Revenue Cycle and Payer News 6-6-2018

Healthcare Startup Decent Raises $8MM to Build Affordable Care for All
Three months ago Michael Lapinski, Richard Luck, and Nick Soman realized US healthcare needs a nervous system and decided to build Decent (@decent). They began to hire a world class team including Molly Moore, Suzanne Scharlock, Andy Skiba, and Sean Leonard. They are delighted to announce that they’ve raised $8MM from an incredible roster of investors across the VC, crypto, and healthcare landscape to fund the beginning of their journey.

New ISO Program Targets Home Healthcare Insurance Market
Insurance Journal reports ISO has launched a new home healthcare program that provides coverage and ratings for insurers covering the home healthcare market. ISO is a Verisk business. The aging population is one factor in the significant expansion of home healthcare in the United States. The U.S. Census Bureau projects that the over-65 population will double to nearly 84 million within 30 years. Other growing segments, such as pediatric and disabled care, are also driving demand. In fact, home healthcare and personal care aide employment is estimated to increase 40 percent from 2016 to 2026, according to the U.S. Bureau of Labor Statistics.

Humana’s Maria Hughes named to BLACK ENTERPRISE’s 2018 Top Executives in Corporate Diversity List
Humana Inc. (@humana) is proud to announce that Maria Hughes, Senior Vice President and Chief Inclusion and Diversity Officer, has been named to BLACK ENTERPRISE’s 2018 Top Executives in Corporate Diversity List.

Anthem Names Felicia Norwood Executive Vice President and President, Government Business Division
Anthem, Inc. (@AnthemInc) announced that Felicia Norwood has been named Executive Vice President and President, Government Business Division, effective June 18, 2018. In this role, Ms. Norwood will be responsible for the company’s Medicaid, Medicare and Federal Government Solutions businesses. Ms. Norwood will also serve as member of the company’s Executive Leadership Team and report directly to Gail K. Boudreaux, President and Chief Executive Officer, Anthem.

LabCorp to Become a Preferred National Laboratory for Aetna
Aetna (@aetna) and LabCorp recently extended and expanded their existing agreement, making LabCorp a preferred national laboratory for substantially all of Aetna’s members beginning January 1, 2019. The expanded agreement will provide more than 20 million eligible members with in-network access to LabCorp’s full range of laboratory services. LabCorp is already an in-network laboratory for several million members of Aetna and Aetna-affiliated health plans in certain markets across the U.S.

Teladoc Acquires Global Virtual Care Provider, Advance Medical
Teladoc, Inc. (@Teladoc), virtual care company, announced that, effective May 31, 2018, it has acquired Advance Medical (@_AdvanceMedical), a virtual care provider outside of the United States. With a broadened international footprint and the ability to offer an expanded set of clinical services worldwide, the combination creates the only global comprehensive virtual care platform capable of serving companies and people everywhere.

CaregiverUSA Becomes One of the Rare Home Healthcare Agency To Accept All Payer Sources In The United States
Caregiver USA Corporation (@caregiver_usa), which encompasses a healthcare agency and its proprietary online caregiver matching platform,, is pleased to announce that it is able to serve patients across the full spectrum of home care market, regardless of their payment sources (CMS reimbursement (Medicare & Medicaid), third-party insurance, self-funded or out-of-pocket private duty). CaregiverUSA has developed a comprehensive model that can handle all payer sources in Ohio.

MobileSmith Appoints Randy J. Tomlin as CEO, Jerry Lepore as Newest Board MemberNew executive hires accelerate company expansion to include healthcare payer market
MobileSmith (@TheMobileSmith), a provider of digital health and mobile development currently reshaping traditional healthcare, announced that Randy J. Tomlin has been named CEO. Additionally, Jerry Lepore, a highly accomplished tech healthcare executive, has been appointed to the Board of Directors. These additions to the leadership team not only signify a new phase of growth for the company’s core strength with hospitals and health systems but are designed to expand its ability to address the app development and mobile integration needs of healthcare payers.

In State News:

Murphy Signs Law to Create NJ’s Own Health Insurance Mandate
In effort to stabilize health insurance market and ensure coverage remains affordable, NJ becomes second state to creates its own individual mandate. Healthcare policy experts, business leaders, and patient advocates praised Gov. Phil Murphy’s endorsement of a state requirement that residents obtain medical insurance or face a fine, a move they said will help protect recent gains in insurance coverage, control premium prices, and ensure New Jersey still receives billions in federal funding.

Kentucky’s New Telehealth Law Expands Insurance Coverage and Reimbursement
Kentucky health care providers and patients will soon enjoy a revamped, and significantly improved, telehealth commercial insurance coverage law. Kentucky Governor Matt Bevin signed SB 112 into law on April 26, 2018, imposing both telehealth coverage and payment parity requirements for Kentucky Medicaid, Medicaid managed care organizations, and commercial health plans in the Bluegrass State. The law is effective July 1, 2019.

Citizen Action of Wisconsin: Walker continues to sabotage quality affordable health care
The Wisconsin Gazette reports that the Walker administration this week built on its 7-year record of sabotaging the Affordable Care Act by permitting the continued sale of substandard “lemon” health plans through the end of 2019 on the individual and small group markets. The move shows that Walker’s dramatic change in tone in his State of the State Address, where he claimed to want to stabilize the Wisconsin individual health insurance market, was nothing more than an empty promise during an election year.

Bright Health Announces Rollout of Supplemental Coverage Package for its Colorado Customers
Bright Health (@mybrighthealthannounced the rollout of Bright Health Secure, a supplemental insurance package that can help its Colorado members cover certain unexpected out-of-pocket costs due to an accident or illness. An expansion of its portfolio of individual insurance products, Bright Health Secure is available for purchase now to consumers in Colorado holding a qualified Bright Health major medical plan, effective beginning July 1.

Upcoming Events:

AHIP Institute and Expo
When: June 20 – 22, 2018
Register for this event.
Twitter: @AHIPCoverage
Event Hashtag#AHIPInstitute

AHIP Institute and Expo 2018 – Take a few days away from the office this June and immerse yourself in creative thinking and idea sharing with health care professions from around the country. You’ll enjoy candid discussions including the good, the bad, and the ugly about ideas that are working, and ones that aren’t. You’ll have time to think, discover, and drive your organization’s success. You’ll quickly discover why Institute & Expo continues to be the essential health care event.