How Social Determinants of Health Will Impact the Future of Benefit Coverages

Do you have access to healthy foods, transportation to a doctor, high-speed internet for telemed appointments, or a roof over your head? These are assumptions that most of us take for granted, and are not the questions that insurers usually take into consideration. But, as they look to increase member outcomes and foster long-term customer loyalty, considering the changing needs of many consumers in the face of today’s current affairs, it’s time they did.

In fact, forward-looking health plans are doing just that by incorporating the concept of Social Determinants of Health (SDOH) into their coverage offerings.

SDOH looks at the totality of the social elements that contribute to health, drawing a connection between the correlations of socio-economics and sickness. It includes factors such as housing, transportation, education, and social isolation. Read More: HIT Consultant

Abacus Insights Raises $35 Million in Series B Financing to Help Health Plans Liberate Data

Abacus Insights, a leading data integration and interoperability platform that enables health plans and their providers to create a more personalized healthcare experience for consumers, today announced it has raised a $35 million Series B round from new and returning investors. The latest round was led by new investor, Blue Venture Fund, and joined by returning investors CRV, .406 Ventures, Horizon Healthcare Services Inc., and Echo Health Ventures, a strategic collaboration of Cambia Health Solutions and Mosaic Health Solutions. The debt facility was provided by J.P. Morgan.

The funds will be used to scale the business, accelerate the capabilities and connections of its technology platform, and add to its roster of technology talent. The financing brings the under three-year-old Boston-based company’s total venture backing to $53 million. Read More: Business Wire


Blue Shield of California Health Reimagined Initiative to Transform Health Care for Individuals, Communities Throughout California

The newest generation of technology in physician offices, consumer-friendly digital apps to keep people healthier, a personalized approach to help patients find the services they need, and tying physician and hospital pay to quality and patient satisfaction – these are just a few offerings of Blue Shield of California’s Health Reimagined initiative, a comprehensive and ambitious effort to improve access to quality health care while making it more affordable.

The program uses the latest innovations and technologies, plus collaborations with medical providers, employers, community stakeholders and others to transform the healthcare system for individuals, families and communities. Read More: Blue Shield of California

Geisinger’s Karen Murphy Stimulates Innovation by Focusing on Fundamentally Different Approaches to Healthcare

Karen Murphy, PhD, RN, started her career at the bedside. Today, as chief innovation officer for The Steele Institute for Health Innovation at Geisinger, a 13-hospital health system in Pennsylvania, she leads a 210-person team that’s working to transform healthcare.

Between those two professional bookends, Murphy served as Pennsylvania’s secretary of health from 2015 to 2017; director of the State Innovation Model Initiative for the Center for Medicare and Medicaid Innovation, leading a $990 million investment designed to accelerate health care innovation across the United States; and president and CEO of Moses Taylor Health System (now Commonwealth Health); among other positions. Read More: HealthLeaders

Cigna Expands Mental Health Network

Cigna is adding online therapy firm Talkspace to its growing menu of telehealth offerings as insurers expand further into offering mental health to their virtual provider networks.

Cigna said 14 million people enrolled in its employer-sponsored health plans have access to Talkspace’s network of licensed therapists. Talkspace links health plan enrollees with licensed therapists by video online and text, allowing patients to conduct private sessions on-demand in the comfort of their own homes, the companies said.

The use of online mental health therapy and psychiatric services has exploded amid the pandemic as Americans across the country face rising unemployment and the daily struggle of complying with “shelter in place” orders amid the surge of cases of the Coronavirus strain Covid-19. On Thursday, Talkspace said the deal with Cigna’s commercial health plan clients will bring “the total number of insured U.S. lives covered for Talkspace to a milestone of 40 million.” Read More: Forbes

The Internal Revenue Service (IRS) Proposed a Rule to Expand Patients’ Access to Health Care Sharing Ministries and Direct Primary Care

The IRS’s proposal would allow for health reimbursement arrangements (HRAs) to subsidize employees’ direct primary care (DPC) and healthcare sharing ministries (HCSMs).

The IRS rule builds off of President Donald Trump’s executive order 13,877, which directs Department of the Treasury Secretary Steven Mnuchin to treat direct primary care arrangements and healthcare sharing ministries as “eligible medical expenses.” Treating these healthcare services as medical expenses allow employers to subsidize employees’ DPCs and HCSMs similarly to an employer-sponsored health insurance plan. Read More: Breitbart

HEALTH CARE BRIEFING: Pelosi Says ACA Measure to Come by July 4

The House will vote on a package of Affordable Care Act measures meant to make insurance cheaper and convince more states to expand their Medicaid programs, Speaker Nancy Pelosi (D-Calif.) said yesterday.

Pelosi told reporters that Democratic leaders have put an “Affordable Care Act stabilization” bill on the schedule for action before July 4. A senior Democratic aide said members have been working on an ACA package that would expand Obamacare’s insurance subsidies and push more states to extend eligibility for their public health insurance programs for the poor to a wider swath of people.

The legislation hasn’t yet been introduced, but it would be similar to legislation (H.R. 1884) already passed by the House that would have beefed up the ACA’s insurance subsidies and made other reforms to the health-care law. That bill was largely ignored by Senate Republican leadership, who didn’t take it up, Alex Ruoff reports. Read More: Bloomberg

How the Patient Portal Improves Health Outcomes in Chronic Illness

Getting more patients on board to actively use the patient portal could drive better patient engagement in care and boost healthcare outcomes, according to new research out of the University of Texas Austin.

The study, published in MIS Quarterly, found that meaningful patient portal use results in fewer hospitalizations, a decrease in emergency department visits, and lower readmission rates. When frequent patient portal users do get admitted into the hospital, it’s often for a shorter period than patients who do not use the patient portal.

All of these outcomes could result in considerable cuts in healthcare costs, the researchers said. Read More: Patient Engagement HIT

Rapid Changes To Health System Spurred By COVID Might Be Here To Stay

The COVID-19 pandemic has done what no president or social movement or venture capitalist could have dreamed of: It forced sudden major changes to the nation’s health care system that are unlikely to be reversed.

“Health care is never going back to the way it was before,” said Gail Wilensky, a health economist who ran the Medicare and Medicaid programs for President George H.W. Bush in the early 1990s. Read More: KHN

Gateway Health Plan Debuts It’s Wholecare Brand Platform, Plans to Donate More Than $1 Million to Address Social Determinants of Health

Gateway Health Plan, a leading managed care organization dedicated to caring for the “total health” of its members, today announced the launch of its new brand platform, Wholecare, along with its redefined mission, vision and core values. As part of these efforts, the company also plans to contribute more than $1 million in 2020 to support strategic community partnerships that focus on social determinants of health (SDoH).