MENOMONEE FALLS, Wisc., June 2, 2017 /PRNewswire/ — The accolades continue to accrue for SKYGEN USA. The company, which is dedicated to transforming the delivery of health benefits through innovative, technology-enabled solutions that drive down the cost of care while ensuring healthier outcomes for all Americans, announced today that it has been ranked number 86 on the prestigious 2017 Healthcare Informatics (HCI) 100 list. [Read more…]

SACRAMENTO, Calif., June 2, 2017 /PRNewswire/ — CAHU is dismayed that the California State Senate saw fit to pass the $400 billion per year tax plan to pay for universal single payer legislation, SB 562 (Lara/Atkins). [Read more…]

American Well announced today that its clinical partner, Online Care Group, is open and available for telehealth visits in Texas, following the historic signing of Bill SB107 into law by Governor Abbott on May 27. This bill embraces telehealth, holding medical professionals using telehealth to the same standard of care as those in a traditional medical practice and paving the way for more expansive use of high-quality telehealth services. [Read more…]

TORONTO, May 16, 2017 /CNW/ – Alternate Health Corp. (CSE:AHG, OTC:AHGIF), a diverse healthcare company revolutionizing patient care and research through compliance and technology in the emerging medical cannabis industry, announced today the completion of its initial study to demonstrate the effectiveness of cannabinoid in treating chronic post-Zika virus symptoms. [Read more…]

Milliman, Inc., a premier global consulting and actuarial firm, has released the 2017 Milliman Medical Index (MMI), which measures the cost of healthcare for a typical American family of four receiving coverage from an employer-sponsored preferred provider plan (PPO). In 2017, costs for this family will increase by 4.3%—which marks the lowest rate of increase in the history of this study—though the total dollar increase of $1,118 is consistent with the last decade of healthcare cost increases. [Read more…]

More Americans now have health insurance than ever before, but that doesn’t mean there are fewer gaps in the screening, monitoring, and management of healthcare and chronic disease. Most health plan members believe their plan’s communications are impersonal and centered around bills rather than healthcare guidance. The majority of members are either disconnected from or rarely visit their health plans on social media and member portals. Additionally, many members feel they are missing valuable support from their plans around digital health data and price transparency. The findings are based on a survey of 750 insured consumers who have sponsored health insurance. The results are now available in the 2017 HealthMine Health Intelligence Report: Communication and Digital Healthcare Tools. [Read more…]

EPIC Insurance Brokers & Consultants, a retail property, casualty insurance brokerage and employee benefits consultant, announced today that Reba Mathew Pharm.D., R.Ph has joined the firm’s Employee Benefits Consulting Practice as Pharmacy Practice Director. [Read more…]

The growing global market presence of SCIO Health Analytics™ is featured in healthcare technology consulting firm Signify Research’s most recent market report, “Population Health Management IT – North America – 2017.” [Read more…]

Aflac will partner with Tough Mudder Inc., the leading active lifestyle brand and media company, as the “Official Supplemental Insurance Provider” for Tough Mudder’s 2017 events season. The partnership includes the introduction of the Aflac Small Business Challenge designed for teams participating in Tough Mudder events on behalf of small businesses. [Read more…]

xG Health Solutions, powered by Geisinger®, and Casenet, through a strategic alliance, will deliver evidence-based assessment and care plan content to the health plan market. Through this partnership, xG’s Intelligent Care Management™ evidence-based content will be available in Casenet’s TruCare GuidedCare product. The clinical content is based on nationally-recognized practice guidelines and standards of care, including assessments and care plans for 45 conditions that are most commonly addressed in care management programs. [Read more…]

DaVita Inc. (NYSE: DVA), a leading independent medical group and a leading global provider of kidney care services has been certified as a “Freedom-Centered Workplace” by WorldBlu. This is the tenth consecutive year the company has been recognized on the list, formerly known as “most democratic” workplaces.

Organizations become eligible for a spot on the WorldBlu List of Most Freedom-Centered Workplaces™ after teammates complete The WorldBlu Freedom at Work™ Assessment, a survey evaluating their practice of the WorldBlu 10 Principles of Organizational Democracy™. The assessment was developed based on a decade of research into what makes a successful freedom-centered company. Organizations from the for-profit and non-profit sectors that have been in operation for at least one full year and have five or more employees can apply for the certification.

WellCare of New York, Inc., a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), has signed an agreement with Catholic Health and Catholic Medical Partners, an independent practice association (IPA) that provides in-network coverage to WellCare’s Medicare Advantage, Medicaid and Child Health Plus members. [Read more…]

ProgenyHealth, the only national company focused exclusively on neonatal intensive care unit (NICU) case management, has entered into an agreement with Family Health Network to manage the unique healthcare needs of their premature and medically complex newborn population. ProgenyHealth will provide comprehensive NICU care management services to their Medicaid members for the first year of life. [Read more…]

Minnesota health insurers reported $687 million in operating losses for 2016, according to information released today by the Minnesota Council of Health Plans. Medical reserves were tapped to pay for doctor visits, nursing, hospital stays, medications and other care.

Overall, revenue from premiums increased 4 percent over the prior year to nearly $25.9 billion, while expenses increased 6 percent to $26.6 billion. State public programs accounted for more than half of the overall red ink, followed by continued losses in the individual market. Insurance employers provide remained steady. On average, health insurers paid $763 per second for care. To pay those bills, insurers withdrew nearly $560 million from state-mandated medical reserves.

Sirius International Insurance Group, Ltd. has acquired ArmadaCorp Capital, LLC., a market leading provider of supplemental healthcare insurance products and administration services in the United States. [Read more…]

The Texas Association of Freestanding Emergency Centers (TAFEC) supports legislation introduced in the Texas Legislature aimed at increasing oversight of health insurance companies and protecting consumers from surprise medical costs. [Read more…]

More than half of commercially-insured patients’ out-of-pocket spending for brand medicines is based on the full list price, according to a new analysis from Amundsen Consulting, a division of QuintilesIMS. The data also show cost -sharing for nearly one in five brand prescriptions is based on the list price. [Read more…]

The Pharmaceutical Care Management Association (PCMA) today released the following points regarding a new PhRMA report on patient out-of-pocket spending:

— According to the Centers for Medicare and Medicaid Services (CMS), the average amount spent out-of-pocket for drugs continues to decline, projected to be 13% of drug spending in 2016, down from 23% in 2006.

— Rising drug costs is a pricing problem, not a coverage problem. Health plans don’t have unlimited funds to pay first dollar coverage on every drug, regardless of its price.

— The simplest, most obvious way for drugmakers to reduce costs and improve access is to cut their prices.

— The report ignores the most obvious and important point: rising out-of-pocket costs are a by-product of rising drug prices and the wave of new high-priced specialty brands coming to market.

— While not all health plans apply manufacturer rebates to reduce cost-sharing on each drug, it’s usually because the savings are being used to reduce premiums.

— Higher cost-sharing on certain brand drugs is often used to promote less expensive but equally effective generics, which comprise almost 90% of prescriptions.

— The employers and unions that offer coverage know better than the drug industry what’s best for their patient populations. Whether health plans decide to reduce costs by reducing premiums for all or cost-sharing on certain drugs should be up to them – not drugmakers.

PCMA is the national association representing America’s pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.

SOURCE Pharmaceutical Care Management Association

WellCare Health Plans, Inc. (NYSE: WCG) today announced that it will release its financial results for the first quarter of 2017 on Wednesday, May 3, 2017, at approximately 6:00 a.m. EDT. The company will also host a conference call at 8:00 a.m. EDT that morning to discuss its financial results. [Read more…]

DW Healthcare Partners, a private equity firm focused exclusively on the healthcare industry, announced today the closing of its fourth fund totaling USD $295 million in total capital commitments. This brings DW Healthcare Partners’ total capital under management to USD $800 million. [Read more…]

Symbility Solutions Inc. (“Symbility”) (TSX.V: SY), a global software company focused on modernizing the insurance industry, confirmed that it will release its fourth quarter and full year 2016 financial results before market open Tuesday, April 11, 2017. The press release, with accompanying financial information, will be posted on the Symbility’s website at www.symbilitysolutions.com and on www.sedar.com [Read more…]

ASPiRA Labs, a Vermillion company (NASDAQ: VRML), today announced it has signed an in-network, contracted agreement with TriCare South for ASPiRA’s U.S. FDA cleared, Centers for Medicare and Medicaid Services (CMS) covered, American College of Obstetricians and Gynecologists (ACOG) Level B recommended ovarian cancer risk assessment test, OVA1® (Multivariate Index Assay or MIA). TriCare South serves about 2.5 million beneficiaries in the states of Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee, Texas (excluding El Paso) and Fort Campbell, Kentucky. [Read more…]

Combined Insurance, a leading provider of individual supplemental accident, disability, health, and life insurance products, and a Chubb company, demonstrates its continued commitment to giving back to U.S. servicemen and women with a $30,000 donation to Luke’s Wings—recipient of the company’s philanthropic sales program for the third consecutive year. [Read more…]

It is that time of year when offers of university places start to drop into electronic mailboxes around the world. Higher education is big business now, places at UK universities are some of the most sought after in the world. These institutions will often charge overseas student annual fees of well over £25,000, so for the parents, ensuring the success of the academic investment is as significant as it is for a company sending key employees abroad. [Read more…]

Recondo Technology, the market leader in cloud-based single-platform revenue cycle management (RCM) solutions, has released a suite of application programming interfaces (APIs) to significantly streamline payment, improve patient satisfaction, and simplify technology innovation. [Read more…]

Centene Corporation (NYSE: CNC) has appointed former Missouri Attorney General Chris Koster to Senior Vice President, Corporate Services effective today. Mr. Koster will report directly to Chairman, President and CEO Michael F. Neidorff, and will assist in business-related issues, outside of Government Relations, for Centene’s locally-based health plans across the country. [Read more…]

Talix, Inc., a premier provider of risk analytics solutions for value-based care, today announced that Shahyan Currimbhoy, senior vice president of product management and engineering at Talix, and Karena Weikel, ASA, FAHM, CSFS, vice president of risk and revenue management at Geisinger Health Plan (GHP), will be presenting at the 2017 RISE Nashville Summit. The summit takes place March 6-8, 2017 at the Omni Nashville Hotel in Nashville, Tenn. [Read more…]

Don’t repeal the Affordable Care Act (ACA) without specifying what will replace it. This is among the policy recommendations issued by the National Alliance of Healthcare Purchaser Coalitions (National Alliance), a nonprofit, membership association of employer led coalitions across the country serving 12,000 purchasers and 41 million Americans.

Additional recommendations include:

— Preserve employer-sponsored coverage by refraining from capping the individual tax exclusion for premiums and continue to allow businesses to fully deduct the costs.

— Avoid increasing the number of uninsured individuals, as the cost of their inevitable medical care will get shifted to those who do pay the bills.

— Continue to move away from fee-for-service (or “volume-based reimbursement”) toward alternative payment models that reward providers for good outcomes and high quality, not medical errors, unnecessary procedures and other low value care. Preserve the ability of the federal government to partner in these efforts (Center for Medicare & Medicaid Innovation and other value-promoting elements of the ACA, and the Medicare Access and CHIP Reauthorization Act of 2015).

— Expand assistance to states, regions, and local communities promoting transparency by pushing hospitals and medical groups to report on the quality of care they provide.

— Support comparative effectiveness research. Employer-purchasers need to know which new or higher cost therapies result in outcomes that are significantly better, somewhat better, about the same, or worse than current or less costly options.

— Allow employer-purchasers maximum flexibility in experimenting with benefit designs.

A Purchaser Viewpoint on Health Policy in Transit is the result of a collaboration of the National Alliance’s Government Affairs Affinity Group led by members including the Louisiana Business Group on Health, Midwest Business Group on Health, Minnesota Health Action Group, Pacific Business Group on Health, and Wyoming Business Coalition on Health.

In three new issue briefs, the American Academy of Actuaries examines a number of key public policy considerations that policymakers should weigh when evaluating specific proposals for reforming or replacing the Affordable Care Act. Developed by the Academy’s Individual and Small Group Markets Committee, the papers address high-risk pools, selling health insurance across state lines, and association health plans. [Read more…]

America’s leading nursing organizations and the over 3.5 million nurses they represent, today called on the Trump Administration and Congress to prioritize patient health and the patient-provider relationship in any health reform proposals. [Read more…]

Consumers are just beginning to discover that Anthem eliminated coverage for out-of-network doctors now that the Affordable Care Act “Open Enrollment Period” to secure health coverage for 2017 ended on January 31. [Read more…]

Aflac, the leader in voluntary insurance sales at the worksite in the United States, is making it even easier for customers to access much-needed financial support while they are in the hospital. [Read more…]

Employer-sponsored health insurance is greatly affected by geographic region, industry, and employer size. While some cost trends have been fairly consistent since the Patient Protection and Affordable Care Act (ACA) was put in place, United Benefit Advisors (UBA) finds several surprises in their 2016 Health Plan Survey. [Read more…]

Secretary of Health Dr. Karen Murphy is urging the commonwealth’s U.S. Congressional delegation to consider the effect that repealing the Affordable Care Act (ACA) could have on all Pennsylvanians, especially children and seniors in need. [Read more…]

Discern Health has announced their affiliation with Mai Pham, MD, MPH as a Senior Advisor. Mai most recently served as Chief Innovation Officer at the Centers for Medicare & Medicaid Innovation (CMMI). Among other achievements at CMMI, Mai spearheaded development and implementation of the alternative payment model (APM) portion of MACRA, which will fundamentally change the way that Medicare pays for physician services. [Read more…]

International Medical Group® (IMG®), a leader in global benefits and assistance services, has named Craig Peters as chief revenue officer (CRO). [Read more…]

Hospitals and health systems in New Jersey have already absorbed nearly $1.5 billion in funding cuts since the Affordable Care Act was enacted in 2010, with the promise of expanded healthcare coverage to mitigate these losses. As the 115th Congress advances legislation to repeal major provisions of the ACA, healthcare providers are concerned the cuts will remain despite the coverage of 796,291 state residents being jeopardized. [Read more…]

The President and CEO of the Senior Care Pharmacy Coalition (SCPC) today predicted the increasingly apparent role of Pharmacy Benefit Managers (PBMs) as unaccountable middlemen in the national drug pricing chain will result in a higher level of scrutiny from Congress, regulators and the media in 2017. [Read more…]

The Permanente Medical Groups serving Kaiser Permanente members and patients across California received 5-star ratings for overall performance — the highest recognition possible by the California Office of the Patient Advocate — in the second annual Medical Group Report Card for Medicare Advantage Members. [Read more…]

Insurance Commissioner Teresa Miller today reminded Pennsylvania consumers that the open enrollment period for 2017 health insurance coverage available through the federal marketplace at www.Healthcare.gov closes at 11:59 p.m. on January 31. More than 413,000 Pennsylvanians are currently enrolled in plans for 2017. [Read more…]

To help people affected by breast cancer understand and prepare for changes to healthcare insurance policies that might affect them, Living Beyond Breast Cancer (LBBC) has created a Healthcare Newsroom on LBBC.ORG. [Read more…]

Milliman, Inc., the premier global consulting and actuarial firm, has published six questions for consideration by healthcare stakeholders about the Trump Administration’s recent executive order, which gives a sweeping command to the leaders of the new administration to unwind certain aspects of the Patient Protection and Affordable Care Act (ACA)—especially those components deemed “burdensome.” It remains unclear how the Trump Administration will implement this authority, especially due to the interconnected nature of the ACA, but given Milliman’s comprehension of the law, several key questions arise. [Read more…]

MailMyPrescriptions.com has entered into an agreement with Alliance HealthCard of Florida, Inc. Alliance HealthCard of Florida, Inc., a division of Aon Benefit Solutions, Inc., an Aon subsidiary (NYSE: AON), will make mailmyprescriptions.com available to America’s Health Care Plan/RX Plan Agency, Inc. (AHCP) owned by National General Insurance Company (NASDAQ: NGHC). [Read more…]

Alere Inc. (NYSE: ALR), a global leader in rapid diagnostic tests, has provided an update on the decision by the Centers for Medicare & Medicaid Services (CMS) to revoke Arriva Medical’s Medicare billing privileges. [Read more…]

ReWalk Robotics Ltd. (Nasdaq: RWLK) (“ReWalk”), the leading global exoskeleton developer and manufacturer, announced today the donation of a ReWalk Personal 6.0 System to Daniel Timms, who sustained a spinal cord injury (SCI) in 2012 in a parachuting accident. Thanks to a number of generous donors, Walkabout Foundation, a London-based not-for-profit organization that donates wheelchairs to disadvantaged individuals worldwide and supports critical research in paralysis, was able to provide the device for Mr. Timms. [Read more…]

WellCare Health Plans, Inc. (NYSE: WCG) has signed a definitive agreement to acquire certain assets, including Medicaid membership and certain provider contracts, from Phoenix Health Plan (PHP), a wholly owned managed care subsidiary of Tenet Healthcare. PHP provides health benefits primarily to more than 50,000 Medicaid beneficiaries as of Dec. 1, 2016 in Maricopa County, Arizona, the state’s largest geographic service area. [Read more…]

Harmony Health Plan, Inc., a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), gave $10,000 to Kidz Korna to help make the holidays special for thousands of children living in Chicago’s low-income communities, such as Englewood, Bronzeville, Roseland and the Westside. [Read more…]

Chubb today announced that Graham Lambourne, currently Global Clients Claims Manager, Europe has been promoted to the role of Head of Multinational Claims for Overseas General Insurance. [Read more…]

Finding a replacement for Obamacare that their colleagues will support may prove to be an impossible task for Republicans on Capitol Hill, says a health economist familiar with the obstacles involved. [Read more…]

Apollo Medical Holdings, Inc. (“ApolloMed” or “the Company”) (OTC: AMEH), an integrated population health management company, and Network Medical Management, Inc. (“NMM”), one of the largest healthcare Management Services Organizations (MSOs) in the United States, have announced that they have signed a definitive merger agreement pursuant to which the companies will combine in a stock-for-stock merger transaction. [Read more…]

Holiday stress can be a pain in the neck…and the teeth, warns Delta Dental. If too much family time or the mad dash for last minute gifts causes you to grind or clench your teeth, be aware that it can cause your teeth to ache, wear down, become loose or even crack. Headaches, pain or soreness of your neck and jaw muscles, and clicking, popping and pain in your jaw joints are also possible side effects. [Read more…]

Medicare’s star ratings of hospitals fail to provide the public with an easy comparison of the quality of inpatient care provided. An analysis by J. Graham Atkinson, D.Phil., Jayne Koskinas Ted Giovanis Foundation for Health and Policy (JKTG) executive vice president for research and policy reveals the biases inherent in the rating system along with conceptual problems in the design of the method used to combine individual quality scores. [Read more…]

NextHealth Technologies Inc., a prescriptive analytics and consumer engagement platform that measurably reduces medical costs for health plans, announced that David H. Klein has joined its board. As a CEO with over 30 years of experience managing health plans and delivery systems, Mr. Klein brings extensive experience in strategy, operations and policy. [Read more…]

WellCare Health Plans, Inc. (NYSE: WCG) announced that its employees are giving back to the Tampa Bay community this holiday season by volunteering with Tampa-based, social-service agency Metropolitan Ministries, which provides life-changing support to those who are homeless and at risk of becoming homeless by assisting them with food, clothing, shelter and other vital services. [Read more…]

Emerge, an online platform that reimagines how consumers purchase emergency insurance, has announced that its site is live and ready to educate individuals and help them avoid the risk of medical debt. [Read more…]

Veterans Deserve Care, a grassroots coalition committed to reducing wait times in VA facilities, applauded a decision by the U.S. Department of Veterans Affairs (VA) to finalize a rule allowing veterans to receive high-quality care by providing direct access to nurse practitioners. [Read more…]

The City of Fort Worth (the “City”) is pleased to announce the expansion of its member healthcare coverage offering starting January 2017 through Employer Direct Healthcare’s SurgeryPlus®, a supplemental benefit for non-emergent surgeries that provides higher quality care, a better experience and lower costs. [Read more…]

The Pennsylvania Medical Cannabis Industry Group (“PAMCIG”) has partnered with Next Wave Insurance Services, LLC (“Next Wave”), which is backed by top rated insurance and reinsurance carrier partners providing comprehensive insurance coverage nationwide. The partnership between the largest marijuana trade association in the state and the leading provider of property and casualty insurance will bring a valuable solution to the potential applicants for Pennsylvania’s medical marijuana industry. [Read more…]

GetInsured, a market leader in individual health insurance ecommerce, announced recently that it has acquired Array Health, a leading provider of group health insurance ecommerce technology. Together, the companies will make it possible for insurers, employers, state governments and benefits brokers to deliver a superior consumer experience through a single, scalable ecommerce solution that supports group, individual and Medicare health enrollment. [Read more…]

The U.S. business group of Sun Life Financial has released a study titled “Voluntary Benefits: An Unknown but Needed Option,” illustrating that due to health care costs continuing to rise, American workers need to adequately understand what voluntary benefits are. [Read more…]

AMSUS, The Society of Federal Health Professionals, announced the creation of a new board, the Executive Advisory Board (EAB), during its Annual Meeting in Maryland recently. [Read more…]

The Partnership for Quality Home Healthcare — a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation’s seniors – recently urged Congress to pass the Pre-Claim Undermines Seniors’ Health (PUSH) Act of 2016 to provide more time for implementing a Medicare home health pre-claim review policy to ensure Medicare and home health agencies are prepared to manage the process and maintain continuity of care for home health beneficiaries. [Read more…]

Research shows old age is seen as a problem, worries about healthcare and social services and people not prioritising or doing enough to prepare for their own retirement. Research conducted by Chase de Vere, the national firm of independent financial advisers, paints a depressing picture of increasing longevity in the UK. [Read more…]

FAIR Health’s consumer website marked another year as the preeminent site for consumers to access accurate, actionable healthcare cost estimates and health insurance information. In a time of flux in healthcare policy at the federal and state levels, the site continues to serve as a lighthouse to consumers at sea among high-deductible health plans, narrow networks and other potentially confusing aspects of the healthcare marketplace. To that end, FAIR Health offers five tips for consumers below. [Read more…]

International Medical Group® (IMG®), a leader in global benefits and assistance services, recently announced the company’s new corporate branding and logo. [Read more…]

The annual enrollment period for Medicare ends next week for most Medicare beneficiaries. For the first time, Magnolia Health, is offering a Medicare Advantage HMO, available to anyone eligible for Medicare and living in the following counties in Mississippi: George, Harrison, Hinds, Jackson, Madison, Rankin and Stone. [Read more…]

Former Walmart associate Jacqueline Cote and her lawyers filed a motion today asking the U.S. District Court for the District of Massachusetts to grant preliminary approval of a class action settlement in Cote’s action that challenged Walmart’s lack of health insurance benefits for same-sex spouses of Walmart associates prior to 2014. [Read more…]

Sovereign Health, a leading national provider of behavioral health treatment services, has announced the seventh installment of the “Beyond NIMBY” series, a second series that addresses the strong community opposition to recovery-oriented housing and addiction treatment services for persons with substance use disorders in residential neighborhoods — often referred to as “not in my backyard.” [Read more…]

UPMC Health Plan Service and Sales Associates are now available to answer individual’s health insurance questions and meet your health care coverage needs at a new Monroeville Mall store. The grand opening celebration was today, Saturday, Nov. 5, 2016 from 10 a.m. to 3 p.m. [Read more…]

Centene Corporation (NYSE: CNC) announced recently that its subsidiary, Kentucky Spirit Health Plan, Inc. (Kentucky Spirit), has settled all lawsuits and complaints associated with its contract with the Commonwealth of Kentucky (the Commonwealth). [Read more…]

Seven California news stations have not aired a single story about Proposition 61 to educate voters on the measure that would cap state prescription drug prices, despite receiving nearly $1.7 million in ad money from the pharmaceutical industry’s record-breaking $126 million No campaign. [Read more…]

Consumer Watchdog today called out the Kaiser Family Foundation for holding a one-sided debate on drug price controls tomorrow that allows the opponents of Prop 61, the drug makers who raised $90 million against the effort to rein in California’s drug bills, a seat but leaves proponents out. [Read more…]

Health insurance premiums will likely increase by an average of 76 percent for Oklahomans who buy individual coverage through the Affordable Care Act’s marketplace. The increases for individual market plans range from 58 percent to 96 percent. [Read more…]

Effective October 1, 2016, the Medi-Cal Fee-For-Service program provides unrestricted, $0 copay access to NARCAN® Nasal Spray for its beneficiaries. As a result of this decision, beneficiaries can now obtain NARCAN® Nasal Spray from pharmacists across the state within 24 hours, establishing an unprecedented level of access and coverage. [Read more…]

Alignment Healthcare has hired former Aetna executive Kevin P. Enterlein to head its Florida market, which the California-based population health management company entered January 1st. [Read more…]

Karen Brach has been named the new President of Meridian Health Plan of Illinois and is scheduled to step into that role on April 5. Brach is a managed care executive with more than 15 years of Medicaid and Medicare managed care senior leadership experience. [Read more…]

AmeriVeri (http://www.ameriveri.com/) helps protect the integrity of Medical Records and saves patients from unnecessary, costly and possibly dangerous treatments resulting from medical coding errors. What many don’t realize is how shockingly common these errors are. [Read more…]

While care transformation continues to lead the list of concerns for hospital and health system executives, this year two of the top four topics relate to patients’ non-clinical needs, according to The Advisory Board Company’s Annual Health Care CEO Survey. Specifically, meeting consumer expectations and patient engagement made notable moves up the list. [Read more…]

Centene Corporation (NYSE: CNC) has appointed Mark Brooks to Senior Vice President and Chief Information Officer, effective immediately. Mr. Brooks will oversee the development and implementation of all information technology and systems for Centene. [Read more…]

According to the latest survey conducted by leading personal finance website GOBankingRates.com, 43 percent of Americans expect to pay more for health insurance in 2016, with 23 percent expecting to pay “a little more than the last year” and 20 percent expecting to pay “a lot more than the last year.” [Read more…]

GeoBlue today announced the appointment of Guillaume Deybach as President and CEO for parent company Highway to Health, Inc (HTH). This concludes the global search conducted over a period of several months for an exceptional candidate able to effectively blend industry expertise with strategic vision. [Read more…]

Leading global startup accelerator Dreamit announced today that the Dreamit Health program developed in collaboration with Penn Medicine and Independence Blue Cross (Independence) has received a $325,000 grant from Blackstone Charitable Foundation to drive innovation in the health care sector. [Read more…]

Capital BlueCross today announced Chris Davis as the company’s new vice president of ancillary services. Davis was previously vice president of sales and service at Dominion Dental Services, a national dental and vision plan administrator headquartered in Alexandria, Va. [Read more…]

ProAssurance Corporation (NYSE: PRA) announced that Chief Financial Officer Edward L. Rand, Jr. will assume additional duties as the President of Medmarc, the Company’s life science and legal professional liability insurance subsidiary. Additionally, ProAssurance announced the promotion of Karen M. Murphy, J.D., to Executive Vice-President of Medmarc and Head of Life Sciences for ProAssurance. The changes will be effective March 1, 2016, following the retirement of Medmarc’s long-time president, Mary Todd Peterson. [Read more…]

Paradigm, a molecular information & Next Generation Sequencing corporation specializing in providing testing for cancer patients recently announced that it has entered into a contractual agreement with UnitedHealthcare for coverage of PCDx™.

PCDx™ is a Next-Generation Sequencing (NGS) based diagnostic test that is designed to provide physicians and patients with a more targeted, personalized approach to cancer treatment by identifying the underlying genomic and proteomic alterations of a patient’s tumor’s DNA, RNA & Protein.

Inland Empire Health Plan (IEHP), with the approval of its Governing Board, added $5 million additional dollars to its Network Enhancement Fund (NEF) to bring new providers to practice in the Inland Empire (IE) to help improve access to care for more than 1.12 million IEHP Members. The program, started in late 2014, continues to add new providers to the Inland Empire. [Read more…]

As the number of Minnesota soldiers returning home after serving overseas continues to increase, so do the challenges that come with transitioning into work and civilian life. Blue Cross and Blue Shield of Minnesota (Blue Cross), which has long supported military members and their families through employment and community outreach, has been recognized as the first and only health insurance provider in Minnesota to be designated as a Beyond the Yellow Ribbon company following a unanimous vote by the State of Minnesota Yellow Ribbon Action Plan Review Board.

Overseen by the Minnesota Department of Military Affairs, the Beyond the Yellow Ribbon program, established in 2008, supports service members, veterans and their families by connecting them with career counseling, professional development training and employment resources. In order to achieve a Beyond the Yellow Ribbon designation, companies must build relationships with local military leaders, identify which employees have military connections and commit to hiring and retaining veterans.

“In just ten days, January 31, 2016, most residents of Atlanta must have health insurance or face new tax penalties,” said Dr. Jane L. Delgado, President and CEO of the National Alliance for Hispanic Health, the nation’s leading Hispanic health advocacy group. She added, “making a decision on health insurance is not easy and many are looking for help they can trust. Our bilingual Navigators are ready to help!.” [Read more…]

Consumer Watchdog will challenge executives at a Department of Insurance hearing into the proposed Centene/Health Net merger to commit to strong consumer protections as conditions of a merger approval.

The Department of Insurance has broad authority to set conditions on the merger deal. [Read more…]

As monthly premiums for the most popular plans offered under the Affordable Care Act are seeing a 10.1 percent spike up from 2015*, GOBankingRates conducted a study to see which states’ residents are paying more (or less) for health insurance in 2016 – and what they’re getting for their money.

New York residents pay the most for basic health insurance, whereas residents of New Mexico pay the least, according to a new study released today by leading personal finance website GOBankingRates.com.

The study compared silver plans ? the most popular plan according to the Department of Health and Human Services ? offered through the national or state-level insurance exchanges administered through the Affordable Care Act.1

The lowest-cost silver plans for each state were ranked based on the favorability of the following cost factors:

The plan’s monthly premium
The deductible
The emergency care copay
The copay for care from a primary physician

To see full details on the methodology, visit:
http://www.gobankingrates.com/personal-finance/10-best-worst-states-health-insurance-costs/

CentraState Medical Center is establishing a new benchmark for patient education best practices by integrating video medication education with a patient’s Electronic Medical Record (EMR) using in-room televisions. Partnering with TeleHealth Services, the 284-bed hospital is optimizing clinical workflows while proactively addressing readmissions, HCAHPS score improvement and Meaningful Use initiatives. [Read more…]

The deadline is drawing near for uninsured consumers to sign up for Affordable Health Care this month. Numerous legislators across the country continue to wrestle with whether to expand their state’s Medicaid provisions to accommodate ACA. However states and others can look at the efficiency of DC-based, Trusted Health Plan, a Medicaid Managed Care Organization that has made significant impacts in the marketplace with a business model that is providing cost savings and efficiency. “Our goal is simple… reduce healthcare cost, improve quality and expand access to care. We are positively impacting the lives of our members,” says Thomas Duncan, Trusted Health Plan; CEO. [Read more…]

DinnerTime has signed an agreement with Johns Hopkins HealthCare to provide Johns Hopkins Employer Health Programs (EHP) members with free access to DinnerTime’s personalized meal planning and sale-smart shopping service. As of January 1, 2016, Johns Hopkins EHP members can sign up for DinnerTime free-of-charge when using their EHP membership number and referral code as part of their EHP benefits package. [Read more…]

WellCare Health Plans, Inc. (NYSE: WCG) announced that it will release its financial results for the fourth quarter and full year of 2015 on Tuesday, February 9, 2016, at approximately 6:30 a.m. Eastern time. The company will also host a conference call at 9:30 a.m. Eastern time that morning to discuss its financial results. [Read more…]

The HealthWell Foundation®, an independent non-profit that provides a financial lifeline for inadequately insured Americans, has announced it has opened a new fund to provide financial assistance to Medicare patients suffering from renal cell carcinoma (RCC). Through the fund, HealthWell will provide grants up to $10,000 to assist RCC patients with copayments and premiums. Patients who are on Medicare and have annual household incomes up to 500% of the federal poverty level are eligible for the fund.

According to the National Kidney Foundation, RCC is the most common type of kidney cancer in adults. About 30 percent of people who are diagnosed with RCC develop advanced (metastatic) disease, in which the cancer spreads to other parts of the body— most often the bones or lungs. Kidney cancer is usually treated with a combination of nephrectomy (surgical removal of all or part of the kidney), radiation therapy, immunotherapy, chemotherapy and hormone therapy. Kidney cancer can often be cured if found and treated before it has spread.

Senior Health Insurance Company of Pennsylvania (SHIP) has announced that it has executed a reinsurance transaction with Teachers Protective Mutual, a mutual insurance company, for SHIP to reinsure all of Teacher’s long-term care business.

Founded in 1912, Teachers Protective Mutual offers a variety of insurance coverage including accident, health, life and disability. The company offered individual long-term care products from 1992-2005 to residents in Ohio, Pennsylvania and Virginia.

As part of the transaction, SHIP will initially provide 100 percent coinsurance of the block of long-term care policies Teachers Protective Mutual holds, and will seek to assume the Teachers policies into SHIP in 2016. The transaction has obtained all required regulatory approvals necessary to proceed.

WellStar Health System is deploying an innovative solution to improve the patient experience while providing better patient care. WellStar’s electronic medical record patient portal, WellStar MyChart, will provide patients with round-the-clock access to their providers’ notes in addition to instructions, next steps, medication lists and test results from outpatient medical visits. WellStar is the first Georgia-based health system to offer this service to its patients. [Read more…]

hCentive, the leader in health insurance exchange solutions, announced recently that the company has added new health and ancillary insurance carriers and benefits administrators to its WebInsure Benefits marketplace. WebInsure Benefits is a single cloud-based platform for brokers to efficiently manage their employer group and individual business and simplify administration. The platform provides employers control to shop, enroll and manage health insurance, ancillary benefits, and consumer-directed accounts while delivering an intuitive online experience for consumers.

WellCare Health Plans, Inc. (NYSE: WCG), a leading provider of managed care services for government-sponsored health care programs, announced recently that it honored its high-performing network physicians in New York by making them the first inductees into WellCare of New York’s new All-Star Quality Team.

WellCare of New York launched the All-Star Quality Team to recognize the instrumental role that physician providers play in helping its members live better, healthier lives. The 25 physicians selected demonstrated excellence in caring for members per federal metrics called Health Care Effectiveness Data and Information Set® (HEDIS) and were recognized for their HEDIS 2015 results. These measures gauge how effectively WellCare manages its members’ chronic diseases, such as asthma and rheumatoid arthritis, and ensures that members receive preventive care, such as immunizations and health screenings.

WellCare now ranks fourth highest out of 16 plans in providing quality care for Medicaid recipients in New York. The ranking is based on health care quality metrics, member and provider satisfaction, and regulatory compliance measurements as determined by New York’s Office of Health Insurance Programs.

The National Association of Professional Insurance Agents (PIA) has hailed passage of the Policyholder Protection Act. The measure was included in the omnibus appropriations agreement that was passed 316-113 in the House and 65-33 in the Senate on December 18.

The Policyholder Protection Act prohibits federal regulators from using assets designated to pay out insurance claims to “prop up” an affiliated bank. [Read more…]