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 →

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

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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

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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

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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

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 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

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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

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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

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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 →

Humana Teams Up with CoverMyMeds to Improve Prior Authorization Process for Members

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LOUISVILLE, Ky.–()–Humana Inc. (NYSE: HUM) and CoverMyMeds, a leading health care innovation company, have recently teamed up to implement an electronic prior authorization model that allows providers to streamline prescription authorization requests, giving patients expedited access to the medications they need.

“Depending on the prescription, some medications require prior authorization before coverage which, as of now, is a time-consuming process for all parties”

Under the new agreement, physicians can submit drug prior authorizations directly to Humana via an online portal. The requests begin processing immediately and providers receive a notification of the status of the member’s prior authorization, often before the member even leaves the doctor’s office. Continue reading →

Kaiser Permanente joins Veterans Affairs Center for Innovation Partnerships Program

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OAKLAND, Calif., and WASHINGTON, D.C., Feb. 3, 2014 /PRNewswire/ — Together, the Veterans Health Administration and Kaiser Permanente provide care and service to nearly 18 million Americans. Today the two organizations announced they will pool resources and ideas to solve some of the largest and most complex challenges in health care.

As part of the Veterans Affairs Center of Innovation Partnership Program, the two organizations will research and share best practices in four specific areas: Continue reading →