HCSC

Mark Farrah Associates Reviewed Enrollment Mix and Financial Metrics for Leading Health Plans

Retrieved on: 
Wednesday, March 27, 2024
Public Policy, Government, Insurance, Finance, Health, Healthcare Reform, Banking, Professional Services, Health Insurance, UnitedHealth Group, Medicare, CVS Health, Medicaid, MFA, CVS, HCSC, Health insurance

Mark Farrah Associates (MFA), www.markfarrah.com , reviewed final year-end 2022 enrollment mix and financial metrics for the top 5 health plans.

Key Points: 
  • Mark Farrah Associates (MFA), www.markfarrah.com , reviewed final year-end 2022 enrollment mix and financial metrics for the top 5 health plans.
  • UnitedHealth, Elevance Inc., CVS Health, Centene, and Health Care Service Corp. (HCSC) insured 43% Americans in the commercial, Medicare and Medicaid markets.
  • Key takeaways include:
    For 2022, leading health carriers comprised 38% for the commercial market and 22% for government lines.
  • Insights for this analysis were gleaned from MFA’s online database tool, Health Plans USA™ , an analytics tool for comparing market mix, market share and financial information about health plans, nationwide.

HCSC Offers Members New Provider Scores in Search

Retrieved on: 
Monday, March 25, 2024
Health, PPO, Internet, Health Care Service Corporation, Physician, HCSC

Since Jan. 1, 2024, PPO members see ranked in-network results when they use the provider search tool available via the apps and websites of HCSC health plans in Illinois, Montana, New Mexico and Oklahoma.

Key Points: 
  • Since Jan. 1, 2024, PPO members see ranked in-network results when they use the provider search tool available via the apps and websites of HCSC health plans in Illinois, Montana, New Mexico and Oklahoma.
  • Provider profiles which score highest on quality, cost efficient care and appropriate treatment plans display a "Top Performing Physician" designation.
  • In 2022, HCSC began to deliver data to providers related to key care metrics to help them better serve members.
  • Surveys show that 90 percent people turn to the internet to help find a provider, but often those scores are opinion-based," said Terri Kitchen, HCSC Divisional Vice President.

RISE announces finalists for 2024 Health Care Hero Award

Retrieved on: 
Saturday, March 16, 2024
Meharry Medical College, Social, Health equity, Patient, HCSC, The, Nursing

NEW ORLEANS, March 16, 2024 /PRNewswire/ -- RISE is pleased to announce the finalists for the 2024 RISE Health Care Hero Award. The prestigious honor, presented annually at The RISE Summit on Social Determinants of Health, acknowledges an individual's effort to make a significant impact on the lives of underserved populations through health care and/or social services interventions, and through superior example of the RISE mission to promote health equity among all patients.

Key Points: 
  • RISE has narrowed the impressive candidate pool of nearly 60 nominations to the top five finalists.
  • NEW ORLEANS, March 16, 2024 /PRNewswire/ -- RISE is pleased to announce the finalists for the 2024 RISE Health Care Hero Award.
  • The prestigious honor, presented annually at The RISE Summit on Social Determinants of Health, acknowledges an individual's effort to make a significant impact on the lives of underserved populations through health care and/or social services interventions, and through superior example of the RISE mission to promote health equity among all patients.
  • The 2024 award recipient will be announced at The RISE Summit on Social Determinants of Health in New Orleans on Tuesday, April 16, the second day of the three-day conference.

Edifecs Solution Addresses New CMS Prior Authorization and Interoperability Mandate

Retrieved on: 
Wednesday, February 21, 2024
Technology, Hospitals, Other Technology, Software, Practice Management, Internet, Health, General Health, Data Management, EDI, Consent management, CMS, API, HIMSS, Interoperability, HCSC, FHIR, Rule, HIPAA, Medicare, HL7, Policy, Automation, Prior authorization, Machine learning, Medicaid, Trust, Health care

The two-time Best in KLAS award winning Edifecs interoperability solution includes its EDI and FHIR Gateways, which have been enhanced to address the provisions in the new Rule, including Prior Authorization and Provider Access APIs.

Key Points: 
  • The two-time Best in KLAS award winning Edifecs interoperability solution includes its EDI and FHIR Gateways, which have been enhanced to address the provisions in the new Rule, including Prior Authorization and Provider Access APIs.
  • In anticipation of the final rule, Edifecs has worked with customers, including a large regional Blues organization, to build a robust interoperability solution that expedites prior authorization, alleviating much of the manual effort and administrative burden.
  • The rule mandates the adoption of electronic prior authorization processes using a Prior Authorization API.
  • “The potential benefits of the Prior Authorization and Interoperability mandate extend beyond what CMS projects – increased efficiency, burden reduction, and patient empowerment,” stated Chris Lance, chief product officer, Edifecs.

Doxy.me appoints Dr. Esteban López as Chief Medical Officer to drive growth and health equity

Retrieved on: 
Thursday, February 15, 2024
Cloud, Google Cloud, Telemedicine service providers, CMO, Doctor of Philosophy, MD, Telehealth, Health, HCSC, Growth, MBA, Health Care Service Corporation, Service provider, Health equity, Harvard Medical School, Financial Times, Physician, Nursing

CHARLESTON, S.C., Feb. 15, 2024 /PRNewswire-PRWeb/ -- Doxy.me, a leading telehealth platform, announced the appointment of Esteban López, MD, MBA, as Chief Medical Officer (CMO), effective February 5, 2024. With over 20 years of healthcare leadership experience and a proven track record of utilizing technology to enhance access and quality, Dr. López will spearhead doxy.me's mission to make telemedicine for all and create the future of healthcare.

Key Points: 
  • Doxy.me, the telemedicine platform, has announced its strategic move to bolster growth and advance health equity by appointing a new Chief Medical Officer (CMO).
  • This key hire underlines the company's commitment to enhancing its services and expanding its reach within the healthcare industry.
  • CHARLESTON, S.C., Feb. 15, 2024 /PRNewswire-PRWeb/ -- Doxy.me, a leading telehealth platform, announced the appointment of Esteban López, MD, MBA, as Chief Medical Officer (CMO), effective February 5, 2024.
  • Further emphasizing his commitment to cutting-edge solutions, Dr. López holds a certificate in leading digital transformation in healthcare from Harvard Medical School.

Mark Farrah Associates Assessed Profit Margin Trends of Blue Cross Blue Shield Plans

Retrieved on: 
Wednesday, February 7, 2024
Insurance, Managed Care, Finance, Health, Banking, Professional Services, Health Insurance, Other Health, MFA, Independence Blue Cross, Blue Shield, HCSC, Cross, FREE, Medicaid, Elevance Health, Blues, Blue Cross, BCBS, Pharmaceutical industry

The leading BCBS affiliated insurers with over $14 billion in revenue as of September 30, 2023, include: Elevance (formerly Anthem), Health Care Service Corp. (HCSC), Guidewell Mutual Holding Group, Independence Blue Cross, and Blue Shield of CA.

Key Points: 
  • The leading BCBS affiliated insurers with over $14 billion in revenue as of September 30, 2023, include: Elevance (formerly Anthem), Health Care Service Corp. (HCSC), Guidewell Mutual Holding Group, Independence Blue Cross, and Blue Shield of CA.
  • In the latest Healthcare Business Strategy report, Mark Farrah Associates (MFA), www.markfarrah.com , analyzed profit margins of BCBS plans, comparing year-to-date performance from third quarter 2020 to third quarter 2023.
  • Elevance Health reported the largest profit margin for top Blues plans with 4.9% in 3Q23.
  • With 54% of its enrollment through Medicaid plans, Independence Blue Cross experienced a marginal increase in profit margin from 3Q20 to 3Q21, from 1.8% to 2.1%, but decreased to 0.9% in 3Q22.

Vheda Health Unveils Dynamic Rebranding to Propel Leadership in Virtual Health Engagement at the Medicaid Innovations Forum

Retrieved on: 
Monday, February 5, 2024
Growth, Life, Health equity, HCSC, SNP, Health, Medicaid, Health Care Service Corporation, Matter, ROI, Pharmaceutical industry

COLUMBIA, Md., Feb. 5, 2024 /PRNewswire/ -- Vheda Health, a national pioneer in virtual health engagement is proud to announce a strategic branding initiative aligned with its continued leadership and innovative approach in the healthcare industry.

Key Points: 
  • COLUMBIA, Md., Feb. 5, 2024 /PRNewswire/ -- Vheda Health , a national pioneer in virtual health engagement is proud to announce a strategic branding initiative aligned with its continued leadership and innovative approach in the healthcare industry.
  • [Vheda Health's] rebranding signifies our unwavering commitment to advancing health equity and access to care from anywhere."
  • The new brand and website will be unveiled at the Medicaid Innovations Forum, a premier event for executives, providers, and leaders focused on Medicaid.
  • The Medicaid Innovations Forum provides a fitting platform to showcase Vheda Health's "commitment to virtual health empowerment and its role in revolutionizing member compliance among Medicaid and Medicare Health Plans.

AM Best Comments on Health Care Service Corporation’s Planned Acquisition of The Cigna Group’s Medicare Business

Retrieved on: 
Friday, February 2, 2024
Insurance, Professional Services, Cigna, Medigap, Medicare Part D, News, AM Best, HCSC, Credit, Health Care Service Corporation, Acquisition, ALL, Medicare

The transaction is expected to expand HCSC’s geographic diversification with the addition of business outside of HCSC’s core Blue Branded states.

Key Points: 
  • The transaction is expected to expand HCSC’s geographic diversification with the addition of business outside of HCSC’s core Blue Branded states.
  • Additionally, the additional membership and revenues will aid in providing additional scale and capabilities to HCSC’s Medicare Advantage business.
  • The transaction is expected to close in the first quarter of 2025, subject to regulatory approval and customary closing conditions.
  • AM Best is a global credit rating agency, news publisher and data analytics provider specializing in the insurance industry.

MATTER opens applications for accelerator focused on reducing maternal mortality in the U.S.

Retrieved on: 
Tuesday, December 12, 2023
Pharmaceutical, Health Technology, Health Insurance, Research, Parenting, Healthcare Reform, Public Policy, Government, Hospitals, Baby, Maternity, Fitness & Nutrition, Clinical Trials, University, Education, Biotechnology, Women, Professional Services, Health, Practice Management, Vitamins, Supplements, General Health, Science, Consumer, Social Services, Other Health, Health Care Service Corporation, Infant, Parkview Health, Incidence, Prenatal care, BayCare Ballpark, Mortality, Pregnancy, Mentorship, Death, Labs, HCSC, Mother, Risk, Organon, Dietary supplement

MATTER , the premier healthcare incubator and innovation hub, has opened applications for the second 51 Labs , an accelerator focused on women’s health.

Key Points: 
  • MATTER , the premier healthcare incubator and innovation hub, has opened applications for the second 51 Labs , an accelerator focused on women’s health.
  • This year’s program focuses on preventing maternal mortality in the U.S. before, during and after birth and receives support from Health Care Service Corporation , Laerdal Million Lives Fund , BayCare , Parkview Health , University of Chicago Medicine , Organon and Stryker .
  • While all ages and races saw an increase in maternal mortality in 2021, many inequities still exist due to a variety of factors, including but not limited to access to quality care, socioeconomic status, race and education level.
  • The second cohort of the 51 Labs accelerator will address the question:
    How can we prevent maternal mortality in the U.S. before, during and after birth?

HCSC Expands Neighborhood Center Model to New Mexico

Retrieved on: 
Thursday, November 16, 2023
Health Care Service Corporation, Health, HCSC

CHICAGO, Nov. 16, 2023 /PRNewswire/ -- Health Care Service Corporation will be bringing a community-based wellness center to Albuquerque, New Mexico.

Key Points: 
  • CHICAGO, Nov. 16, 2023 /PRNewswire/ -- Health Care Service Corporation will be bringing a community-based wellness center to Albuquerque, New Mexico.
  • The Albuquerque neighborhood center, slated to open in summer 2024, will be located in the South Valley.
  • "Partnering with communities through our neighborhood centers strengthens the connection between access and health," said Maurice Smith, HCSC President, CEO and Vice-Chair.
  • We've been serving people across New Mexico for more than 80 years, and we're committed to improving the overall health of our communities."