Revenue Cycle and Payer News 4-25-2018

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Posted By: Annmarie Budniak April 25, 2018

US doctors try to cut out insurers and government with ‘direct primary care’
Dr. Michael Ciampi never felt alone with his patients. Every appointment seemed to be adjudicated by “big” government or insurance companies, two things he resents in respective order. All decisions and payment went through these third-parties. So, five years ago he cut out the middlemen. Now his patients pay his office directly for treatment. WikiTribune reports on direct primary care.

Harlow on Healthcare: Dr. Rob Lamberts does not Accept Health Insurance Payment
For a more in depth look at direct primary care give a listen to HealthcareNOW Radio’s show Harlow on Healthcare. Host David Harlow talks with Dr. Rob Lamberts (@doc_rob), a primary care physician or, as he sometimes says, a recovering doctor, who recently celebrated five years of no longer accepting payment from health insurance companies. After nearly twenty years in a traditional practice, and developing a national reputation as an expert on electronic health records, he has shifted course and has a direct primary care practice.

Humana, Together with TPG Capital and Welsh, Carson, Anderson & Stowe, Announce Agreement to Acquire Curo Health Services
Humana Inc. (@humana), TPG Capital, Welsh, Carson, Anderson & Stowe (collectively, the Consortium) announced a definitive agreement to acquire privately held Curo Health Services (Curo), one of the nation’s leading hospice operators providing care to patients at 245 locations in 22 states. The Consortium is purchasing Curo for approximately $1.4 billion, in which Humana will have a 40 percent minority interest.

UnitedHealth Group Reports First Quarter Results
UnitedHealth Group (@UnitedHealthGrp) reported first quarter results, led by continued strong, broad-based performance across the enterprise.

STRIVE Benefits and American Well Announce Record-Breaking Telemedicine Utilization Exceeding 50% in First Year of Program
STRIVE Benefits, the benefits communication platform of choice for thousands of businesses across the country, and American Well (@AmericanWell), a U.S. telehealth provider, announced over 50 percent utilization of telehealth when offered jointly by the two organizations. Companies across the country in multiple industries are experiencing the benefits of consumer-focused, cost effective, high quality healthcare, delivered via web and cell phone.

Aetna to Release First-Quarter 2018 Results; Announces Business Segment Realignment
Aetna (@Aetna) recently announced that first-quarter 2018 results will be made public on Tuesday, May 1, at 6:30 a.m. ET. Given the pending transaction with CVS Health, Aetna will not host a conference call in conjunction with its earnings release and does not expect to do so for future quarters.

EmblemHealth and Cityblock Health Introduce New Model of Care to New York
EmblemHealth (@emblemhealth), one of the nation’s largest non-profit health insurers, and Cityblock Health, a new company that uses technology-enabled services to address the unmet health and social needs of urban populations, have forged a unique partnership to bring a new model of care to New York. This comprehensive and integrated approach addresses social determinants and behavioral health as fundamental pillars of delivering services to those who are traditionally underserved.

Amid mega-mergers, Harvard Pilgrim Health Care sees role for independent, regional insurers
Harvard Pilgrim Health Care CEO Eric Schultz isn’t phased by the mega-mergers engulfing his industry. Despite major competitors like Aetna and Cigna teaming up with the likes of CVS and Express Scripts, respectively — deals some say could change the way healthcare is delivered in this country — Schultz said he still sees a role for regional insurers like his, which covers 1.2 million lives and recorded $3 billion in revenue across its four state-footprint in 2017.

99 Percent of Recipients Say They Receive Excellent Service from Their Supplemental Health Insurance Provider
There is nearly unanimous consent (99 percent) among those with a supplemental insurance plan that their insurance provider offers excellent service. The new survey by Global Strategy Group, on behalf of America’s Health Insurance Plans (@AHIPCoverage), also found over 95 percent are satisfied with their supplemental plan benefits, which help augment their general health coverage.

CVS/Aetna, Cigna/Express Scripts Megamergers Could Lower Long-term Medical Costs
Moody’s Investors Service says the proposed acquisition of Aetna by CVS Health and Cigna Corp. acquisition of Express Scripts will be a short-term ding on their credit outlooks but could lower medical costs in the long run.

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