Revenue Cycle and Payer News – March 29, 2023

Company News

Humana to Exit Employer Group Commercial Medical Products Business
Humana Inc. (@Humana) announced that it will be exiting the Employer Group Commercial Medical Products business, which includes all fully insured, self-funded and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. No other Humana health plan offerings are materially affected.

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

UnitedHealth Group Announces Earnings Release Date
UnitedHealth Group (@UnitedHealthGrp) will release its first quarter 2023 financial results on Friday, April 14, 2023, before the market opens, and will host a teleconference at 8:45 a.m. ET to discuss the results with analysts and investors.

US drops appeal of UnitedHealth acquisition of Change Healthcare
The U.S. Justice Department has dismissed its own appeal challenging UnitedHealth Group’s (UNH.N) nearly $8 billion acquisition last year of Change Healthcare, a court filing showed.

Oscar Health Announces Appointment of Healthcare Veteran Mark Bertolini to CEO; Co-Founder and CEO Mario Schlosser Transitions to President of Technology
Oscar Health, Inc. (@OscarHealth), the first health insurance company built around a full-stack technology platform, announced the appointment of Mark Bertolini to the role of Chief Executive Officer, effective April 3, 2023. Co-Founder Mario Schlosser, will transition to President of Technology, reporting to Mark.

CVS Health completes acquisition of Signify Health
CVS Health® (@CVSHealth) announced that it has completed its acquisition of Signify Health. Signify Health is a technology and services company, focused on provider enablement and bringing clinicians into the home to identify chronic conditions, close gaps in care, and address social determinants of health

Diverse, Inclusive Data Leads to Better Health Outcomes and Healthier Communities
The Blue Cross Blue Shield Association (@BCBSAssociation) in partnership with the National Minority Quality Forum (NMQF) is proud to release recommendations for improving and standardizing data collection methods around race, ethnicity, and language (REL) and sexual orientation and gender identity (SOGI) to reduce health disparities and increase access to higher-quality care for underserved populations.

United Health Foundation Awards $2 Million Grant to Rainbow Health To Increase Access to Mental Health Care for LGBTQ+ and BIPOC Youth
The United Health Foundation, the philanthropic foundation of UnitedHealth Group, announced a three-year, $2 million grant partnership to address disparities related to suicide, depression and anxiety among LGBTQ+ and BIPOC youth and young adults ages 14-25 in Minnesota.

Humana Completes Aggregate $1.25 Billion Debt Offering
Humana Inc. (@Humana) announced the completion of its public offering of $1.25 billion in aggregate principal amount of senior notes.

Collaboration News

Independence Blue Cross engages Vistia Health to help simplify the health care experience
Independence Blue Cross (@ibx) announced it has engaged an exciting new entity to enhance member experience: Vistia Health. Through compassionate, personalized navigation, Vistia Health works to cut through the complexities of health care and change how employers and employees interact with care management.

BeMe teams up with CareSource to provide digital mental health support for teens
BeMe, a digital behavioral health company, and CareSource (@caresource), a nationally recognized nonprofit health plan, are announcing a new partnership to provide teens enrolled in Indiana’s Hoosier Healthwise coverage access to digital mental health support and interventions designed specifically to address teens’ unique needs.

The Rosalynn Carter Institute for Caregivers Teams Up With Cigna Healthcare to Deliver Workshops for Dementia Caregivers
The Rosalynn Carter Institute for Caregivers (RCI) is proud to collaborate with Cigna Healthcare (@cigna) to deliver 25 Dealing with Dementia (DWD) virtual workshops in 2023. The four-hour interactive sessions, offered virtually, will provide dementia caregivers with the tools they need to manage the challenges they may encounter along their caregiver journey.

To Read

See You in Portland: Five Reasons to Love the City of Roses by AHIP – As one of the biggest cities in the Pacific Northwest, Portland, Oregon is known for its relaxed vibe, diverse cultural scene, and access to the great outdoors. And it just so happens to be where AHIP 2023, their signature annual event, is calling home this year.

Policy News

AHIP Files Amicus Brief in Support of Copay Coupon Accumulators
AHIP (@AHIPCoverage) filed an amicus brief in HIV and Hepatitis Policy Institute v. United States Department of Health and Human Services (HHS), which is before the U.S. District Court for the District of Columbia. AHIP supports HHS’s defense of its copay coupon accumulator rule, which allows health insurance providers to determine whether to count direct financial assistance from drug manufacturers toward a patient’s annual cost-sharing limitation. AHIP’s brief provides context that demonstrates both the reasonableness and importance of the accumulator rule.

Biden-Harris Administration Celebrates the Affordable Care Act’s 13th Anniversary and Highlights Record-Breaking Coverage
The Biden-Harris Administration celebrated the 13th anniversary of the Affordable Care Act (ACA) by highlighting record-breaking enrollment numbers during the 2023 Marketplace Open Enrollment Period and lower health care costs because of President Biden’s American Rescue Plan (ARP) and Inflation Reduction Act (IRA).

HHS Releases Initial Guidance for Historic Medicare Drug Price Negotiation Program for Price Applicability Year 2026
For the first time in history, Medicare will have the ability to negotiate lower prescription drug prices because of the Inflation Reduction Act, President Biden’s historic law which lowers health care and prescription drug costs. The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued initial guidance detailing the requirements and parameters—including requests for public comment— on key elements of the new Medicare Drug Price Negotiation Program for 2026, the first year the negotiated prices will apply.


A Payer’s Pathway to Outcomes and Equity

Each health and wellness consumer has a different journey, hence a different set of needs. A virtual first delivery of care model aims to provide access to healthcare services through digital platforms and technologies, such as telemedicine, remote monitoring, chronic care management and other mobile health applications.

This 10-page guide outlines the strategies for establishing a virtual first delivery of care model.  Read the Guide

Upcoming Events

AHIP 2023 (@AHIPCoverage)

What: ATA’s 2022 EDGE Policy Conference
When: June 13-15, 2023
Where: Portland, OR
Register Now

Experience what’s next, now at AHIP 2023 (Formerly Institute & Expo.) We’re building on AHIP’s decades-long heritage of bringing together the people, ideas, and solutions guiding greater health for years to come.