Oct 31, 2020 | Managed Care Friday
$50: The cost of a new 12-week Embrace Wellness program offered by Carroll Hospital in Maryland for people going through cancer treatment. Participants have access to self-care activities, nutrition education, wellness classes, and weekly exercise classes. The program runs through November 24, 2020 and costs $50 per person. Coordinator Bridgette Bostic says the program has been successful despite COVID-19. Cleveland Rocks: University Hospitals, based in Cleveland, formed a joint venture with digital health company, ValueHealth, to create a high-value network of ASCs. The centers will focus...
Oct 23, 2020 | Managed Care Friday
1.1B: The amount of money Highmark's True Performance value-based reimbursement program saved in healthcare costs. The savings were related to ED visits and hospitalizations and were generated from 2017-19. About 2M Highmark members see a primary care doctor through the True Performance program. Payer results in value-based care vary - one Blue plan told us they lowered cost of care by about 3%, Aetna and Cigna somewhat less, while United has saved more (7-9%). In one example the plan saved $1.5M via value-based design (which they describe as not a lot of money), keeping about $1M of that....
Oct 16, 2020 | Managed Care Friday
68: Percent of older adults exactly one year ago who said the quality of care during a telehealth encounter would not be as good as a face-to-face visit, according to a University of Michigan poll on aging, with half saying they did not feel personally connected to the healthcare professional and four in ten reporting difficultly seeing or hearing. The poll asked a national sample of 2,200 adults, ages 50 to 80, about their ‘tele’ experience and, welp, things sure have changed. By May, according to our own poll of 1,362 adult parents aged 35-55, 51% preferred virtual over in-person as...
Oct 9, 2020 | Managed Care Friday
2021: Cigna will offer telehealth services to all Medicare Advantage members next year, including virtual visits with behavioral health providers at no cost. They will also offer a $0 premium plan next year. Biosimilar or Different?: Regence Blue Cross in the northwest is implementing a new step therapy program for medications covered under Medicare Part B in 2021, like biosimilar Zirabev. What’s interesting is that Pfizer launched it earlier this year at a wholesale acquisition cost of around $60 for every 10 mg, which is nearly 25% less than its reference product Avastin, a Pfizer...
Oct 2, 2020 | Managed Care Friday
$200M: The amount Blue Cross NC is giving out in health and wellness retail cards to fully insured members during October and November. The cards will be pre-loaded with between $100-500 and members will be able to use them to purchase anything over the counter. Blue Cross in Tennessee mailed rebate checks to 143,000 members in September because their health insurance costs were lower than originally anticipated. Members who purchased individual health insurance coverage through the Federally Facilitated Marketplace in 2019 qualify. Which Specialty? A new report by Doximity shows that...
Sep 25, 2020 | Managed Care Friday
12: Percent of hospitals receiving incentive payments for reducing cesarean sections and meeting quality goals related to episiotomies, early elective deliveries, and maternity care under a pilot from Tricare set to conclude in March 2021. Tricare, which provides healthcare coverage to 9.6 million uniformed service members, retirees, and their families, has several value-based initiatives underway. 3,640 hospitals participated in the maternity pilot. Asthma Device: Anthem is pairing with UC-Irvine to study whether smart devices can help asthmatics predict an asthma attack. Anthem members...
