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Last updated on April 21, 2014 at 0:02 EDT

Latest Managed care Stories

2014-04-18 23:08:07

In an upcoming webinar from Atlantic Information Services, participants will hear pharmacy experts from a top-rated Medicare plan discuss key aspects and decision-making components involved in developing effective star-rating strategies. Washington, DC (PRWEB) April 18, 2014 As CMS enhances and modifies its star-ratings program each year, it raises the bar for Medicare plans to deliver ever-higher quality care. Since the pharmacy benefit is the primary objective of Prescription Drug Plans...

2014-04-16 23:02:27

New White Paper by TMG Health outlines best practices for meeting the challenge of managing CMS requirements for collateral, letters and notifications. King of Prussia, PA (PRWEB) April 16, 2014 It is a significant challenge for Medicare Advantage Plans and Prescription Drug Plans to manage CMS-required collateral, letters and notifications in-house, according to a new white paper by TMG Health. A partnership with a third party administrator can relieve the internal burden and provide...

2014-04-16 12:29:39

SUNNYVALE, Calif., April 16, 2014 /PRNewswire-USNewswire/ -- Given the health reform debate over elevated Medicare Advantage reimbursement rates, HealthPocket investigated the prevalence of extra insurance benefits provided by Medicare Advantage plans. These insurance benefits are not covered by original Medicare and they are frequently overlooked in discussions of Medicare Advantage's value proposition to consumers. When reviewing data on 2014 Medicare Advantage plans, HealthPocket found:...

2014-04-15 23:11:27

In an upcoming webinar from Atlantic Information Services, two Medicare Advantage and Part D financial and strategy experts will outline what the final 2015 rate notice and Call Letter mean for MA and Part D plans. Washington, DC (PRWEB) April 15, 2014 The final 2015 Medicare Advantage (MA) and Part D pay notice and Call Letter, issued by CMS earlier this month, contains good news but also a host of changes that plans were not expecting. There is a lot of uncertainty, since the impact of...

2014-04-15 08:29:52

LAKE MARY, Fla., April 15, 2014 /PRNewswire/ -- Access MediQuip, the nation's largest and leading innovator in surgical and implant management solutions, today announced an agreement with Osler Health IPA/Osler Health Management to provide quality-driven surgical bundles and pay-for-performance programs. The surgical bundle will be coordinated via Osler's national primary-care driven independent practice association (IPA) and delivered to Osler's growing surgical network. Osler is...

2014-04-14 23:11:54

In an April 24 Atlantic Information Services webinar, participants will learn how to avoid narrow-network legal and public relations problems, and set rates for out-of-network providers. Washington, DC (PRWEB) April 14, 2014 To keep premium rates affordable and competitive, health insurers have turned to narrow networks inside and outside of insurance exchanges. They also are partnering with provider groups on accountable care organizations (ACOs), which raises other questions of network...

2014-04-14 23:01:01

The combination of Orange Health Solutions’ population health management and care coordination services paired with MZI HealthCare’s suite of health benefit technology solutions will enable health care providers to successfully participate in the value-based care transformation underway in the health care industry. JACKSONVILLE, FL and GREENWICH, CT (PRWEB) April 14, 2014 Orange Health Solutions (“Orange”), a Jacksonville, FL based technology enabled health care services company,...

2014-04-11 11:29:18

New Dartmouth study in the journal BMJ offers roadmap for better risk adjustment The methodology Medicare uses to adjust the billions of dollars it pays health plans and hospitals to account for how sick their patients are is flawed and should be replaced, according to a new study by Dartmouth investigators published in the journal BMJ that weighed the performance of Medicare’s methodology against alternatives. The researchers from the Dartmouth Atlas Project compared Medicare’s...

2014-04-10 08:29:53

Inovalon's HEDIS Advantage(TM) QSI®-XL Solution Offers Technical Solution that Utilizes Big Data Processing and Analytics, Significantly Reducing Data Integration and Cycle Times BOWIE, Md., April 10, 2014 /PRNewswire/ -- Inovalon, Inc., a leading technology company providing advanced analytics and data-driven solutions to the healthcare industry, today announced the acceleration of big data processing empowering Healthcare Effectiveness Data and Information Set (HEDIS(®))...

2014-04-08 23:04:54

New ACO covers over 3,000 Horizon members and more than 80 doctors at 22 office locations. Newark, NJ (PRWEB) April 08, 2014 Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) and Teaneck-based Holy Name Medical Center, through its HNMC Hospital/Physicians ACO, announced today the formation of a new Accountable Care Organization (ACO) designed to improve patient care coordination and quality outcomes for over 3,000 Horizon BCBSNJ members. The new ACO will serve Horizon BCBSNJ...