Preferred provider organization

Risk Strategies Annual Education Practice Student Health Plan Survey Finds Controlling Cost Reemerges as Primary Concern; Student Mental Health Drops to Third

Retrieved on: 
Thursday, April 25, 2024
Risk management, Cigna, School, Preferred provider organization, ACA, Mental health, Student, University

The survey results also showed mental health coverage continues to be a top-three priority for plan administrators.

Key Points: 
  • The survey results also showed mental health coverage continues to be a top-three priority for plan administrators.
  • The survey of approximately 140 colleges and universities, conducted midyear 2023, revealed that the average student health plan cost mean increase rose in 2023 by 4.7%.
  • In the past two years, student health plans had seen a full 5% rise in mean increase.
  • “In this third year of our annual survey, we see clear signs that student health plan administrators are looking not only at costs, but overall value,” said Terry Lyons, National Education Practice Leader, Risk Strategies.

New Research From Inovalon and Harvard Analyzes Medicare Advantage Plan Design Impact on Healthcare Utilization and Health Equity

Retrieved on: 
Monday, April 8, 2024
Harvard Medical School, HMO, Health, Preferred provider organization, Importance, Inovalon, Research, Health maintenance organization, PPO, Medicare, Medicare Advantage, FFS, Health insurance

The findings, published in the white paper " The Importance of Plan Design in Medicare Advantage ," represent the fourth installment of Inovalon’s and Harvard Medical School’s research collaboration to understand the underlying factors influencing enrollment, quality outcomes, and utilization in MA vs. FFS Medicare.

Key Points: 
  • The findings, published in the white paper " The Importance of Plan Design in Medicare Advantage ," represent the fourth installment of Inovalon’s and Harvard Medical School’s research collaboration to understand the underlying factors influencing enrollment, quality outcomes, and utilization in MA vs. FFS Medicare.
  • Previous research found that MA delivers superior quality outcomes and utilization reductions compared to FFS Medicare, even after controlling for differences in who enrolls.
  • However, until now, there was limited data on the differences within MA, and how specific MA plan designs and features impact outcomes.
  • "By understanding the populations Medicare Advantage plans attract, policymakers and health plans can come together to incentivize and deliver superior, cost-effective outcomes for every Medicare enrollee."

Segal Unveils 2024 State Employee Health Benefit Study and Interactive Plan Comparison Map Tool

Retrieved on: 
Friday, March 29, 2024
General Health, Professional Services, Technology, State, Local, Public Relations, Investor Relations, Insurance, Communications, Human Resources, Finance, Other Technology, Health, Public Policy, Government, Consulting, PPO, Care Act 2014, HDHP, Preferred provider organization, Organization, Growth, Map, OOP, ACA, Affordable Care Act, Health insurance

Leading benefits and HR consulting firm Segal released its 2024 State Employee Health Benefit Study today, alongside an interactive map revealing state-by-state comparisons of health benefit plans.

Key Points: 
  • Leading benefits and HR consulting firm Segal released its 2024 State Employee Health Benefit Study today, alongside an interactive map revealing state-by-state comparisons of health benefit plans.
  • High-deductible health plans (HDHPs) are more prevalent in America today, in fact more than half of state plans offer an HDHP plan option.
  • Complementing the study, Segal's innovative, interactive map tool enables users to perform detailed state-by-state comparisons, shedding light on the intricate details of each state's employee health benefit plan.
  • This groundbreaking study and accompanying digital map are built on Segal’s extensive expertise gained from decades of advising health plans.

Despite slowing growth and regulatory headwinds, Medicare Advantage enrollment remains strong and outlook positive

Retrieved on: 
Tuesday, March 5, 2024
Preferred provider organization, SNP, Special needs plan, United States Census Bureau, CMS, Chronic condition, Management, Medicare Advantage, Growth, FFS, American International Group, Medicare, Region, Optimism, CBSA, Health insurance

CHICAGO, March 5, 2024 /PRNewswire/ -- Chartis, a comprehensive healthcare advisory firm, today announced the release of its annual 2024 Medicare Advantage competitive enrollment report. This year's report is a collaboration between Chartis and HealthScape Advisors, A Chartis Company. Together, they help payers and providers manage transformational change in a rapidly evolving healthcare ecosystem that is increasingly defined by payer-provider convergence.

Key Points: 
  • This year's edition of the report shows that despite strong enrollment gains, market growth appears to be slowing.
  • The Medicare Advantage market grew by 1.7 million beneficiaries (+5.4%) in 2023, slowing down from the record growth of 2.7 million (+9.4%) in 2022.
  • This ongoing enrollment growth is fueled by an increasing senior market but is overshadowed by regulatory pressures, declining quality scores, and rising medical costs.
  • In addition to top-line enrollment statistics and executive sentiment, Chartis' 2024 Medicare Advantage report analyzed:
    Special Needs Plan (SNP) growth: SNP enrollment has surged, adding 1.2 million members.

United States Health Insurance Market Analysis Report 2023: A $1,639 Billion Industry by 2028 from $1,150 Billion in 2022 - Competition, Forecasts and Opportunities - ResearchAndMarkets.com

Retrieved on: 
Friday, December 15, 2023
Health, Health Insurance, Preferred provider organization, United States Census Bureau, Medicaid, Conditional sentence, Affordable Care Act, Prevalence, California Insurance Commissioner, International Diabetes Federation, Cardiovascular disease, Insurance, Elevance Health, Patient, National Association, USD, Telehealth, Health maintenance organization, NAIC, COVID-19, ACA, Cancer, Plasma protein binding, POS, Growth, Hospital, Diabetes, DSM-IV codes, Trump, Health insurance, Cigna

The "United States Health Insurance Market Competition, Forecast and Opportunities, 2028" report has been added to ResearchAndMarkets.com's offering.

Key Points: 
  • The "United States Health Insurance Market Competition, Forecast and Opportunities, 2028" report has been added to ResearchAndMarkets.com's offering.
  • United States health insurance market is expected to reach a value of $1639.44 billion by 2028, up from $1150.23 billion in 2022, driven by the increasing private health insurance provider and rising medical expenditures during the forecast period.
  • The United States health insurance market has experienced significant growth over the past decade, driven by several factors, such as rising healthcare costs, increasing awareness of health insurance, and a surging population.
  • The United States offers ample opportunities for health insurance companies to expand their offerings beyond traditional health insurance products.

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS ANNOUNCES INNOVATIVE PRODUCTS FOR 2024

Retrieved on: 
Monday, November 27, 2023
Carbon, Vision, Health savings account, Blue Cross, Travel, HealthEquity, Steward Health Care System, HSA, Pharmacy, Option, Atrius Health, Preferred provider organization, PPO, Glossary of music terminology, Calendar, Disability studies, EPO, Carbon Health, Medicine, HPN, Hospital, Common, Physician, Diabetes, Health, Health insurance

BOSTON, Nov. 27, 2023 /PRNewswire/ -- Blue Cross Blue Shield of Massachusetts (Blue Cross) today announced a suite of innovative new medical, pharmacy, dental and vision offerings that support the health plan's commitment to provide quality, affordable and equitable health care.

Key Points: 
  • BOSTON, Nov. 27, 2023 /PRNewswire/ -- Blue Cross Blue Shield of Massachusetts (Blue Cross) today announced a suite of innovative new medical, pharmacy, dental and vision offerings that support the health plan's commitment to provide quality, affordable and equitable health care.
  • Blue Cross announced the following new offerings:
    Exclusive Provider Organization (EPO) Plans: Blue Cross is offering new EPO plan options for fully insured customers and now will offer these plans to student groups.
  • The health plan will be the first in the market to offer an EPO plan to Massachusetts individuals and small groups.
  • Pharmacy Program through Sempre Health: To improve medication adherence and affordability for members with select chronic conditions including diabetes, Blue Cross is partnering with Sempre Health.

Donor Concierge Honors Dr. Said Daneshmand with 2023 Fertility Provider Excellence Award

Retrieved on: 
Thursday, September 28, 2023
Parent, Concierge, Hope, Attention, Fertility clinic, Donor, IVF, Fertility, Trust, MD, Patient, Physician, SAN, Preferred provider organization, Gynaecology, Family, Medical device, Birth control, Obstetrics

SAN FRANCISCO, Sept. 28, 2023 /PRNewswire-PRWeb/ -- Today, Donor Concierge named Dr. Said Daneshmand, MD, as the recipient of the 2023 Donor Concierge Fertility Provider Excellence Award. This annual award recognizes fertility practitioners who meet Donor Concierge's stringent standards of excellence and provide outstanding care to fertility patients.

Key Points: 
  • Donor Concierge is proud to award the 2023 Fertility Provider Excellence Award to Dr. Said Daneshmand and San Diego Fertility Center, recognizing exceptional care for fertility patients.
  • SAN FRANCISCO, Sept. 28, 2023 /PRNewswire-PRWeb/ -- Today, Donor Concierge named Dr. Said Daneshmand, MD, as the recipient of the 2023 Donor Concierge Fertility Provider Excellence Award.
  • This annual award recognizes fertility practitioners who meet Donor Concierge's stringent standards of excellence and provide outstanding care to fertility patients.
  • For nearly two decades, Donor Concierge has assisted thousands of hopeful parents in the third-party fertility sector.

Sendero Health Plans Names Sharon Alvis as Next Chief Executive

Retrieved on: 
Thursday, September 21, 2023
Insurance, EAP, Health, Central Health, Saint David, PHO, PPO, Central Health (Texas), HMO, Preferred provider organization, Health maintenance organization, Organization, Medicare, Hospital, Affordable Care Act, Hugh Delargy, ACA, Physician, National Hospital Organization Nagara Medical Center, Provisions of the Affordable Care Act, Alvis, St Davids, Health insurance marketplace, Curative, Health insurance, Retail, Central Texas

AUSTIN, Texas, Sept. 21, 2023 /PRNewswire/ -- Sendero Health Plans Inc. (Sendero) announced Wednesday it has named Sharon J. Alvis as the new chief executive officer to lead the nonprofit health maintenance organization (HMO), which was created and is funded and owned by Central Health.

Key Points: 
  • AUSTIN, Texas, Sept. 21, 2023 /PRNewswire/ -- Sendero Health Plans Inc. (Sendero) announced Wednesday it has named Sharon J. Alvis as the new chief executive officer to lead the nonprofit health maintenance organization (HMO), which was created and is funded and owned by Central Health.
  • Sendero offers health insurance plans through the Affordable Care Act's (ACA) federal Health Insurance Marketplace.
  • I have closely followed the evolution and experience of Sendero Health Plans from its inception and was excited about the potential to directly contribute."
  • Alvis continued, "With its unique structure and ownership, Sendero, in collaboration with the Central Health System, has a unique opportunity to maximize powerful collective resources.

Oxford Health Founder, Steve Wiggins, launches a new type of health insurance plan with nirvanaHealth’s Aria platform on Microsoft Azure

Retrieved on: 
Monday, August 14, 2023
Health Technology, Health Insurance, Insurance, Technology, Robotics, Pharmaceutical, Practice Management, Apps, Applications, Professional Services, Venture Capital, Artificial Intelligence, Software, Networks, Health, Medical Supplies, Oxbridge, RPA, Medicaid, Partnership, Oxford, PPO, Oxford Health Plans, HealthMarkets, Payer, HMO, Point, Multimedia, Preferred provider organization, Pharmacy, Government, Acos, Private health services plan, Health maintenance organization, Medicare, Patient, Risk, Machine learning, PBM, Architecture, Point of service plan, Health insurance, Apple, UnitedHealth Group

These capabilities will be linked to the Oxbridge platform to enable creative use of bundled payments and episode of care allowances in benefit plan designs.

Key Points: 
  • These capabilities will be linked to the Oxbridge platform to enable creative use of bundled payments and episode of care allowances in benefit plan designs.
  • “We are excited to work with Oxbridge to drive innovation and to help them launch with a highly competitive cost structure.
  • The Oxbridge platform has been designed to move up to 50% of an employer’s annual health benefit spending into episode of care programs.
  • The Aria platform was designed to administer any type of health benefit program, whether a Medicare or Medicaid plan, a commercial health insurance program, an employer self-funded plan or prescription drug programs.

Pinwheel becomes Plaid's Preferred Provider for direct deposit switching and helps power additional payroll data for income verification

Retrieved on: 
Thursday, August 17, 2023
Fintech, Partnership, Employment, Seamless, Microsoft Partner Network, Preferred provider organization, API, Intelligence, Automation, DDS, Mobile phone, Insurance, Bank, Plaid, Pinwheel

NEW YORK, Aug. 17, 2023 /PRNewswire/ -- Today Pinwheel, the market-leading provider of income and employment data engineered for fintech innovation, partners with Plaid, the leading open finance network, to provide complementary payroll data services for its Income product. In addition, Pinwheel will become a Preferred Provider for direct deposit switching (DDS) services. As the Preferred Provider, Plaid will refer customers in need of direct deposit switching services to Pinwheel.

Key Points: 
  • Pinwheel joins Plaid's Partner Network as its Preferred Provider for direct deposit switching (DDS) services and is helping to provide additional consumer-permissioned payroll data to Plaid's Income product.
  • In addition, Pinwheel will become a Preferred Provider for direct deposit switching (DDS) services.
  • As the Preferred Provider, Plaid will refer customers in need of direct deposit switching services to Pinwheel.
  • Pinwheel is Plaid's Preferred Provider for DDS and helps provide additional payroll data to its Income product.