Monthly Archives: December 2014

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

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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 →

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Innovation Meets Insurance: 5 More Disruptive Payers | FierceHealthPayer

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FierceHealthPayer has recognized five more payers that recognized the growing trends this year and made leaps and bounds to revolutionize both their businesses and the industry. Click here to read the article.

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

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PITTSBURGH, Pa., Dec. 22, 2014 (GLOBE NEWSWIRE) — via PRWEB – Officials at Highmark Health, Allegheny 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 →

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Colorado Wins $65 Million Health Care Innovation Grant

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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 →

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

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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 →

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

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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 →

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