CMS gets green light to Evaluate Indiana’s alternative Medicaid Expansion Plan | Modern Healthcare

By Virgil Dickson  | Modern Healthcare| April 1, 2016

The federal Office of Management and Budget has approved an emergency request by the CMS to let it examine whether Indiana’s conservative-friendly, alternative Medicaid expansion model has hurt beneficiaries’ access to care.

The OMB’s quick approval of the three beneficiary surveys proposed by the CMS is critical, because other Republican-led states including Arizona, Kentucky and Ohio are looking to implement versions of Indiana’s plan, said Judith Solomon, vice president for health policy at the left-leaning Center on Budget and Policy Priorities. Acquiring data on the impact of Indiana’s expansion strategy will quickly offer insights about whether there are any drawbacks for patients, she said. Read the full story here.

WellCare’s Staywell Health Plan Offers Behavioral Health Care via Telehealth to Increase Access, Convenience and Engagement for Its Florida Medicaid Members

Through its relationship with IMPOWER, an Orlando-based nonprofit mental health and child well-being organization, Staywell members are able to have video conference sessions with clinicians using a computer or tablet from the comfort of their own homes. This convenient option eliminates the time and cost associated with traveling to appointments and missed work or school. If medication is needed, it can be delivered directly to members’ homes, in some cases within 24 hours.

Until this month, IMPOWER was the only behavioral health organization in Florida with permission from the state for its providers to prescribe controlled substances for the treatment of mental illness to telehealth members. The Florida Board of Medicine recently updated its telemedicine regulations to allow other telehealth providers to also prescribe under the right conditions.

Jennifer Castro, 41, of Davenport, is a big proponent of telehealth. She and her 14-year-old son, Angel, are Staywell members.

After the unexpected death of his father, Angel, who has Asperger’s Syndrome, withdrew even further. He stopped eating and didn’t want to go to school. Castro got him the behavioral health care he needed, and persuaded him to give telehealth a try.

“It was hard to convince him, but he loves his therapist now,” Castro said. “It’s been helping. You can see it on his face. His self-esteem is improving big time.”

Castro, who works as a preschool teacher at a daycare center, also appreciates the convenience and savings. She doesn’t miss the hour-long drive to his appointments, or the cost of gas and food breaks along the way. Now Angel just takes the family laptop into his room for his appointments.

“Offering convenient treatment options to help our members get the care they need is critical to maintaining health and well-being,” said Julie Harmon, WellCare of Florida’s director of product operations – behavioral health. “Telehealth is a very convenient option that increases access to care, especially for those who live in rural areas and busy families juggling work and school schedules.”

“IMPOWER has been the pioneer in utilizing telehealth for psychiatric and therapy services in Florida,” said Anna M. Baznik, IMPOWER’s president and CEO. “From the onset of our contract with WellCare, we have been strategic partners to both pilot test and implement our platform in Central Florida and soon statewide.”

IMPOWER entered the telehealth arena due to a lack of available psychiatrists in the state, Baznik said, and quickly saw the benefits for members in improved access to care. Through telehealth, she said, members can get almost immediate access to a clinician versus traditional appointments, which can carry a three-month wait list.

“We are working to change the face of mental illness and improve outcomes,” she said. “Our partnership with WellCare has been key to our success thus far.”

For more information about IMPOWER, visit

As of Dec. 31, 2015, WellCare serves approximately 781,000 Medicaid members, 55,000 Florida Healthy Kids members, 107,000 Medicare Advantage members and 39,000 Medicare Prescription Drug Plan members in Florida.

About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. The Company serves approximately 3.8 million members nationwide as of Dec. 31, 2015. For more information about WellCare, please visit the Company’s website at or view the company’s videos at

Anthem, Humana, UnitedHealth Partner with Grocery Stores to Keep Members Healthy | FierceHealthPayer

Three insurers–Anthem, Humana and UnitedHealth–hope to compel their members to eat better by partnering with local grocery stores to create special member programs that provide discounts of up to 10 percent on certain healthy foods, reported Kenosha News.

The grocery programs show that insurers increasingly adopt a preventive care approach to insurance. UnitedHealth, for example, has been working to capitalize on the fact that retail is a “significant portion of individuals’ lives” by creating new retail partnerships so consumers can access all aspects of the insurance industry, Tom Paul, chief consumer officer at UnitedHealth, previously told FierceHealthPayer in an exclusive interview.

The nation’s largest insurer has recently partnered with Milwaukee, Wisconsin-based Roundy’s Supermarkets to launch its Healthy Savings program, which lets members save money on certain grocery products. (Read more at

CIGNA Compass Uses Anticipatory Computing to Help Health Plan Customers Stay Healthy While Saving Money

BLOOMFIELD, Conn., January 14, 2015 – Global health service company, Cigna (NYSE: CI), announces today the release of Cigna CompassSM , a new web application designed to use anticipatory computing to guide U.S. health plan customers to proactively build their own personal health care team, save money, and get the most from their plans.

Cigna announced the introduction of the new digital experience at the National Business Group on Health’s 2015 Employers’ Summit on Health Care Costs and Solutions .

Cigna Compass synthesizes data related to a consumer’s medical plan use, biometric data, incentive information, claims history, and coaching program involvement. Those insights create personalized alerts to notify customers of their top opportunities to improve their health and lower their health care costs. Continue reading

Healthtech: Which Portland Company was Named a Top Digital Health Investor for 2014?

Cambia Health Solutions was one of the most active corporate investors in the digital health universe in 2014, according to Rock Health, a full-service seed fund for digital health based in San Francisco. (See the full story at:



ConnectiCare Partners with Doctors Statewide; Sees Members’ Primary Care Visits Rise

Community Medical Group, Inc. (formerly known as New Haven Community Medical Group, Inc.) the Latest to Begin Collaboration Arrangement

FARMINGTON, CT (December 11, 2014) – ConnectiCare, Inc. and Affiliates, Connecticut’s local health plan, has made significant progress in getting its members to their doctors regularly through active collaboration arrangements with doctors statewide.  As a result, primary care visits are up and hospital admissions, readmissions and emergency room visits are down.

ConnectiCare has practice collaboration arrangements with eight Connecticut-based medical groups throughout the State including:  Integrated Care Partners (Hartford HealthCare), St. Francis HealthCare Partners, ProHealth Physicians, Connecticut State Medical Society IPA, Grove Hill Medical Group, Charlotte Hungerford Multi-Specialty Group and Connecticut Multi-Specialty Group.  Most recently, Community Medical Group, a physician-led independent practice association, based in New Haven has entered into a collaboration arrangement with ConnectiCare. Continue reading

Allegheny Health Network, Highmark Health and Johns Hopkins Medicine Announce Collaboration

PITTSBURGH, Pa., Dec. 22, 2014 (GLOBE NEWSWIRE) — via PRWEB – Officials at Highmark HealthAllegheny Health Network, Highmark Inc. and Johns Hopkins Medicine today announced the signing of a new master collaboration agreement that will complement the formal oncology collaboration that began earlier this year. These collaborations aim to leverage the collective strengths of the organizations and improve the availability and affordability of health care to Pennsylvania patients.

“Highmark Health is proud and excited to expand the scope of our partnership with Johns Hopkins to improve patient care today and in the future,” said David L. Holmberg, president and chief executive officer of Highmark Health. “Our goal is to ensure that patients have affordable access to high-quality health care services, and the increased collaboration we anticipate with Johns Hopkins through this agreement is an important step in the fulfillment of that mission.” Continue reading

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. Continue reading

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, 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