-in-Chief
article
As physician-based and hospital-based organizations plunge further into risk-based contracting, managing the contracts and the processes is turning out to be highly challenging for everyone.

The First 3 Things ACOs Should Do with Their Data

August 28, 2018  |  Aaron Elias, Industry Voice
article
New ACOs are inundated with many activities, from strategic decisions to technical requirements, but managing and using data should also rank highly on one's list of priorities.

Analyzing Blockchain’s Evolution in Healthcare: Two Experts Dive into the Details

August 15, 2018  |  Rajiv Leventhal, Managing Editor
article
Two leaders at KPMG recently spoke with Healthcare Informatics about the greatest use cases for blockchain in healthcare today, and how quickly providers and payers might start moving into full-scale projects.

Fitbit, Blue Cross Blue Shield Launch Mobile Health Partnership

August 13, 2018  |  Heather Landi
news
San Francisco-based fitness wearable maker Fitbit continues its push into the health plan market with a new digital health deal to incorporate its fitness tracker into health and wellness programs.

Assessing CMS’s Risky Move on Risk: Has Seema Verma Pushed MSSP ACOs Into Uncharted Territory?

August 13, 2018  |  Mark Hagland, Editor-in-Chief
commentary
Will Seema Verma’s August 9 announcement of CMS’s new “Pathways to Success” proposal light a fire under the MSSP ACOs, or will it cause provider organizations to flee? CMS officials are taking a risky gamble—with no clear outcome

At the Health IT Summit in Boston, One ACO’s Data-Facilitated Journey Into Value

August 7, 2018  |  Mark Hagland
article
What does it mean for an organization to pursue a data-facilitated journey into value-based care? Bill Gillis, CIO of the Beth Israel Deaconess Care Organization, shared his learnings and perspectives on that subject, at the Health IT Summit in Boston

Can Blue Cross of North Carolina Help to Reshape Its State’s Healthcare Landscape?

July 31, 2018  |  Mark Hagland
commentary
Remarks made by Patrick Conway, M.D. this spring point to some of the opportunities—and profound challenges—facing the shift towards a value-based healthcare system in North Carolina—and the challenges facing health insurers attempting to stimulate that change

Anthem Expands $500M Deal with IBM with Focus on IT Automation, AI

July 26, 2018  |  Heather Landi
news
Health insurer Anthem has expanded its services agreement with technology leader IBM with a focus on using artificial intelligence (AI) and automation to improve operational efficiency and modernize technology platforms.

HSX, Food Alliance Partnership Extends Data-Sharing to Food, Nutrition

July 24, 2018  |  Heather Landi
news
The Philadelphia-based Metropolitan Area Neighborhood Nutrition Alliance (MANNA) has become a participating member of HealthShare Exchange (HSX), which enables the food alliance to receive important medical updates from HSX on its clients.

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