Health Plans & Payor Services

Where Providers Have Leverage in Negotiations with Medicare Advantage Plans

To thrive and survive in a value-based care world, post-acute care providers need to be able to partner – and pivot – on the fly. Convincing payers of their worth is undoubtedly the first step, however. Quality home-based care providers have significant worth, they just need to be able to show it. But where providers …

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Virgin Pulse and HealthComp Complete Merger

Virgin Pulse, a leading global digital-first health, wellbeing, and navigation company, and HealthComp, a next-generation benefits and analytics platform, have announced the completion of their merger. Together, the new company will address the issues of increasing healthcare costs and complexity with an innovative, holistic approach that brings together engaging technology, data, and expert services in …

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MA Enrollees Have Fewer Hospitalizations, Harvard Study Finds

Medicare Advantage (MA) beneficiaries have better quality of care and health outcomes than traditional fee-for-service counterparts, researchers from Harvard Medical School found. The recently released report found that MA enrollees experience 70% fewer readmissions than fee-for-service beneficiaries and 24% fewer preventable hospitalizations, primarily driven by 59% fewer preventable acute hospitalizations. “The study provides strong evidence …

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Medicare Advantage Rates Stressing Out Home Health Providers

Older adults shifting from fee-for-service Medicare to Medicare Advantage is costing the home health industry millions of dollars in revenue, prompting some providers to demand higher reimbursements from private insurers or end contracts with them. Read the full article: Medicare Advantage Rates Stressing Out Home Health Providers // Source: https://www.modernhealthcare.com/providers/medicare-advantage-rates-home-health-enhabit-home-health

Apollo Medical Holdings, Inc. Announces Definitive Agreement to Acquire Assets of Community Family Care Medical Group IPA, Inc. and Health Plan

Apollo Medical Holdings, Inc. (“ApolloMed,” and together with its subsidiaries and affiliated entities, the “Company”) (NASDAQ: AMEH), announces that it and its affiliated professional entity have entered into a definitive agreement to acquire assets relating to Community Family Care Medical Group IPA, Inc. (“CFC”), including the CFC independent physician association (“IPA”), the CFC Health Plan …

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