Value-Based Insurance

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 …

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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 …

Taking a fresh look at value-based insurance design | 3/11/2020

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 …

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 …

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 …

ADA, AAPD asks Medicare, Medicaid to cover more procedures | 3/6/2020

The ADA and the American Academy of Pediatric Dentistry (AAPD) want the Centers for Medicare and Medicaid Services (CMS) to expand procedures included in value-based insurance plans and continue automatic reenrollment. On February 28, the organizations made these requests in response to CMS’ proposed 2021 notice of benefit and payment parameters for the Patient Protection and Affordable Care Act, according to an ADA press release issued on March 3 …

ADA and AAPD File Join Comments with CMS | 3/6/2020

The two dental organizations asked the agency to expand procedures included in value-based insurance and continue automatic enrollment. The American Dental Association (ADA) and American Academy of Pediatric Dentistry (AAPD) filed comments related to the Centers for Medicare and Medicaid Services’ (CMS) proposed 2021 notice of benefit and payment parameters for the Affordable Care Act (ACA). In a joint letter to CMS, Chad P. Gehani, DDS, president of the …

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

… HealthMine offers a dynamic 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 …

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 offers a dynamic 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 …

Insurers’ Perspectives on MA Value-Based Insurance Design Model | 11/19/2019

Insurers’ Perspectives on MA Value-Based Insurance Design Model Published in: The American Journal of Managed Care, Volume 25, Issue 7, pages 198-203 (2019) Posted on RAND.org on November 19, 2019 This article was published outside of RAND. The full text of the article can be found at the link above. Objectives Value-based insurance design (VBID) lowers cost sharing for high-value healthcare services that are clinically beneficial to …

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

… designed in a way that compliment the benefits of a veteran receives through VA Healthcare, underscoring our commitment to veterans. We are also expanding 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 D rewards, COBD adherence and wellness and health planning. SSBCI is …

High-Deductible Health Plans Are a Big Hit to Medication Adherence | HealthPayer Intelligence | 11/5/2019

… is a potential risk factor for discontinuation of branded medications. Payers, policy makers, and health care professionals can and should implement aligned incentives to ensure patients have access to clinically indicated care.” For example, value-based insurance design (V-BID) could help connect more patients to affordable medications, thus improving medication adherence. V-BID in type 2 diabetes treatment would call for plan designs that favor the use of low …

HealthMine Appoints Amy Lung Chief Operating Officer | PR Newswire | 10/22/2019

… Her experience and capabilities from these specialized trainings help her to derive data-driven strategies that produce measurable results. About HealthMine, Inc. HealthMine is the only Health Action Engagement company originally built inside a Value-Based Insurance Design (VBID) health plan that continuously empowers and incentivizes individuals to take action and improve their health. HealthMine’s services help health plans target and empower individuals to complete health actions through advanced analytics …

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

… to all Colorado residents. While actuaries said the lower premiums would primarily come from 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. “We’re really hopeful that we’re going to have partnerships from our hospitals throughout the state. We’re also committed to making sure …

Administrative Complexity Ups Spending Despite Value-Based Care | HealthPayer Intelligence | 10/8/2019

… change the course of high spending and drug pricing, the researchers acknowledged. Value-based care has no authority over pharmaceutical companies, which go untouched by care delivery and reimbursement strategies. READ MORE: Fast-Tracking Value-Based Insurance Design on Exchange Marketplaces Instead, to undermine the effects of soaring prices, the study suggested supporting increased competition and price transparency. The conflict to resolve competition and price transparency issues is currently underway …

Hospitals lose under public option plan in Colorado | Modern Healthcare | 10/8/2019

… to all Colorado residents. While actuaries said the lower premiums would primarily come from 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. “We’re really hopeful that we’re going to have partnerships from our hospitals throughout the state. We’re also committed to making sure …

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 …

NCQA

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

… multi-year, sustainable quality improvement programs for several organizations - in achieving and sustaining 4.0 Star Ratings in Medicare Advantage, 4.0 NCQA Medicaid Health Plan Ratings for top-rated Medicaid Plan Performance and capturing significant revenue … 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 …

Readmissions

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

… Healthcare, underscoring our commitment to veterans. We are also expanding 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 … and then advancing the downstream costs, such as admissions and readmissions in addition complications of particular conditions in total. The second thing is when we constructed the deal and did our forecast, we constructed the …

Medication Adherence

High-Deductible Health Plans Are a Big Hit to Medication Adherence | HealthPayer Intelligence | 11/5/2019

Value-Based Care News High-Deductible Health Plans Are a Big Hit to Medication Adherence Patients in high-deductible health plans are facing higher costs for branded medications, causing an issue with medication adherence. Source … ensure patients have access to clinically indicated care.” For example, value-based insurance design (V-BID) could help connect more patients to affordable medications, thus improving medication adherence. V-BID in type 2 diabetes treatment …

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 …

Homecare Homebase

Distinguished Panel of Population Health Judges Announced for the 2020 Hearst Health Prize | Business & Finance | heraldchronicle.com | Business Wire | 6/20/2019

… nine judges, who have all previously served on the panel, include: A. Mark Fendrick, MD: A nationally recognized expert on value-based insurance design, Fendrick is the director of the Center for Value-Based Insurance … Hearst Health network includes FDB (First Databank), Zynx Health , MCG , Homecare Homebase , MHK (formerly MedHOK—Medical House of Knowledge) and Hearst Health Ventures ( www.hearsthealth.com ). Hearst also holds a minority interest in the precision medicine and …

Amedisys, Inc. (AMED) CEO Paul Kusserow on Q1 2019 Results - Earnings Call Transcript | Seeking Alpha | 5/2/2019

… country. The integration of compassionate care is well under way as our first wave of care centers to convert to Homecare Homebase will go live today and we wish everybody good luck on this conversion … be permitted to offer the Hospice benefit. VBID being the Value-Based Insurance Design Program. Currently this year as of ‘19 there’s about I think there’s 25 states in the VBID program which represents about …

Humana

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

Humana, Inc. (NYSE: HUM ) Q3 2019 Earnings Conference Call November 6, 2019 9:00 AM ET Company Participants Amy Smith – Vice President-Investor Relations Bruce Broussard – President and Chief Executive Officer Brian Kane – Chief Financial Officer … 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 …

Administrative Complexity Ups Spending Despite Value-Based Care | HealthPayer Intelligence | 10/8/2019

… tangled administrative complexity, out of the $760 billion to $935 billion that healthcare professionals consider wasteful each year, according to Humana’s recent study . “This study highlights the opportunity to reduce waste in our current healthcare … by care delivery and reimbursement strategies. READ MORE: Fast-Tracking Value-Based Insurance Design on Exchange Marketplaces Instead, to undermine the effects of soaring prices, the study suggested supporting increased competition and price transparency. The …