Medica to Improve Access to Recommended Health Care Services Through Partnership with Target

MINNETONKA, Minn.–(BUSINESS WIRE)–Medica is introducing programs designed to provide its members with improved access to affordable, convenient and recommended health care services through a partnership with Target. The programs are built around increasing flu vaccinations; ensuring babies get a healthy start; and accessing care for common everyday ailments.

“We believe these programs will help motivate our members to get care that follows recommended guidelines and best practices,” said Mark Werner, M.D., Medica chief clinical and innovation officer. “Medica is committed to ensuring convenient, quality care at affordable prices. We are delighted to introduce these programs that benefit our members.” Continue reading

Connecticut Health Care Redesign Plan Focuses on Primary Care, Doctor Payments and Reducing Waste

The ct Mirror is reporting that a team of state officials and health care industry representatives are trying to redesign the way health care is paid for and delivered to the vast majority of Connecticut residents.

According to a draft of their plan, their vision includes bolstering primary care practices to take on a larger role in patient care and offer treatment during expanded hours. It calls for better linking of medical practices with social services and other supports that could help people in high-risk communities. And it includes changing the way health care providers are paid by giving them an incentive to rein in what their patients’ care costs — a model that’s been embraced by Medicare and insurance companies but has drawn fire from patient advocates. Continue reading

House Lawmakers Unveil Bill To Boost Telehealth Coverage

We are following a story that was reported on iHealthBeat.org that said that a bipartisan group of House lawmakers last week introduced a bill (HR 3306) that aims to expand telehealth coverage through Medicare and Medicaid.

The Telehealth Enhancement Act of 2013 was introduced by Reps. Gregg Harper (R-Miss.), Devin Nunes (R-Calif.), Mike Thompson (D-Calif.) and Peter Welch (D-Vt.).

Among other things, the legislation would:

  • Adjust Medicare home health payments to account for remote patient monitoring;
  • Expand telehealth coverage to all critical access and sole community hospitals;
  • Cover home-based video services for hospice care, home dialysis and homebound Medicare beneficiaries; and
  • Allow state Medicaid programs to set up high-risk pregnancy networks.

The bill has been referred to the House committees on Energy and Commerce and Ways and Means. – To see more go to  iHealthBeat.org.

 

Are CO-OPs Doomed to Fail?

Over on FierceHealthPayer is asking the question: Are Co-Ops doomed to fail? She notes that of the 24 Co-Ops now open for business, one has closed, another is struggling and at least nine other startup insurance companies are projected to have financial problems.

Where they not designed with enough financial support, or are there other problems at work? – See more at FierceHealthPayer.com.

 

Narrow-Network Plans Spark Lawsuits and Renewed Debate

Carriers are increasingly turning to narrow-network plans help lower premiums to attract cost-conscious consumers to thier products offered through insurance exchanges .

This trend is getting pushback from some hospitals in the form of lawsuits and has renewed the debate over what is “reasonable access.”

AISHealth examines this issue in their featured Health Business Daily story found here.

New Look for Health Plan Innovation News

The Health Plan Innovation News has a new, fresher look. It will also give our readers the same great experience when using mobile devices and tablets as it does when using a computer.

Let us know what you think.

 

Humana Launches Blue Button® Resource that Provides Members Access to Their Medical Information Digitally

LOUISVILLE, Ky.–(BUSINESS WIRE)–Humana Inc. (NYSE: HUM), one of the country’s leading health and well-being companies, is taking another step to simplify the ability of members to take charge of their health by providing access to their medical and financial information in digital form in alignment with the Blue Button initiative.

Blue Button, accessible to Humana health plan members that use MyHumana.com, encourages these members to participate in and manage their health and health care. The technology equips them with tools to understand and track their health benefits in an easy, streamlined way. Blue Button furnishes members with detailed health and claims records, which they can bring to physician visits to discuss their health and treatment options. Continue reading

SCAN Health Plan AZ Adds Two Plans for Chronic Conditions

PHOENIX–(BUSINESS WIRE)–SCAN Health Plan Arizona announced the introduction of two new HMO Special Needs Plans (HMO SNPs) for Medicare-eligible residents in Maricopa and Pima counties. The plans are designed to help members with diabetes or heart disease better manage their chronic conditions.

The SCAN Balance (HMO SNP) plan is for Medicare beneficiaries with Type 1 or Type 2 diabetes. In this plan there is no co-payment for insulin or diabetic supplies, such as a monitor, test strips or lancets. The Heart First (HMO SNP) plan is available to anyone with Medicare who has been diagnosed with congestive heart failure, cardiac arrhythmia, coronary artery disease, peripheral vascular disease or chronic venous thromboembolic disorder. SCAN uses social workers, case managers and other professionals to help members with chronic conditions. Continue reading

Next Generation Retail Technology Designed to help Health Plans Differentiate their Private Exchange Marketplaces

SEATTLE – October 22, 2013 – Array Health, a leading provider of private health insurance exchange technology, today announced the next generation of its Array Spectrum™ Member Marketplace, the consumer-facing module of its private exchange solution.

Array Health claims that exchanges built with this next generation retail technology will help health plans differentiate their privately branded online marketplaces from less consumer-friendly offerings and ultimately help them attract and retain more customers. Continue reading

Most Health Insurers will Pursue Multi-Channel Strategy with Private Exchanges Within the Next Six Months: Survey

A post over on the Acclaris Blog this morning breaks down the results of a survey conducted late this summer by Array Health to find out what health industry leaders are predicting to be the future for private exchanges and defined contribution health plans.

The survey reports that almost 80% of respondents believe that within the next six months health insurers will participate in private exchanges and 70% believe that insurers will participate in both private and public exchange models.

See more at Acclaris.com/blog.