PPO

CorVel Announces New Integrations for Managed Care Services Enabling Partners to Increase Connectivity and Create a Seamless Workflow Experience

Retrieved on: 
星期二, 四月 23, 2024
EDI, API, Risk management, Human, CorVel Corporation, PPO, Synthetic media, Generative, Cryptocurrency

As a result, CorVel is pleased to introduce a new hub platform to the carrier market.

Key Points: 
  • As a result, CorVel is pleased to introduce a new hub platform to the carrier market.
  • Founded over thirty years ago, CorVel started as a managed care solutions provider, and these services have remained the cornerstone of the business.
  • As a leader in the industry, CorVel is committed to technological innovation and bringing new solutions to our partners.
  • Our goal is to create seamless solutions that address both their business needs and the well-being of their people," said Ron Wojciechowski, Vice President of Managed Care Strategy at CorVel.

Mark Farrah Associates Presents Health Insurance Market Share at the County Level

Retrieved on: 
星期二, 四月 16, 2024
Insurance, Managed Care, Finance, General Health, Health, Professional Services, Health Insurance, Other Health, Intelligence, HMO, Private, MFA, PPO, Medicaid, Medicare Advantage, PDP, Medicare, Metropolitan statistical area

Mark Farrah Associates, www.markfarrah.com , a leading provider of market data and intelligence solutions, provides county-level market share and demographics data essential for the analysis of health insurance market position and competition.

Key Points: 
  • Mark Farrah Associates, www.markfarrah.com , a leading provider of market data and intelligence solutions, provides county-level market share and demographics data essential for the analysis of health insurance market position and competition.
  • MFA maintains reasonable estimates of health plan membership by county in the County Health Coverage™ product.
  • This product features company market share by state, county, and plan for the Private Risk; now with Individual and Group segments split out, Private ASO, Managed Medicaid, Medicare Advantage, and PDP segments.
  • are also presented, as well as market share by Metropolitan Statistical Areas (MSAs), population demographics and visual mapping tools.

United Real Estate Unveils Financial Wellness Services Nationally

Retrieved on: 
星期五, 四月 26, 2024
Real estate, W2, Health, Wellness, Franchise Times, Motion, Culture, PPO, Marketing, GCI, Property management

DALLAS, April 25, 2024 /PRNewswire/ -- United® Real Estate (United) announced the official rollout of its Financial Wellness Program. The curated bundle of services bridges longstanding gaps for independent contractors.

Key Points: 
  • Groundbreaking program to improve financial, physical and mental wellness for 23,000 agents nationwide
    DALLAS, April 25, 2024 /PRNewswire/ -- United® Real Estate (United) announced the official rollout of its Financial Wellness Program.
  • The Financial Wellness Program bridges longstanding gaps for self-employed real estate practitioners.
  • While much of the real estate industry is pulling back on resources for its affiliates, United is directing more investment to strategic initiatives.
  • Wealth Management Services: access to private banking, wealth planning services and comprehensive financial planning, including estates, trusts and wills.

MARPAI INC. BOLSTERS SALES TEAM WITH TWO WORLD-CLASS EXECUTIVES

Retrieved on: 
星期三, 四月 24, 2024
Ben, RBP, TPA, Growth, PPO, Record, HPN, Center of excellence, Health

The new additions to the Marpai team bring a wealth of experience and proven track records of success.

Key Points: 
  • The new additions to the Marpai team bring a wealth of experience and proven track records of success.
  • Richard has 3 decades of experience working with brokers to help self-funded health plans take control of their medical benefit spend.
  • Ben comes to Marpai as an industry leader in the analytics and payment integrity sectors.
  • "We could not be more excited to welcome Ben and Richard to the Marpai team," said John Powers, President of Marpai Inc. "As we looked to grow our team, we only considered professionals that are proven winners.

New Research From Inovalon and Harvard Analyzes Medicare Advantage Plan Design Impact on Healthcare Utilization and Health Equity

Retrieved on: 
星期一, 四月 8, 2024
Harvard Medical School, HMO, Health, Preferred provider organization, Importance, Inovalon, Research, Health maintenance organization, PPO, Medicare, Medicare Advantage, FFS, Health insurance

The findings, published in the white paper " The Importance of Plan Design in Medicare Advantage ," represent the fourth installment of Inovalon’s and Harvard Medical School’s research collaboration to understand the underlying factors influencing enrollment, quality outcomes, and utilization in MA vs. FFS Medicare.

Key Points: 
  • The findings, published in the white paper " The Importance of Plan Design in Medicare Advantage ," represent the fourth installment of Inovalon’s and Harvard Medical School’s research collaboration to understand the underlying factors influencing enrollment, quality outcomes, and utilization in MA vs. FFS Medicare.
  • Previous research found that MA delivers superior quality outcomes and utilization reductions compared to FFS Medicare, even after controlling for differences in who enrolls.
  • However, until now, there was limited data on the differences within MA, and how specific MA plan designs and features impact outcomes.
  • "By understanding the populations Medicare Advantage plans attract, policymakers and health plans can come together to incentivize and deliver superior, cost-effective outcomes for every Medicare enrollee."

Clover Health Reports Fourth Quarter and Full Year 2023 Financial Results; Delivers Continued Momentum in Financial Performance and Provides Full-Year 2024 Guidance

Retrieved on: 
星期二, 三月 12, 2024
Insurance, PPO, Clover, Medicare, MCR, Economics, Clover Health

FRANKLIN, Tenn., March 12, 2024 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (NASDAQ: CLOV) ("Clover," "Clover Health" or the "Company"), a managed care company focused on physician enablement, today reported financial results for the fourth quarter and full year 2023. Management will host a conference call today at 5:00 p.m. ET to discuss its operating results and other business highlights.

Key Points: 
  • FRANKLIN, Tenn., March 12, 2024 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (NASDAQ: CLOV) ("Clover," "Clover Health" or the "Company"), a managed care company focused on physician enablement, today reported financial results for the fourth quarter and full year 2023.
  • For the fourth quarter 2023, the Company reported revenue of $510.3 million and net loss of $70.5 million, with full-year revenue of $2,033.7 million and net loss of $213.4 million.
  • Insurance revenue during the fourth quarter grew by 12% to $303.1 million, and grew by 14% to $1,235.8 million for full-year 2023.
  • Insurance MCR also meaningfully improved to 82.4% in the fourth quarter and 81.2% for full-year 2023, as compared to 92.4% in the fourth quarter 2022 and 91.8% for full-year 2022.

Segal Unveils 2024 State Employee Health Benefit Study and Interactive Plan Comparison Map Tool

Retrieved on: 
星期五, 三月 29, 2024
General Health, Professional Services, Technology, State, Local, Public Relations, Investor Relations, Insurance, Communications, Human Resources, Finance, Other Technology, Health, Public Policy, Government, Consulting, PPO, Care Act 2014, HDHP, Preferred provider organization, Organization, Growth, Map, OOP, ACA, Affordable Care Act, Health insurance

Leading benefits and HR consulting firm Segal released its 2024 State Employee Health Benefit Study today, alongside an interactive map revealing state-by-state comparisons of health benefit plans.

Key Points: 
  • Leading benefits and HR consulting firm Segal released its 2024 State Employee Health Benefit Study today, alongside an interactive map revealing state-by-state comparisons of health benefit plans.
  • High-deductible health plans (HDHPs) are more prevalent in America today, in fact more than half of state plans offer an HDHP plan option.
  • Complementing the study, Segal's innovative, interactive map tool enables users to perform detailed state-by-state comparisons, shedding light on the intricate details of each state's employee health benefit plan.
  • This groundbreaking study and accompanying digital map are built on Segal’s extensive expertise gained from decades of advising health plans.

HCSC Offers Members New Provider Scores in Search

Retrieved on: 
星期一, 三月 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.

Industry Veteran Clay Thornton Joins Clover Health as CFO of Medicare Advantage

Retrieved on: 
星期四, 三月 7, 2024
PPO, Humana, Clover Health, Medicare, Clover, Region, Management

FRANKLIN, Tenn., March 07, 2024 (GLOBE NEWSWIRE) -- Today Clover Health ("Clover" or "the Company") announced Clay Thornton as the newly appointed Chief Financial Officer of its Medicare Advantage (MA) division.

Key Points: 
  • FRANKLIN, Tenn., March 07, 2024 (GLOBE NEWSWIRE) -- Today Clover Health ("Clover" or "the Company") announced Clay Thornton as the newly appointed Chief Financial Officer of its Medicare Advantage (MA) division.
  • Thornton's expertise in driving financial strategies that bolster quality outcomes, member and provider satisfaction, and sustainable business expansion makes him an ideal fit for Clover.
  • "I am thrilled to join the team at Clover Health and drive forward their PPO-first approach in the Medicare Advantage space," said Thornton.
  • His leadership will be instrumental in advancing our PPO-first approach, ensuring we continue to thrive in Medicare Advantage through our technology-driven, patient-centered care model."

Humana and Strive Health Announce Expansion of Holistic, Patient-Centered Care for People with Kidney Disease

Retrieved on: 
星期二, 三月 5, 2024
General Health, Other Health, Health, Managed Care, Health Insurance, Chronic kidney disease, Multimedia, HMO, PPO, Kidney disease, Quality of life, Dialysis, Entrepreneurship, Humana, Medicare, Patient, Partnership

Leading health and well-being company Humana Inc. (NYSE: HUM) and kidney care provider Strive Health have announced a new value-based care multi-state agreement for most Humana Medicare Advantage HMO and PPO plan members who live with kidney disease.

Key Points: 
  • Leading health and well-being company Humana Inc. (NYSE: HUM) and kidney care provider Strive Health have announced a new value-based care multi-state agreement for most Humana Medicare Advantage HMO and PPO plan members who live with kidney disease.
  • With this agreement, members with chronic kidney disease and end-stage kidney disease in Indiana, Illinois, Kentucky, Michigan and northwest North Carolina now have access to Strive’s value-based kidney care.
  • “Humana is committed to providing our members with evidence-based, multi-specialty kidney care,” said Jim Stodola, Humana Vice President of Trend Management.
  • “Our expanded partnership will allow us to serve thousands of patients through a value-based approach to kidney care and further our mission to deliver compassionate kidney care through data-driven insights, high-touch care and prevention.”
    The new value-based care agreement builds on an existing Humana and Strive relationship, which began in Indiana and Kentucky in 2020.