Revenue Cycle and Payer News 6-2-2015

stethoscope-money-150In the News…

In just 21 months, health startup Oscar hits valuation of $1.5B. Johathan LaMantia reporting in Crain’s New Your Business, Health Pulse, this Manhattan health insurance company is attracting investors, and young, tech savvy enrollees. In April they raised $145 million in funding from investors, led by Peter Thiel and Brian Singerman of Founders Fund, and it will prepare to expand into California while doubling its staff in New York.

Jason deBruyn reported in the Triad Business Journal that Health insurer UnitedHealthcare will spend $11.5 million to resolve decade-old lawsuits brought by the N.C. Medical Society and three other state medical societies. Read his article: Major insurer settles lawsuit over payments to N.C. doctors.

athenahealth released their 10th annual PayerView Report. This is their ranking of commercial and government health plans based on nine specific measures focusing on financial, administrative and transactional performance. These metrics reflect how well each payer works with health care providers. The data set for this year’s study was from the 2014 calendar year with more than 59,000 providers across all 50 states, covering 166 payers and over $28.5 billion in charges.

Modern Healthcare reported that Fortune 500 managed care company Molina Healthcare will buy the Medicaid assets of distressed Michigan insurer, HealthPlus.This is an attempt for HealthPlus to salvage their company after state sanctions for not meeting required cash reserves. By divesting its Medicaid assets, HealthPlus is hoping to keep its doors open.

Washington DC based CareFirst BlueCross BlueShield insurer has disclosed a data breach involving more than one million of its customers from last June. This becomes the third discloser this year from major insurers. The other two being Anthem Insurance and Premera Blue Cross. Read Chris Bing’s article in DCInno.

InstaMed, a Healthcare Payments Network, announced the release of the 2014 Trends in Healthcare Payments Annual Report. This is the fifth year for the report and features key market trends impacting the healthcare payments industry. These trends are based on quantitative data derived from the InstaMed Network and qualitative proprietary survey data from healthcare providers, payers and consumers. The purpose of the report is to present key market trends that affect the healthcare payments industry and educate and promote awareness, change and greater efficiency within the marketplace.