Revenue Cycle and Payer News – February 1, 2023

SmartRx Represents the Newest in Prescription Discount Cards, With Premium Savings Options
Higher prices across most health related goods and services have consumers reeling to find better options to save money. Starting now, these consumers have access to SmartRx, the newest prescription discount card. While designed to compete directly with GoodRx, SingleCare and Carecard, SmartRx (a division of Smarty) acts as a premium health savings that goes beyond prescription drugs.

Digital-First Health Insurance Provider Angle Health Raises $58 Million To Modernize Access to Comprehensive Healthcare Benefits
Angle Health (@angle_health), the digital-first, fully-licensed health insurance provider bringing transparency, simplicity, and ease of use to members, employers, and brokers in a frictionless experience, announced $58 million Series A funding led by Portage.

Elevance Health to Acquire Blue Cross and Blue Shield of Louisiana
Elevance Health, Inc. (@elevancehealth) and Blue Cross and Blue Shield of Louisiana announced that the companies have entered into a definitive agreement through which Elevance Health agrees to acquire Blue Cross and Blue Shield of Louisiana (BCBSLA). BCBSLA will join Elevance Health’s affiliated Anthem Blue Cross Blue Shield family of brands.

CVS Health Launches Community Equity Alliance to Improve Health Outcomes in Underserved Communities
CVS Health® (@CVSHealth) announced a new initiative that will address barriers to care in underserved communities across the country. The CVS Health Community Equity Alliance is being established to expand the community health worker workforce, enhance connections between health care institutions and communities and address disparities in heart health and mental health outcomes. The Alliance is part of the Company’s commitment to advancing health equity.

Blue Cross Blue Shield Association Policy Solutions Could Lower Health Care Costs by $767 Billion
The Blue Cross Blue Shield Association (@BCBSAssociation) released policy solutions that could reduce health care costs in the United States by $767 billion over 10 years. The recommendations, Affordability Solutions for the Health of America, address the root causes of rising health care costs by improving competition, lowering prescription drug costs and prioritizing high-quality care.

Karen Moran Named President of Humana Military
Humana Military, a wholly owned subsidiary of Humana Inc. (@Humana), announced that it has appointed healthcare industry veteran Karen Moran to Senior Vice President, President of Humana Military, effective January 1, 2023. She is the first woman to hold this role in its 26-year history and succeeds Brent Densford who is retiring from Humana after more than 32 years.

UnitedHealthcare Expands Suite of Behavioral Health Offerings With Virtual Behavioral Coaching
More than 5 million UnitedHealthcare® (@uhc) commercial members now have access to virtual behavioral coaching at no added cost. Effective Jan.1, 2023, the virtual behavioral coaching program, administered by Optum, provides support for adults experiencing symptoms of mild depression, stress and anxiety, through digital modules and 1:1 video or telephonic conferencing and messaging with trained coaches.

Independence Blue Cross Launches Advanced Network for Gene-Based Therapeutics
Independence Blue Cross (@ibx) announced the launch of its Advanced Network for Gene-Based Therapeutics, which will be effective March 1, 2023. The new network is designed to help members access potentially life-changing gene-based therapies from best-in-class health care providers that have demonstrated an ability to exceed quality, safety, and value benchmarks in administering gene-based therapies.

HHS Approves California’s Medicaid and Children’s Health Insurance Plan (CHIP) Demonstration Authority to Support Care for Justice-Involved People
The U.S. Department of Health and Human Services (@hhsgov), through the Centers for Medicare & Medicaid Services (CMS), approved a first-of-its-kind section 1115 demonstration amendment in California which will provide a set of critical pre-release services and improve access to critically needed care for people returning home from jails and prisons.

HHS Issues Final Rule to Protect Medicare, Strengthen Medicare Advantage, and Hold Insurers Accountable
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA program payments. Under this program, CMS identifies improper risk adjustment payments made to Medicare Advantage Organizations (MAOs) in instances where medical diagnoses submitted for payment were not supported in the beneficiary’s medical record.

Well City Challenge 2023 officially launches, inviting individuals across the region to submit innovative solutions to address inequities in mental and heart health
The Economy League of Greater Philadelphia launched the 2023 Well City Challenge: “Community Solutions for Mind and Heart Health” by issuing an official Call for Ideas to community leaders and innovators. Individuals are encouraged to submit their proposals for community-driven solutions that address barriers to equitable access to mental and heart health support and services for all Philadelphians. The 2023 Well City Challenge is presented by the Economy League of Greater Philadelphia and Accelerate Health Equity (AHE), and powered by Independence Blue Cross.

Biden-Harris Administration Announces Record-Breaking 16.3 Million People Signed Up for Health Care Coverage in ACA Marketplaces During 2022-2023 Open Enrollment Season
The Biden-Harris Administration announced that a record-breaking more than 16.3 million people have selected an Affordable Care Act (ACA) Marketplace health plan nationwide during the 2023 Marketplace Open Enrollment Period (OEP) that ran from November 1, 2022-January 15, 2023 for most Marketplaces.

Cigna Recognized as One of America’s Greatest Workplaces for Diversity by Newsweek
Cigna Corporation (@cigna) announced the organization was named a top workplace for diversity, earning the highest possible score in a study by Newsweek and Plant-A Insights.

AHIP 2023 (@AHIPCoverage)

What: ATA’s 2022 EDGE Policy Conference
When: June 13-15, 2023
Where: Portland, OR
Register Now

Experience what’s next, now at AHIP 2023 (Formerly Institute & Expo.) We’re building on AHIP’s decades-long heritage of bringing together the people, ideas, and solutions guiding greater health for years to come.