Accountable care organization

Aledade and Anthem Announce New Medicaid Partnership to Bring the Benefits of Value-Based Care to More Virginians

Retrieved on: 
Thursday, November 30, 2023
Blue Shield, Partnership, Breast cancer, Physician, Health system, Medicare Advantage, Health, Diabetes, Accountable care organization, Community, Health equity, Region, Elevance Health, Medicare, ACO, Commonwealth, A1C, CHC, Patient, Anthem, Health insurance

Anthem and Aledade’s collaboration in Medicaid now means that more than 150,000 Anthem members in the Commonwealth of Virginia will have easier access to high-quality primary care, including preventive care and screenings.

Key Points: 
  • Anthem and Aledade’s collaboration in Medicaid now means that more than 150,000 Anthem members in the Commonwealth of Virginia will have easier access to high-quality primary care, including preventive care and screenings.
  • This partnership will impact more than 80 practices, 15 health centers and 25 rural health clinics across Virginia and covers Medicare Advantage, commercially insured, or Medicaid members.
  • Aledade is working to bring the benefits of value-based care to patients all across the Commonwealth, especially those in underserved communities and those who receive care through a community health center.
  • Nationwide, Aledade’s model has helped millions of patients get better care, delivered hundreds of millions of dollars back to community primary care, and saved the health care system billions.

VBCare Network Joins Forces with Spatially Health: Leveraging Advanced Technology to Improve Patient Health Equity and Address Social Determinants of Health

Retrieved on: 
Tuesday, December 19, 2023
SDOH, Partnership, Accountable care organization, Health, Health equity, Acos, Equity, Social, Patient, Organization, Medical imaging

MIAMI, Dec. 19, 2023 /PRNewswire-PRWeb/ -- Spatially Health, a cloud-based, health equity platform focused on identifying and addressing social determinants of health (SDOH) and health equity barriers, has partnered with VBCare Network, a value-based provider network serving Medicaid and Medicare beneficiaries in Arizona. VBCare Network focuses on assisting patients to achieve their healthiest lives by driving lower-cost, better-quality, and more equitable healthcare outcomes. VBCare Network operates statewide serving over 100,000 Health Plan Medicaid enrollees providing value-based care to Medicaid, Medicare, and commercial health plan members.

Key Points: 
  • MIAMI, Dec. 19, 2023 /PRNewswire-PRWeb/ -- Spatially Health , a cloud-based, health equity platform focused on identifying and addressing social determinants of health (SDOH) and health equity barriers, has partnered with VBCare Network , a value-based provider network serving Medicaid and Medicare beneficiaries in Arizona.
  • VBCare Network's partnership with Spatially Health is a leap toward our mission to bridge the health equity divide.
  • Developed by Spatially Health, the platform is designed to identify distinct barriers to health equity for each patient and provide customized strategies to encourage patient participation.
  • VBCare Network will incorporate Spatially Health's advanced platform to conduct an in-depth analysis of the social determinants of health (SDoH) for each patient.

Survey Reveals Only 36% of Healthcare Organizations are Prepared to Meet the Requirements of the 21st Century Cures Act

Retrieved on: 
Tuesday, December 12, 2023
Technology, Health, Other Health, Consulting, Public Policy, Government, Professional Services, Managed Care, Networks, Hospitals, Data Analytics, Health Technology, White House, Federal Government, Data Management, Security, 21st Century Cures Act, Data management, Pressure, Organization, Prevalence, AHIMA, Accountable care organization, Patient, OIG, HHS, Medicare, Hospital, Nursing

The 21st Century Cures Act set standards for the secure and frictionless exchange of data among payers, providers and consumers, including the establishment of an information-blocking rule that was finalized earlier this year.

Key Points: 
  • The 21st Century Cures Act set standards for the secure and frictionless exchange of data among payers, providers and consumers, including the establishment of an information-blocking rule that was finalized earlier this year.
  • Only 41% of respondents report being able to completely comply with the info-blocking rules set forth in the Cures Act.
  • “The information blocking rules in the 21st Century Cures Act will also significantly raise the amount of data that flows between organizations within the healthcare industry.
  • Two thirds of healthcare organizations are not completely confident in their data management infrastructure’s ability to protect the integrity of patient data.

Community Care Cooperative has named Jenny Carney as its new Chief Operating Officer

Retrieved on: 
Tuesday, December 5, 2023
Philanthropy, Health, Other Philanthropy, Other Health, Managed Care, General Health, Pharmaceutical, Medicare Advantage, Organization, Mathematics, Federally Qualified Health Center, Accountable care organization, MSSP, Multimedia, University of Massachusetts, ACO, C3, University, REACH, Medicare, Carney, Nursing, Medicaid, Milliman

Jenny Carney has been named the chief operating officer for Community Care Cooperative (C3), a national, non-profit Accountable Care Organization (ACO) that is governed by Federally Qualified Health Centers (FQHCs) to improve the health and wellness of its members throughout the United States.

Key Points: 
  • Jenny Carney has been named the chief operating officer for Community Care Cooperative (C3), a national, non-profit Accountable Care Organization (ACO) that is governed by Federally Qualified Health Centers (FQHCs) to improve the health and wellness of its members throughout the United States.
  • View the full release here: https://www.businesswire.com/news/home/20231205320574/en/
    Community Care Cooperative Chief Operating Officer Jenny Carney (Photo: Business Wire)
    Ms. Carney joins C3 from Milliman, where she was serving as a senior healthcare consultant in integrated health systems, health plans, and negotiation contract support for its Medicare Shared Savings Program (MSSP), Accountable Care Organization (ACO) REACH, Medicare Advantage, Medicaid, and commercial lines of business.
  • Jenny has also worked at Network Health, where she led its medical economics and performance analytics team.
  • “Jenny’s knowledge and successful leadership experience adds significant value as we continue to grow,” says C3 President and Chief Executive Officer Christina Severin.

NextGen Healthcare Value-Based Care Solutions Help Unlock $82 Million in Medicare Savings

Retrieved on: 
Thursday, November 16, 2023
Technology, Hospitals, Health Technology, Software, Internet, Managed Care, Health, General Health, Data Management, EHR, Population health, Organization, Accountable care organization, NextGen Healthcare, MSSP, Patient, Acos, Nextgen, ACO, North Central Kansas, Medicare, Health care, Hospital, Physician, Health insurance, Informatics

NextGen Healthcare, Inc. a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year.

Key Points: 
  • NextGen Healthcare, Inc. a leading provider of innovative, cloud-based healthcare technology solutions, today announced that its clients participating in the Medicare Shared Savings Program (MSSP) leveraged NextGen® Population Health to achieve a cumulative $82 million in total Medicare savings last year.
  • The MSSP incentivizes hospitals, associations of physicians, and other healthcare facilities to form accountable care organizations (ACOs) that optimize resources to save costs and better serve Medicare beneficiaries in their communities.
  • Nine NextGen Healthcare clients around the country participated in MSSP ACOs in 2022, the latest year for which data is available.
  • “This powerful analytics solution accelerates our ability to mine data and make insights-based decisions.”
    Visit NextGen Healthcare to learn more about how NextGen Population Health is helping organizations practice value-based care.

Progressive Care's PharmcoRx Pharmacies Expands Medicare Advantage Over-the-Counter Benefits Acceptance Program Through New Agreement with ProHealth Connect

Retrieved on: 
Thursday, December 14, 2023
Ultimate, OTCQB, Long-term care, Pharmacy, Acos, Prescription, CMS, Connect, Partnership, GMS, Medicare, OTC, Accountable care organization, Health insurance, UnitedHealth Group, Vitality, Humana

MIAMI, Dec. 14, 2023 /PRNewswire/ -- Progressive Care Inc. (OTCQB: RXMD) ("Progressive Care" or the "Company"), a personalized healthcare services and technology provider, today announced that its PharmcoRx ("PharmcoRx") pharmacy subsidiary announced an agreement with ProHealth Connect LLC ("ProHealth Connect") aiming to extend over-the-counter product ("OTC") benefits provided by health insurance plans to qualifying members nationwide.

Key Points: 
  • Providing benefits of up to $300 per month, OTC benefit programs were historically only available at large-scale retailers and pharmacy chains.
  • Through Progressive Care's PharmcoRx agreement with ProHealth Connect and its earlier agreement with NationsBenefits , the Company is now able to serve the additional healthcare needs of potentially millions of Medicare Advantage network members in its communities who utilize their OTC benefits.
  • Andrew Winakor, President of ProHealth Connect LLC, added, "We welcome the participation of PharmcoRx Pharmacies to the ProHealth network of independent retailers.
  • For more information about Progressive Care Inc., please visit www.progressivecareus.com and connect with us on Facebook and Twitter .

Progressive Care's PharmcoRx Enters into Agreement with NationsBenefits to Offer Enhanced OTC Benefits to Health Plan Members

Retrieved on: 
Monday, November 20, 2023
OTCQB, Food, Long-term care, State, Patient, Acos, Prescription, Health, CMS, Partnership, Medicare, Skin, Humana, Quality of life, OTC, Accountable care organization, Pharmacy, Health insurance, UnitedHealth Group

MIAMI, Nov. 20, 2023 /PRNewswire/ -- Progressive Care Inc. (OTCQB: RXMD) ("Progressive Care" or the "Company"), a personalized healthcare services and technology provider, today announced that its PharmcoRx ("PharmcoRx") pharmacies in Florida will expand their ability to provide customers with access to over-the-counter ("OTC") benefits through a new partnership with NationsBenefits LLC. ("NationsBenefits) for its NationsOTC program.

Key Points: 
  • NationsBenefits is a leading provider of supplemental benefits, flex cards, and member engagement solutions for health plans.
  • OTC benefits are provided by many State and Nationwide Medicare Advantage ("MA") plans such as those offered by Humana, Devoted, Wellcare, and United Health.
  • The OTC benefits provide MA members with the ability to purchase a wide array of goods including over-the-counter medicines, food, and groceries.
  • MA plan members in the NationsOTC program can immediately access their OTC benefits which can exceed $3,000 annually, at PharmcoRx pharmacies when they have their prescriptions filled.

MSSP ACOs Using Milliman MedInsight Achieved Over $274M Shared Savings in 2022 Under CMS Medicare Shared Savings Program

Retrieved on: 
Friday, November 17, 2023
Organization, Accountable care organization, Acos, Success rate, ACO, Milliman, CMS, Medicare, Health, Hospital, Physician, Overalls, Health insurance, MSSP

Key Highlights of 2022 Performance Results for Milliman MedInsight clients:

Key Points: 
  • Key Highlights of 2022 Performance Results for Milliman MedInsight clients:
    80% Success Rate: 80% of MSSP MedInsight Platform users achieved shared savings, surpassing the 63% national average of MSSP ACOs.
  • Substantial Savings: Milliman MedInsight clients collectively achieved an impressive total of $274 million of shared savings, contributing significantly to the nationwide total of $2.52 billion.
  • Despite representing only 5% of total MSSP ACOs, MedInsight clients generated 11% of the total shared savings.
  • The Centers for Medicare & Medicaid Services (CMS) announced the 2022 MSSP savings in August, marking the sixth consecutive year of program savings, as reported by CMS.

Together Senior Health Partners with Leading ACO Rainier Health Network, an Affiliate of CommonSpirit, to Bring Dementia-Specific Care Programs to Dementia Patients

Retrieved on: 
Wednesday, November 15, 2023
Alzheimer's disease, Research, SAN, RADAR, Risk, Chairperson, Dementia, Disease, UCSF, CommonSpirit Health, Patient, Acos, ACO, Moving, NIH, MD, Caregiver, Alzheimer's Association, University, Partnership, Medicare, NPS, Quality of life, Bangladesh Technical Education Board, Accountable care organization, Nursing, Health insurance, Residential care, Together, Lecanemab, Health

SAN FRANCISCO, Nov. 15, 2023 /PRNewswire/ -- Together Senior Health, a brain health company delivering evidence-based solutions for individuals with Alzheimer's Disease and Related Dementias (ADRD), today announced a new strategic partnership with Rainier Health Network, a prominent Accountable Care Organization (ACO) overseeing the healthcare of over 60,000 Medicare patients. Rainier Health Network is solely owned by Virginia Mason Franciscan Health, a division of the national nonprofit health system CommonSpirit Health. The partnership will introduce Together's evidence-based suite of dementia-specific programs, including in-home virtual interventions, to patients across Rainier Health Network in Washington state.

Key Points: 
  • Rainier Health Network is solely owned by Virginia Mason Franciscan Health, a division of the national nonprofit health system CommonSpirit Health.
  • The partnership will introduce Together's evidence-based suite of dementia-specific programs, including in-home virtual interventions, to patients across Rainier Health Network in Washington state.
  • Rainier Health Network, Virginia Mason Franciscan Health and CommonSpirit are deeply committed to serving vulnerable populations, including making dementia care more accessible.
  • "Supporting our members with ADRD is critical," said Dr. Francis Mercado, MD, Chief Medical Officer and Board Chair, Rainier Health Network.

Mercy Launches AI-Driven Texting Program to Prevent Chemo-Related Hospitalizations

Retrieved on: 
Wednesday, November 15, 2023
Holiday, Medicine, Research, Epidemiology, Biostatistics, Fatigue, Cardiovascular disease, Patient, Multimedia, Algorithm, Doctor of Philosophy, Mercy, Heart, Greenwood, Food and Drug Administration, Saint Louis University, Machine learning, Conference, Organ, Diarrhea, Cancer, Diagnosis, National Research Corporation, Pain, Transplant, Medicare, Family, Hospital, Physician, Microsoft, Knowledge, Fever, Diabetes, Public, Accountable care organization, Pharmacy, Medical device, Nursing, Food, Health

ST. LOUIS, Nov. 15, 2023 /PRNewswire/ --Chemotherapy is a lifesaving treatment for many cancer patients, but the side effects can lead to hospitalizations. Named The Chen Chemotherapy Model after lead data scientist Jiajing Chen, the new AI-driven texting platform is proving valuable at keeping patients out of the hospital by raising red flags before symptoms become severe. Click to see pictures of Chen and her family.

Key Points: 
  • Chen served Mercy for nearly four years before she lost her own battle to cancer earlier this year.
  • Once opted into the smart texting platform, patients receive a daily text for seven days, except weekends and holidays.
  • The new smart texting program using The Chen Chemotherapy Model is the first of many use cases made possible by the Mercy and Microsoft collaboration .
  • Prior to joining Mercy, Chen was a faculty member at the Saint Louis University Department of Health and Clinical Outcomes Research.