The real story isn’t about denial rates or stakeholders acting as villains. It’s about a healthcare system that forces intelligent, well-intentioned professionals to make critical decisions in information silos.
Centivo, a health plan that sells to self-funded employers, acquired virtual-first primary care startup Eden Health. With this acquisition, Centivo now serves more than 160 employers in all 50 states.
Zelis highlights how employers, payers, and consumers are integrating digital tools to manage healthcare costs.
Last week, the CFO of Universal Health Services stated that the company chooses which patients to treat based on whose insurance plans offer the highest payments. The comments have sparked some media attention, but healthcare finance experts say the practice of cherry-picking patients is nothing new to the industry.
Blue Shield of California's new health plan, Virtual Blue, gives members virtual access to primary care through Accolade and virtual access to specialty care through TeleMed2U. If needed, they can also receive in-person care through the payer's PPO network.
Nearly 90% of Americans prefer to receive their health coverage through an employer versus other means, according to a new survey. Quality, affordability and convenience are the key reasons for why Americans favor employer-sponsored insurance.
More than half, or 58%, of health plan members are “overwhelmed” when it comes to managing their health plans. Insurers need to provide information in a way that's accessible and easy to understand, the report stated.
Enterprise EHR boosts scalability, interoperability, and governance for large healthcare systems.
Through this health plan — expected to become available October 1 — members will have access to Frontier’s primary care services, as well as hospital visits, prescription drugs and other needs. Flume will handle the administrative hassles of designing the plan.
The 6.5% increase in average costs for U.S. employers is more than double the 3% increase employers experienced in 2022, the report said. However, the increase is below the 9.1% increase in the Consumer Price Index.
A new telehealth company, called Antidote, is taking aim at rising healthcare costs in the U.S. by providing an alternative inspired by the healthcare system in Israel. For a monthly membership fee, Antidote users gain unlimited virtual visits and zero copays on most medications.
Together, the companies will add race, ethnicity and language information as well as social determinants of health factors to a database of millions of Blues plan members. The insights gleaned will be used to design interventions and develop community partnerships to reduce disparities in care.
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
Insurance startup Bind Benefits just raised $105 million in a Series B funding round to further expand into the fully insured market. CEO Tony Miller sees the company's health plan product as a way for employers to stay agile while offering insurance in a rapidly changing world.