Value-Based Insurance

Hospice Scale, Outcomes, Staffing Key to Attracting Buyers, Payers | 9/16/2020

… trend to continue into 2021, and the market may pick up even more steam as hospice moves into programs such as the Primary Care First Serious Illness Population model, direct contracting programs or the value-based insurance design demonstration project, commonly known as the Medicare Advantage hospice carve-in. “Private equity consolidation, along with some of the new entry to the sector, has really created a very robust atmosphere for …

Palliative Care Expanding in the Hospice Space | 9/11/2020

… care costs by $103 billion nationwide over the next two decades. Providers investing in palliative care programming stand to benefit from the ability to demonstrate reduced health care costs, a goal under the forthcoming value-based insurance design (VBID) payment model demonstration projects set to take effect in January 2021, commonly called the Medicare Advantage hospice carve-in. Advertisement “One of the reasons that a lot of people are looking …

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Taking a fresh look at value-based insurance design | 9/3/2020

Taking a fresh look at value-based insurance design FRIDAY, APRIL 19, 2019 Taking a fresh look at value-based insurance design Taking a fresh look at value-based insurance design VBID has been on employers’ radar for a while, but the concept appears to be experiencing a second wind. Suzanne Delbanco April 15, 2019 at 10:43 AM Do consumers really value items that cost money more than those that …

Data, Referral Partnerships Keys to Success in Value-Based Hospice Care | 9/2/2020

… opens up to include end-of-life care. Starting January 2021, the U.S. Centers for Medicare & Medicaid Services (CMS) will roll out the Primary Care First initiative and add a hospice component to the value-based insurance design (VBID) program, both focused on improving the quality and continuity of patient care as their illnesses progress. The VBID demonstration project is commonly called the Medicare Advantage hospice carve-in. Designed to …

Getting Upstream: A Hospice Playbook for Value-Based Care | 8/26/2020

… to participate in the Medicare Advantage demonstration project and Primary Care First payment models. Beginning January 2021, the U.S. Centers for Medicare & Medicaid Services (CMS) will add a hospice component to the Medicare Advantage Value-Based Insurance Design (VBID) Model, commonly called the Medicare Advantage hospice carve-in. Additionally slated for an early 2021 start is the Primary Care First initiative, rolling out phases in 26 regions nationwide. These value …

Hospices Need to Understand Risk within Medicare Advantage | 8/24/2020

… to understand the relationship between payment and risk within programs like Medicare Advantage. Starting in 2021, providers will have the option to participate in a demonstration project testing the inclusion of hospice in the value-based insurance design model, commonly called the Medicare Advantage hospice carve-in . Health care value-based payment has been gravitating towards risk-based models in recent years. Many Medicare Advantage plans are founded on risk …

News from Monday, July 27, 2020 | 7/27/2020

… Michelle M. Stein, Inside Health Policy ) reports “Medicare Advantage and hospice stakeholders say legislation could be introduced soon that would push back until 2023 the option for MA plans to add hospice to the Value-Based Insurance Design demonstration run through the innovation center – but while hospice providers say a delay is needed, the Better Medicare Alliance says plans have prepped for the demo and a two-year delay is …

BCA Insurance Group Now an NJM Premier Agent | 7/18/2020

… 2020 – BCA Insurance Group announces it has contracted with NJM Insurance Group (NJM) as an NJM Premier Agent, notably expanding its ability to marry the business needs of its clients with NJM’s highly regarded, value-based insurance solutions. This unique relationship positions BCA as a primary gateway to NJM Business Insurance. As an NJM Premier Agent, BCA can provide easy access to all NJM Business Insurance products, including commercial auto …

A Scalpel Instead Of A Sledgehammer: The Potential Of Value-Based Deductible Exemptions In High-Deductible Health Plans | 6/22/2020

… Reducing these costs has been the focus of major policy proposals, including prescription drug bills from both the House and the Senate; forthcoming plans for the Center for Medicare and Medicaid Innovation to test value-based insurance models following the president’s executive order 13890 on Protecting and Improving Medicare for Our Nation’s Seniors; and H.R. 2774 , the Primary Care Patient Protection Act of 2019, which would create a primary care …

Zero-Dollar Drug Copays Lowered Total Chronic Disease Spending | HealthPayer Intelligence | 6/15/2020

Value-Based Care News Zero-Dollar Drug Copays Lowered Total Chronic Disease Spending Total chronic disease spending may decrease if value-based insurance designs eliminate copays for a comprehensive range of drugs for multiple chronic diseases. Value-based insurance designs that incorporate zero copay programs for certain drugs may help decrease total chronic disease spending—including member and payer costs—when the designs focus on a broad set of drugs …

News from Monday, April 27, 2020 | 4/27/2020

… Christina Mattina, The American Journal of Managed Care ) “We spoke with Dr Mark Fendrick, co-editor-in-chief of The American Journal of Managed Care®, and director of the University of Michigan Center for Value-Based Insurance Design, or V-BID, on how the principles of V-BID can be used to make a real difference for the millions of American families financially struggling with the impacts of coronavirus disease …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insuranc | 4/23/2020

… benefit capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model.The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and then …

Parkview Health and Cigna Reach New Agreement for More Affordable Hospital Care for Employers and Customers | PR Newswire | 4/23/2020

… to redefine the playing field by transforming the way we collaborate with insurance companies,” said Greg Johnson , DO, chief clinical integration officer, Parkview Health. “We are partnering with insurance companies like Cigna to create value-based insurance design and partnering with employers to create value-based benefit design, where the two are not only in alignment but also allow for shared risk – and reward – among all. This shift requires that …

News from Friday, April 17, 2020 | 4/17/2020

… featuring tools and resources for understanding value in health care and value assessment. These resources are intended to help patients and patient advocates engage in discussions on and the assessment of value.” Full Is Value-Based Insurance Design Experiencing a Renaissance? (4/17, Ryan Olmstead, Employee Benefit Adviser ) comments “…Many employers and other health care purchasers have had V-BID in place for several years, much to the appreciation of their …

Is value-based insurance design experiencing a renaissance? | 4/17/2020

Is value-based insurance design experiencing a renaissance? By Closeup of pharmacist’s hands taking medicines from shelf at the pharmacy alvarez/Getty Images Register now Think of your favorite movie. Maybe it’s a classic from your childhood or early adulthood. In these days of what’s old is new again, it may experience a renaissance for a new generation. (Full disclosure: I’m a child from the “Back to the Future” years …

Humana Inc (NYSE: HUM) Q4 2019 Earnings Call Transcript | 4/7/2020

… of those we serve through our social determinants capabilities, which positions us strongly to serve the vulnerable populations Medicare and Medicaid and provide us with the experience needed to meaningfully participate in the MA value-based insurance design program and Medicaid procurements. In 2019, we scaled social determinants of health screenings to over 1 million, more than doubled the number of screenings in 2018 and connected those in need to …

AGG Hospice Quarterly 2020 | 3/30/2020

CMS Announces Hospice Capitation Rates for Medicare Advantage - The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design model (VBID), often referred to as the Medicare Advantage hospice carve-in. Please see full Newsletter below for more information. DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations …

Congress, regulators offer financial relief for Americans seeking tests, treatment for new coronavirus | Wordpress.com | 3/23/2020

… cost testing for patients reduces the financial burden for COVID-19 diagnosis, but does not protect infected individuals who need COVID-19 related care,” said A. Mark Fendrick, M.D., director of the Center for Value-Based Insurance Design at the University of Michigan. “For those who receive their health insurance from their employers, the Kaiser Family Foundation estimated that the average out-of-pocket cost for a COVID-19 associated …

Congress, regulators offer financial relief for Americans seeking tests, treatment for new coronavirus | 3/23/2020

… cost testing for patients reduces the financial burden for COVID-19 diagnosis, but does not protect infected individuals who need COVID-19 related care,” said A. Mark Fendrick, M.D., director of the Center for Value-Based Insurance Design at the University of Michigan. “For those who receive their health insurance from their employers, the Kaiser Family Foundation estimated that the average out-of-pocket cost for a COVID-19 associated …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance De… ( FORT WA…) | 3/10/2020

… benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | Markets Insider | Business Insider | 3/10/2020

… benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | PRWeb | 3/10/2020

… benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | 3/10/2020

… benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | 3/10/2020

… benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and …

IOM Workshop Explores Growing Problems in Patient Access to Cancer Drugs - The ASCO Post | 3/10/2020

… means are different for specialty pharmaceuticals—drugs and biologicals that are the hope of the future. A. Mark Fendrick, MD , Professor, Departments of Internal Medicine and Health Management and Policy, and Director, Center for Value-Based Insurance Design, University of Michigan, Ann Arbor, said that these drugs will comprise about half of all pharmaceutical reimbursement for commercial health plans by 2018. To control spending, many payers have established requirements for …

Medicare

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | Markets Insider | Business Insider | 3/10/2020

Medicare Advantage and Special Needs plans, is proud to announce the value based benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box …

Medicaid

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | Markets Insider | Business Insider | 3/10/2020

Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and then adjust their patient responsibility accordingly. The system provides functionality to identify specific co-payments, coinsurance and / or deductibles that can be waived for patients participating in pre-defined initiatives. VBID …

Medicare Advantage

HealthMine Report Published on Five Gaps Between Medicare Advantage Plans and Beneficiaries Hindering a Personalized Experience | PR Newswire | 11/24/2019

DALLAS , Nov. 24, HealthMine, the health action engagement company, published a report today as part of its series on Medicare Advantage Plan Beneficiary Insights, entitled: “Closing Gaps to Create a Personalized Experience.” The report covers … satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help …

Population Health

HealthMine Report Published on Five Gaps Between Medicare Advantage Plans and Beneficiaries Hindering a Personalized Experience | PR Newswire | 11/24/2019

Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help plans thrive. Our personalized solution can help enhance or supplement targeted member engagement strategies through smart rewards distribution and fulfillment. HealthMine is online at www.healthmine.com SOURCE HealthMine, Inc. Related Links https://healthmine.com …

Member Engagement

HealthMine Report Published on Five Gaps Between Medicare Advantage Plans and Beneficiaries Hindering a Personalized Experience | PR Newswire | 11/24/2019

member engagement solution that motivates members through multiple modalities to continuously complete health actions, while diligently monitoring them for continued satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help plans thrive. Our personalized solution can help enhance or supplement targeted member engagement strategies through …

AHIP

HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st | PR Newswire | 11/20/2019

HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help …

Provider Engagement

HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st | PR Newswire | 11/20/2019

HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help …

Home Health

Humana’s (HUM) CEO Bruce Broussard on Q3 2019 Results - Earnings Call Transcript | Seeking Alpha | 11/6/2019

… disease conflicts. During 2020 we will roll this same functionality to all Kindred at Home and other health care – health home health providers including integration with the new home care – home based system. The integration … our supplement benefit offerings and introduced offerings under the CMS Value-Based Insurance Design or VBID and Special Supplemental Benefits for the Chronically Ill or SSBCI programs. Our VBID offerings include healthy food cards, Part …

Health Management

Humana’s (HUM) CEO Bruce Broussard on Q3 2019 Results - Earnings Call Transcript | Seeking Alpha | 11/6/2019

… are developing for our members and providers that simplify their experience, enable proactive clinical interventions and advance value-based population health management. For example, in January, 2020 we are launching a new population health management … our supplement benefit offerings and introduced offerings under the CMS Value-Based Insurance Design or VBID and Special Supplemental Benefits for the Chronically Ill or SSBCI programs. Our VBID offerings include healthy food cards, Part …

ACA

Colorado’s proposed public option uses lower hospital pay to cut premiums | Modern Healthcare | 10/8/2019

… lower provider facility reimbursement rates, Colorado Insurance Commissioner Michael Conway said in an interview that savings could also result from value-based insurance designs and ensuring that pharmacy benefit managers pass drug rebates onto consumers … insurers to offer lower-cost, tightly regulated plans on the ACA exchange for 2021. The plans would pay providers no more than an average of 160% of Medicare rates. New Mexico’s Legislature also recently passed …

Pharmacy Benefit Management

AMCP Partnership Forum Identifies Key Opportunities to Improve Patient Financial Burden in Oncology | PR Newswire | 11/21/2017

… Insurance benefits must innovate to better support patient engagement and shared decision making, including through the development of oncology specific value-based insurance designs that incentivize patients to choose high-value care. The system needs … therapies for the 250 million Americans served by health plans, pharmacy benefit management firms, emerging care models and government. www.amcp.org . View original content with multimedia: http://www.prnewswire.com/news-releases/amcp-partnership-forum-identifies-key-opportunities …

RAM Technologies

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | Markets Insider | Business Insider | 3/10/2020

… RAM Technologies, Inc., the perennial leader in the development of enterprise software for healthcare payers administering Medicare Advantage and Special Needs plans, is proud to announce the value based benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The …

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model | PRWeb | 3/10/2020

RAM Technologies, Inc. and Medicare Advantage-in-a-Box Ready for CMS Changes to Value Based Insurance Design Model Share Article RAM Technologies solution, HEALTHsuite Advantage™, provides advanced functionality for value based benefits. Overall, the … participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model. The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health …

HealthMine

HealthMine Report Published on Five Gaps Between Medicare Advantage Plans and Beneficiaries Hindering a Personalized Experience | PR Newswire | 11/24/2019

DALLAS , Nov. 24, HealthMine, the health action engagement company, published a report today as part of its series on Medicare Advantage Plan Beneficiary Insights, entitled: “Closing Gaps to Create a Personalized Experience.” The report covers … satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help …

HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st | PR Newswire | 11/20/2019

HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help …