Feb 5, 2021 | Managed Care Friday
20: Number of primary care centers Humana opens in four states this year, including Atlanta, New Orleans and Las Vegas. Leaning on Humana as your major Medicare payer for your primary care operation brings upside given the company’s investment in risk-based models and in some cases elevated PMPMs, but it also brings this evolving dynamic of competition from Humana’s Partners in Primary Care owned practice. Staff Boom Or Zoom? Two companies merged in January to become the biggest healthcare staffing firm in Washington state. The joint company, now known as Actriv Healthcare, will employ over...
Jan 29, 2021 | Managed Care Friday
29: Percent of primary care practices “hiring” mental health staff in 2021 according to our poll of 567 PCPs, pediatricians, internists and specialty doctors who manage conditions in which depression and anxiety are common, like asthma, crohn’s, cancer, pregnancy and rheumatoid arthritis. Landing Home: Landmark Health, which focuses on in-home medical care to frail populations, formed a value-based care partnership with Southwestern Health Resources, a clinically integrated network. Through this partnership, the pair will offer multidisciplinary medical care at patients’ homes for...
Jan 22, 2021 | Managed Care Friday
7: The number of additional physician organizations BCBS of Michigan is adding to its risk-sharing payment model, Blueprint for Affordability. In total, 21 organizations are participating, representing roughly 38% of Blue Cross’ total commercial membership and 42% of the Medicare Plus Blue membership. The new physician organizations joining include ACOs and multi-specialty provider groups. Bundle This: A maternity MAT initiative kicks off this month for all OB/GYNs and maternal and fetal medicine doctors in Blue Michigan’s physician performance program, this one focused on addiction....
Jan 15, 2021 | Managed Care Friday
3: The amount of free PCP visits Blue Cross NC members will have through a new feature designed to encourage their members to go to the doctor’s office. Effective January 1, 2021, select Blue Cross NC members have no copay for their first 3 visits when visiting their PCP on file. Benefit available to ASO, fully insured, and fully insured individuals under-65 with a copay for office visits. Kidney Care: Beginning this month kidney care management company Somatus launched a pilot to better integrate care for CareFirst BCBS patients with chronic kidney and end-stage renal disease. 250 members...
Jan 8, 2021 | Managed Care Friday
2.2B: The amount Centene is spending to acquire Magellan Health in an effort to strengthen its mental health business. The deal will add 2 million pharmacy benefit members and 16 million medical pharmacy members to Centene's portfolio, the company said. The deal will also bring Centene 18 million third-party customers of specialty health services, which includes physical medicine and rehabilitation to people with disabilities. Acne: “I’m not sure if we’re missing an opportunity to reduce depression, alcoholism, violence and suicide by adding payment incentives to encourage dermatologists to...
Jan 1, 2021 | Managed Care Friday
15: Percent increase in reimbursement starting in February for physicians who do certain procedures in ASCs rather than hospitals under a Michigan Blue plan policy. The change applied to PPO membership, as HMO patients are "managed" and use ASCs more often already. Penn & Tella: This is how my brother-in-law from Boston’s north shore pronounces the magician pair but it’s also a new telehealth program from Penn Medicine that has reduced rehospitalizations 75% among patients who’ve had hip or knee replacements. The program, Home Connect, gives patients wearable devices and text messages to...
