Colorado Wins $65 Million Health Care Innovation Grant

GRAND JUNCTION, Colo., Dec. 17, 2014 /PRNewswire-USNewswire/ — The Centers for Medicare & Medicaid Services has awarded Colorado $65 million in State Innovation Model (SIM) funding to create a coordinated, accountable system of care that improves integration of physical and behavioral health services.

The award builds on an earlier planning grant Colorado received in 2013, which funded development and identification of four major goals:

  • Create a coordinated, accountable system of care that gives Coloradans access to integrated primary care and behavioral health.
  • Leverage the power of the public health system to achieve broader population health goals and support delivery of care.
  • Use outcomes-based payments to enable transformation.
  • Engage individuals in their care.

The effort supports multi-stakeholder collaboration, not just regionally but across the state, says Patrick Gordon, associate vice president, Rocky Mountain Health Plans (RMHP), who contributed to the grant request. “We don’t need yet another new ‘intensive care management’ program in provider, payer or agency-based silos. We must network existing community resources around patients and communities in new ways to address the cognitive, social, behavioral and economic needs of each member of the community.”

This funding will support advances underway throughout Colorado, allowing for more rapid care delivery transformation. RMHP and Western Colorado leaders have a history of supporting behavioral health and broader community integration. To learn more about these efforts, read Tear down this wall: Integrating behavioral health and primary care.

“Health–physical, emotional and behavioral—is a community resource that requires community-wide support. RMHP takes our commitment to our community very seriously,” Gordon says. “SIM will contribute to the creation of a statewide framework of policies and supports that promote better integration and use of existing community resources.”

About Rocky Mountain Health Plans
Founded in 1974 in Grand Junction, Colorado, as an independent, not-for-profit health insurance provider, Rocky Mountain Health Plans uniquely understands the needs of Coloradans. We provide access to affordable, high-quality health care enabling our almost 300,000 members to live longer, healthier lives, while maintaining our mission to put people before profits. Rocky Mountain Health Plans is the only health plan in Colorado to serve every market segment, including individuals, families, employers, Medicare, Medicaid and Child Health Plan Plus beneficiaries. The National Committee for Quality Assurance recently awarded Rocky Mountain Health Plans a “commendable” status for continuously improving the quality of care and services provided to members. For more information, visit rmhp.org or connect with RMHP on social media: @RMHPColorado on Facebook, @RMHP on Twitter, @rmhpColorado on Pinterest and @rmhpcolorado on Instagram.

 

SOURCE Rocky Mountain Health Plans

Humana Launches Points of Care to Support Medicare Advantage Members in Managing Health

LOUISVILLE, Ky.–()–More than 2.9 million Humana Medicare Advantage members and their family and friends now have access to HumanaPointsofCare.com, a new online destination from Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies.

“Humana Points of Care enables Medicare members and their circle of support to maintain a sense of community on their journey to achieving optimal health”

Humana Points of Care offers a variety of comprehensive health and education tools to assist Humana Medicare Advantage members nationwide and provide support and resources for their family and friends which today account for approximately 65.7 million unpaid caregivers in the United States.  Continue reading

Cigna and Safeway Reference-Based Pricing Study Shows Employee Education and Online Shopping Tools Can Help Control Lab Costs

BLOOMFIELD, Conn. & PLEASANTON, Calif.–()–A study conducted by Cigna (NYSE: CI) and Safeway Inc. (NYSE: SWY), published in the December issue of the American Journal of Managed Care, shows that reference-based pricing can help control lab costs when individuals are supported with education and an online shopping tool.

“The understanding of reference pricing along with adoption of online tools to inform the consumer has increased significantly since the early days of 2011. Thoughtful application of reference pricing warrants consideration as a mechanism to improve value in health care and help individuals reduce their costs for certain services.”

The study, “Reference-based Pricing: An Evidenced-based Solution for Lab Services Shopping,” is the first published reference-based study to focus on lab services. Previous published studies have focused on the application of reference-based pricing to pharmaceuticals.

Reference-based pricing is a benefit design that sets a maximum contribution (reference price) from the health plan to pay for a particular service; in this case, lab services such as a lipid panel, comprehensive metabolic panel or prostate-specific antigen test. Employers see this type of benefit design as a way to incent employees to consider the price of services when making care decisions. Employees reap a savings when they choose services at or below the reference price. If they choose services above the reference price, they are responsible for the additional cost. Continue reading

Wellmark, Hy-Vee & UnityPoint Health Collaborate on New Health Insurance Plans

Wellmark Blue Cross and Blue Shield, Hy-Vee and UnityPoint Health jointly announced a unique new option in health insurance, collaboratively designed to reward customers for healthy behaviors. Blue RewardsSM integrates the true coordinated care of the UnityPoint Health provider network combined with the retail convenience of Hy-Vee’s pharmacy, healthy food, wellness and dietitian services all in an affordable ACA-health insurance option from Wellmark Blue Cross and Blue Shield.

“This collaboration is part of our strategy to keep health care local and sustainable, and promote health through convenience,” said Laura Jackson, Wellmark’s executive vice president for Health Care Innovation & Business Development. “We know consumers turn to brands they know and trust, which makes this collaboration among three strong Iowa brands even more meaningful for Iowans.” Continue reading

Humana Once Again Named Top Payer in athenahealth® PayerView® Rankings

LOUISVILLE, Ky.–(BUSINESS WIRE)–For the second year in a row, Humana Inc. (NYSE: HUM) was ranked as the number one company for its ease of doing business with providers. Humana ranked number one in overall performance among 148 U.S. health insurers based on a review of 2013 claims-payment data conducted by athenahealth, Inc. (NASDAQ: ATHN). Continue reading

2.8 Trillion U.S. Healthcare Market Threatened By Disruptive New Entrants Like Those That Reshaped Retail, Banking and Travel, According To PwC’s Health Research Institute

NEW YORK, April 10, 2014 /PRNewswire/ — New entrants are poised to draw tens of billions of dollars in revenue from traditional healthcare’s $2.8 trillion revenue pie as these market disruptors rapidly develop

NY66894LOGO

 products and services like the innovations that transformed banking, entertainment and publishing, according to Healthcare’s New Entrants: Who will be the industry’s Amazon.com?, a new report released today by PwC’s Health Research Institute (HRI). HRI found that consumers are ready to embrace new options being developed by new entrants from the retail, technology and telecommunications sectors, from smartphone otoscopes to online evaluations of digital photos of rashes. Continue reading

Humana Appoints Christopher Kay as Chief Innovation Officer

LOUISVILLE, Ky.–()–Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today that it has appointed Christopher Kay as Senior Vice President and Chief Innovation Officer, effective March 17. Kay will report to President and Chief Executive Officer Bruce Broussard and serve on the company’s Management Team.

In his new role, Kay will lead the company’s innovation strategy. Among other priorities, he will focus on innovations in personalized health designed to simplify the health care experience, leading to better health outcomes. Continue reading

Aetna and Medtronic Collaborate to Help Members Take Better Control of Type 2 Diabetes

HARTFORD, Conn. & MINNEAPOLIS–(BUSINESS WIRE)–Beginning this month, Aetna (NYSE: AET) and Medtronic, Inc. (NYSE: MDT) will work with doctors in a new program to reach up to 300 fully insured members with uncontrolled type 2 diabetes who may improve their health using insulin pump therapy. Eligible members will receive targeted education, case management and other patient support to help control blood sugar, which also may lower their health care costs. Information gathered from the program also is expected to help doctors and other health care providers more easily identify and support those who can benefit most from this therapy.

“We want to help members with type 2 diabetes to enjoy a more flexible lifestyle and have better glucose control. Improving education and assistance for those learning to use insulin pumps may help increase consideration and successful use of a proven therapy that can help them achieve these goals,” said Ed Pezalla, M.D., Aetna’s national medical director for pharmacy policy and strategy. “We also are excited to create value-based arrangements with companies like Medtronic who are ready to share accountability for the role their products and services play in improving members’ health.” Continue reading

Fallon Health Partners With Cognizant to Become the First Massachusetts Health Insurer to Provide Quotes for Merged Market Plans Under Affordable Care Act

TEANECK, N.J., Feb. 25, 2014 /PRNewswire/ – Cognizant (NASDAQ: CTSH) today announced that it has enabled Fallon Health, a Massachusetts-based not-for-profit health care services organization, to become the first Massachusetts health insurer to provide quotes for merged market plans mandated by the Affordable Care Act (ACA). Continue reading