Revenue Cycle and Payer News – August 23, 2023

Collaboration News

Independence Blue Cross and The Colorectal Cancer Alliance launch 45+ Reasons campaign to support colorectal cancer prevention
Independence Blue Cross (@ibx) and the Colorectal Cancer Alliance (the Alliance) announced the launch of 45+ Reasons, a campaign to get more than 5,000 Black Philadelphians ages 45-75 screened for colorectal cancer to reduce the significantly higher incidence and mortality rates of Black Americans.

CareFirst BlueCross BlueShield and Ryse Health Partner to Accelerate Value-Based Care for Diabetes Patients
CareFirst BlueCross BlueShield (@carefirst), the largest not-for-profit health plan in the mid-Atlantic region, and Ryse Health (Ryse), an operator of specialized cardiometabolic health clinics, announced a first of its kind quality improvement partnership serving individuals with uncontrolled type 2 diabetes in CareFirst’s commercial networks.

Company News

Aetna Better Health of Illinois Receives NCQA Health Equity Accreditation
Aetna Better Health of Illinois®, a CVS Health® company (@CVSHealth), was awarded Health Equity Accreditation from The National Committee for Quality Assurance (NCQA).

Humana Supports Health Equity, Community Organizations via National Grants
Humana (@Humana) announced sixteen community-based organizations across the nation will receive grants totaling over $121,500. With millions of medical and specialty care members across the nation, the healthcare company is taking intentional action toward a more equitable, accessible and affordable healthcare ecosystem.

UnitedHealthcare Accelerator announces its 2023 cohort of 10 digital health startups
A fundamental priority for UnitedHealthcare has always been to be a leader in modernizing the health system and advancing new solutions for some of the most pressing challenges in health care. To continue playing a leading role in driving the future of health, UnitedHealthcare (@uhc) has brought together 10 world-class health tech startups to participate in a collaborative mentorship-driven program.

Philadelphia-area health organizations form Regional Coalition to Eliminate Race-Based Medicine
The Regional Coalition to Eliminate Race-Based Medicine (Regional Coalition) launches. The Regional Coalition members will work together to remove race “adjustments” from 15 commonly used clinical decision support tools that may adversely impact patients’ outcomes. This group, convened by Independence Blue Cross, has committed to focus on 15 clinical decision support tools that adjust results based on a person’s race, potentially causing delays and inequities in care.

CVS Health reports second quarter results
CVS Health Corporation® (@CVSHealth) announced operating results for the three months ended June 30, 2023.

UnitedHealthcare Selected by New Mexico Human Services Department To Serve Medicaid Members via Turquoise Care
The New Mexico Human Services Department has announced its intention to award UnitedHealthcare (@UnitedHealthGrp) as one of four organizations to administer Turquoise Care, the state’s Medicaid program, statewide. After contract negotiations conclude, UnitedHealthcare expects its Medicaid offering to be available to members beginning July 1, 2024.

Cigna Healthcare Affirms its Approach to Expediting Physician Payments
In response to recent media misrepresentations, Cigna Healthcare (@cigna), the health benefits provider of The Cigna Group, shared information about one of its processes used to expedite payments to health care clinicians for a small number of relatively low-cost procedures. Cigna believes that the inaccurate portrayal of the PxDx – or “procedure to diagnosis” – process may lead to confusion or misunderstanding about how it works and how it is used. Here are the facts about this claims review process.

Making the Cut, Milestones, Accolades, Awards and More

Humana Ranked No. 1 Among Health Insurers for Customer Experience
For the third year in a row, Humana ranked No. 1 among health insurers for customer experience (CX) by Forrester*. Humana received the highest CX Index™ score among Health Insurers in Forrester’s proprietary 2023 CX Index™ survey.

CareSource earns 2023 Great Place To Work Certification™
CareSource (@caresource), a national nonprofit health plan, announced they are proud to be Certified™ by Great Place To Work® for the second year in a row. The prestigious award is based entirely on what current employees say about their experience working at CareSource.

Product News

Cigna Healthcare and Virgin Pulse Launch Personalized Digital Experience for Individuals to Improve Health and Vitality
Cigna Healthcare, the health benefits division of The Cigna Group, is partnering with Virgin Pulse, a global digital-first health and well-being engagement company. This new partnership will offer a connected and more personalized health experience to support the vitality of approximately 11 million customers. The new platform, available on myCigna, is part of Cigna Healthcare’s commitment to empower individuals – and workforces as a whole – to make better health choices and develop better habits throughout their health journey.

Policy News

New HHS Report Shows National Uninsured Rate Reached All-Time Low in 2023 After Record-Breaking ACA Enrollment Period
The U.S. Department of Health and Human Services (@hhsgov) released a new report showing that the national uninsured rate reached an all-time low of 7.7 percent in early 2023. Approximately 6.3 million people have now gained coverage since 2020, coinciding with the beginning of the Biden-Harris Administration in January 2021.

Hospitals, Physicians, Health Insurance Providers Urge CMS Not to Implement Costly, Conflicting Prior Authorization Standards
In a remarkable demonstration of unity, AHIP, the American Medical Association (AMA), the American Hospital Association (AHA), and the Blue Cross Blue Shield Association (BCBSA) came together to urge the Centers for Medicare & Medicaid Services (CMS) to reconsider prior authorization standards the agency has proposed.

Health Insurance Providers Actions Concerning Medicaid Redeterminations
As states begin to redetermine the eligibility of Medicaid enrollees following the COVID-19 crisis, health insurance providers are taking important steps to mitigate gaps in coverage and ensure Americans maintain continuous access to health care.

Upcoming Events

Consumer Experience & Digital Health Forum (@AHIPCoverage)

What: Consumer Experience & Digital Health Forum
When: September 13-14, 2023
Where: Portland, OR
Register Now

Join AHIP for a dynamic program focused on the emerging digital health innovations and novel strategies transforming the consumer experience in health care.