Revenue Cycle and Payer News 4-4-2018

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Posted By: Annmarie Budniak April 4, 2018

In the News…

How to Purchase Health Care Like Amazon
Roundstone (@CaptiveInsurer) to host its annual Medical Captive Forum at FirstEnergy Stadium in Cleveland, Ohio on Wednesday, May 9th. Several hundred employers will learn ways they can take control of their health benefit spend. With the recent health care venture between Amazon, JPMorgan and Berkshire Hathaway, even Fortune 500 companies have realized the benefit of joining forces and taking control of their health care costs. This same strategy of control and keeping what you don’t spend has been delivered by Roundstone to small and mid-size companies since 2005.

Aetna to Provide Pharmacy Rebates at Time of Sale, Encourages Transparency from Drug Manufacturers
Beginning in 2019, Aetna (@aetna) will automatically apply pharmacy rebates at the time of sale for its Commercial fully insured plan members. While the majority of rebates have always been passed on to plan sponsors and their employees through lower premiums, Aetna believes that greater transparency is needed throughout the pharmaceutical supply chain in response to the nearly 25 percent increase in drug prices between 2012 and 2016.

Tom Lindquist Tapped as CEO of Allina Health Aetna Joint Venture
Allina Health and Aetna have named Tom Lindquist as CEO of Allina Health and Aetna Insurance Company (Allina Health | Aetna), the jointly owned health care company that was announced by the two organizations in January 2017.

Apple’s Pact with 13 Health Care Systems Might Actually Disrupt the Industry
An announcement on January 24 didn’t get the large amount of attention it deserved: Apple and 13 prominent health systems, including prestigious centers like Johns Hopkins and the University of Pennsylvania, disclosed an agreement that would allow Apple to download onto its various devices the electronic health data of those systems’ patients — with patients’ permission, of course. It could herald truly disruptive change in the U.S. health care system. The reason: It could liberate health care data for game-changing new uses, including empowering patients as never before.

Walmart in Early-Stage Acquisition Talks With Humana
According to The Wall Street Journal, Walmart Inc. is in preliminary talks to buy insurer Humana Inc. (@humana), according to people familiar with the matter, a deal that would mark a dramatic shift for the retail behemoth and the latest in a recent flurry of big deals in health-care services. It isn’t clear what terms the companies may be discussing, and there is no guarantee they will strike a deal. If they do, the deal would be big: Humana currently has a market value of about $37 billion.

Why Some Americans Are Risking It and Skipping Health Insurance
Across America there are thousands of people like the Buchanans, the Owenses and the Bobbies making the same hard decision to go without health insurance, despite the benefits. They’re risking it—betting that they’ve got enough savings, enough of a back-up plan, or enough luck to get them through a twisted knee, a cancer, or a car wreck. Bloomberg is following a dozen of these families this year in an effort to understand the trade-offs when a dollar spent on health insurance can’t be spent on something else. Some are financially comfortable. Others are scraping by.

MetaBank Announces Partnership with Health Credit Services to Originate Personal Healthcare Loans
MetaBank; a wholly-owned subsidiary of Meta Financial Group, Inc. and a leader in delivering innovative payment, community banking and financing solutions to partners throughout the country, announced a new, three-year agreement with Health Credit Services (“HCS”), a technology driven, patient financing company. MetaBank will approve and originate loans for elective procedures for HCS provider offices throughout the country. HCS will work with its provider partners to market the loans, as well as provide servicing for them. Over the course of this relationship, MetaBank expects to originate at least several hundred million dollars in personal loans.

Cigna’s Partnership with Physicians Successfully Reduces Opiod Use by 25 percent – One Year Ahead of Goal
Cigna (@Cigna) recently announced that in partnership with more than 1.1 million prescribing clinicians, the global health service company has achieved a 25 percent reduction in opioid use among its customers, reaching this key metric one year ahead of its ambitious initial goal. The broad based effort meaningfully contributes to curbing the opioid epidemic, which has taken thousands of lives, sidelined millions of workers and diverted billions of dollars in the United States.

Cigna Enters Voice Control Space, Launching “Answers by Cigna” Skill for Amazon Alexa
Cigna announced it is entering the voice control space with the launch of “Answers by Cigna” skill for Amazon Alexa. Cigna is the first global health service company to offer a skill aimed at personalizing and simplifying health benefits information. The new hands-free skill is designed to demystify language about health care by providing instant and easy-to-understand answers to more than 150 commonly-asked health care questions.

CareSource Names Next CEO
CareSource (@caresource) is naming Erhardt Preitauer as its next CEO. Preitauer will succeed founding CEO Pamela Morris, who will retire in May 2018. Preitauer is currently with Horizon Blue Cross Blue Shield of New Jersey. He is the CEO of Horizon NJ Health which is the state’s largest Medicaid plan with more than $6B in revenue and 1 million members. Preitauer has an impressive resume that includes leadership positions with multiple national insurers.

Webinar – Preparing For The New Medicare Card
Beginning in April, CMS will start mailing new Medicare cards, are you prepared? The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandated the removal of the Social Security number (SSN)-based health insurance claim number (HICN) from Medicare cards to address the risk of beneficiary medical identity theft. The legislation requires that CMS mail out these new cards with a new Medicare Beneficiary Identifier (MBI) beginning in April 2018. With new Health Insurance Claim Numbers being replaced by Medicare Beneficiary Identifiers (MBI), you’ll want to make sure that your organization understands the upcoming changes and can implement a plan for the transition. Join ZirMed (@zirmed) expert Crystal Ewing to learn how the upcoming changes to the Medicare cards may impact your organization.

Upcoming Events:

2018 Medical Captive Forum
What: 2018 Medical Captive Forum
When: May 8 – 9, 2018
Where: Cleveland, Ohio
Event Hashtag: #RoundstoneForum2018