Revenue Cycle and Payer News 12-19-2018

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Posted By: Roberta Mullin December 19, 2018

Health Care Leaders Unite to Protect Patients Against Surprise Medical Bills
“Every American deserves affordable, high-quality coverage and care, as well as control over their own health care choices.” That’s according to nine organizations representing consumers, businesses, and health insurance providers that have joined forces to defend those rights.

The Health Care Venture from Amazon, Berkshire and JP Morgan just hired Its First Female Exec, and She comes from a Big Insurance Company
The joint health care venture by Amazon, Berkshire Hathaway and J.P. Morgan has hired a well-known health insurance exec who specializes in analyzing data to improve patient health. The group has scooped up Dana Gelb Safran, formerly a chief performance measurement and improvement officer at Blue Cross Blue Shield of Massachussetts, CNBC has learned. Safran will start her new gig early next year with the title “head of measurement.” A spokesperson for the health initiative confirmed the hire.

CMS Administrator Discusses Initiatives to Strengthen Health Insurance Markets
Centers for Medicare & Medicaid Services’ (@CMSGov) Administrator Seema Verma—in an address to the States and Nation Policy Summit of the American Legislative Exchange Council (ALEC) in Washington, D.C.—shared her vision for innovations and reforms that will empower states and provide the flexibility states need to create alternatives to the Affordable Care Act (ACA) that improve health insurance options.

CVS Defends Settlement that Allowed Aetna Merger as Judge Assesses
CVS Health Corp (@CVSHealth) defended on Friday an agreement with the U.S. Justice Department which allowed it to purchase health insurer Aetna for $69 billion, a settlement that a federal judge is still assessing.

AHIP Issues Statement Regarding District Court Decision in TX v. United States of America
Matt Eyles, president and CEO of America’s Health Insurance Plans (@ahipcoverage), issued this statement following the District Court decision in TX v. United States of America regarding the constitutionality of the Affordable Care Act. “The district court’s decision is misguided and wrong. This decision denies coverage to more than 100 million Americans, including seniors, veterans, children, people with disabilities, hardworking Americans with low-incomes, young adults on their parents’ plans until age 26, and millions of Americans with pre-existing conditions.”

Cigna Expands Financial Wellness Services to Help Customers Improve Overall Well-Being
Global health service company Cigna (@cigna) is expanding the My Secure Advantage (MSA) financial wellness program to group insurance customers effective January 1, 2019. The MSA program includes “money coaching,” identity theft protection and resolution services, and tools and resources for preparing wills and other important legal documents. Through the MSA program expansion, Cigna aims to help millions more individuals live more financially secure lives and improve their overall well-being.

UnitedHealth Renews Contract With ER Doctors After Months Of Hardball
UnitedHealth Group (@uhc) said it has renewed a contract with Envision Healthcare after months of hardball tactics and threats to terminate a relationship with the provider of emergency room services to hundreds of U.S. hospitals.

Delaying Care a Healthcare Strategy for Three in 10 Americans
Gallup’s annual Health and Healthcare poll once again finds roughly three in 10 Americans reporting they held off seeking some kind of medical treatment in the past year due to costs. Today’s 29% saying they did this is consistent with the rate seen each year since 2005 but is up from an average 24% in the four years prior to that — from 2001-2004 — and from 22% in 1991.

Blue Cross Blue Shield Association Statement on the Texas et al. v. United States et al. Ruling
Blue Cross Blue Shield Association President and CEO Scott Serota issued the following statement in regard to the U.S. District Court ruling on the Affordable Care Act. “Blue Cross and Blue Shield (BCBS) companies’ core principle is that all Americans, including those with pre-existing medical conditions, have access to quality health coverage no matter who they are or where they live.

In State News:

Catalyst Health Network and UnitedHealthcare’s Accountable Care Organization Relationship Fostering Quality Care at Lower Cost
Catalyst Health Network and UnitedHealthcare’s (@UnitedHealthGrp) accountable care organization (ACO) has improved the number of annual preventive screenings year over year for cervical cancer, breast cancer and colorectal cancer, and lowered health care costs in North Texas by more than $28 million in the last two years.

OhioHealth joins the CareSource Medicare Advantage Plan Network
CareSource (@caresource) and OhioHealth announced that beginning January 1, 2019, OhioHealth will be in network for CareSource Medicare Advantage plans to provide access to high quality healthcare services for Columbus and central Ohio CareSource.

California, Connecticut Extend Health Insurance Sign-Ups
At least two states running their own marketplaces have extended sign-up periods for health insurance coverage following a federal judge’s ruling that the Affordable Care Act is unconstitutional. Recently, Judge Reed O’Connor in Texas declared the Affordable Care Act, also known as Obamacare, to be unconstitutional following Congress’ repeal late last year of a tax penalty for those who are uninsured. The ruling was issued a day before open enrollment through the federal HealthCare.gov marketplace closed.