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Payer Housing Partnership Addresses Social Determinants of Health

Source: Thinkstock By Thomas Beaton February 20, 2018 – Health Partners Plans (HPP) and two community programs in Philadelphia announced a partnership to address housing-related social determinants of health by connecting homeless individuals to healthcare services, free clinics, free meals, and social engagement professionals. HPP is working with Broad Street Ministry […]

Modernizing Medicare Fee-for-Service Cost-Sharing Has Trade Offs

Source: Thinkstock By Thomas Beaton February 13, 2018 – Medicare’s fee-for-service (FFS) cost-sharing design requires modernization to protect beneficiaries from catastrophic costs, but changing the current design may bring new financial concerns, a new GAO report found. In 2015, eighty-one percent of Medicare beneficiaries receiving care in the FFS environment obtained […]

Merger Impacts, Medicaid Growth Drove 2017 Earnings for Payers

February 06, 2018 – Aetna experienced a 4 percent drop in year-to-year earnings because of fallout from its proposed Humana merger, while other payers increased revenues by taking advantage of growing Medicaid, Medicare, and ACA-compliant business opportunities. Based on fourth quarter earnings reports, traditionally strong health plan markets including the commercial […]

Medicare Fraud Cases Lead to Mix of Convictions, Settlements

Source: Thinkstock By Thomas Beaton February 05, 2018 – The Department of Justice’s (DoJ) crackdown on Medicare fraud continued as new investigations led to one provider conviction and two multi-million dollar settlements with provider organizations. The conviction found a provider guilty of participating in schemes that defrauded the Medicare program through […]