As a combined entity, Virgin Pulse and HealthComp will serve more than 1,000 self-insured employers and more than 20 million members. New Mountain Capital will be the majority owner.

Evvy’s $14 million funding round was led by Left Lane Capital and included participation from General Catalyst, LabCorp Venture Fund, RH Capital, Ingeborg Investments, G9 Ventures, Virtue and Amboy Street Ventures. In total, Evvy has raised $19 million. 

The average monthly plan premium for Medicare Advantage is expected to increase only slightly in 2024 from 2023, CMS said. About 73% of beneficiaries will see no increase at all.

Costco is partnering with Sesame to offer Costco Members discounted pricing on virtual health services, including primary care and mental health. But the move is a little different from other retailers like CVS Health and Walgreens.

A new study found that MA beneficiaries have more than 50% fewer inpatient stays and 22% fewer emergency department visits than traditional Medicare enrollees.

The Supreme Court’s recent summer decision in Health and Hospital Corporation of Marion County, Indiana, et al. v. Talevski has raised the stakes for nursing homes by ruling that private litigants may bring civil claims against facilities to recover damages for violations of certain provisions of the Federal Nursing Home Reform Act (FNHRA). This decision provides powerful incentives for nursing homes and other facilities subject to the FNHRA to enhance their monitoring and compliance processes.

Issues around healthcare affordability, mental health challenges and worsening chronic conditions are all top of mind for Ellen Kelsay, president and CEO of Business Group on Health.

There are concerns that Medicare Advantage TV ads are misleading patients. A new KFF analysis of Medicare Advantage TV ads found that the ads often rely on celebrity endorsements and suggest that seniors are missing out on benefits that they’re entitled to.

Providers, administrators, health insurers and other healthcare-access gatekeepers can learn, train, change policies and remove barriers facing vulnerable groups so they can receive the long-overdue opportunity to pursue their best health and well-being.

The next generation of senior living searchers are markedly different from their predecessors, and they will challenge us to work together to reshape their search experience.

Thirty states have been conducting Medicaid and CHIP automatic renewals incorrectly, leading to many individuals being wrongly removed from coverage. Because of this, nearly 500,000 children and other individuals will have their coverage reinstated.

Americans are getting older, and some healthcare leaders expect this to be a challenge for the healthcare industry. Others, however, think this is an opportunity for the industry to make improvements, such as engaging adults in their care before they turn 65.

The commercial market has struggled to adopt value-based care, but HealthPartners has had some success, according to Mark Hansberry, senior vice president and chief marketing officer of the company. During a conference, he shared five rules for scaling value-based care, including creating trust and providing real-time data.

The Federal Trade Commission only gets notified when a merger/acquisition deal value is above $100-$110 million, so smaller deals nonetheless lead to a slow consolidation of the market. In conference remarks, FTC Chair Lina Khan outlined the ways in which the agency is trying to counter this phenomenon.

Postpartum Depression has been a recognized — but stigmatized — possibility during the so-called “fourth trimester of pregnancy” for generations. However, it is now being firmly addressed through femtech innovations.

For the past 30 years, even with the various headwinds over time, consistent winners in MA have adapted and adjusted to new standards required for success. Now is no different. Short-term headwinds are just that – short-term.

MedCity News is launching a new podcast called MedCity FemFwd, which will discuss the breakthroughs and challenges in the women’s health space. In the inaugural episode, Michelle Long of KFF examines whether Opill — the first daily oral contraceptive approved for nonprescription use in the U.S. — will be covered by insurance.

More than a dozen civil rights organizations alleged in a new complaint that Florida uses administrative practices that are preventing underserved communities from renewing their Medicaid coverage.

MedImpact and GoodRx are teaming up to lower costs for MedImpact members. When eligible MedImpact members refill a generic prescription, the companies’ savings solution will compare the member’s benefit to GoodRx’s price and will automatically apply the lowest one.

When Medicaid expansion was first enacted, it was a hot topic debate between Democrats and Republicans. But more and more states are starting to expand Medicaid, including several conservative states.

Solera Health recently launched a program that aims to help patients who are interested in GLP-1s gain access to lifestyle change support. It also provides educational materials on GLP-1s.

By leveraging technology and strategies used within the gig economy—and even tapping into the talent pool of gig workers themselves—healthcare organizations can address staffing shortages, retain and motivate more workers, and ultimately deliver better patient care.

Pumpspotting’s funding round was led by Sincere Corporation and Maine Venture Fund and included participation from Unum Business Ventures and Maine Technology Institute. In total, pumpspotting has raised more than $3.3 million.

In rural areas, the share of eligible beneficiaries enrolled in MA plans nearly quadrupled from 11% in 2010 to 40% in 2023, according to new research from KFF. This represents 400,000 rural MA beneficiaries in 2010 and 1.8 million in 2023.

Employers expect health benefit costs to increase 5.4% per employee on average in 2024, new data from Mercer shows. This is due to inflationary pressures and health system consolidation.

A new survey from Alignment Health found that economic instability, food insecurity, lack of support and transportation access are the biggest social barriers for seniors.

Medicare Advantage beneficiaries with a cancer diagnosis spend $3,996 on out-of-pocket costs and premiums annually, versus $6,091 for traditional Medicare beneficiaries with cancer, a new report found.

In a day of vast innovation, expansion, and acquisitions, an engineering mindset can bring a unique and effective approach to thinking across the system, evaluating the current and future state, standardizing on best practices, and considering upstream and downstream workflows.

Precision medicine for neurodegenerative conditions has the potential to radically change the way patients are treated and managed over time. As an industry, we must continue to expand our thinking and push the boundaries of science, technology, and data analytics to capture precision medicine opportunities in broader areas of unmet medical needs.

The current dual-system model is inefficient, wasteful, and inconvenient. There is a clear need to integrate workers’ comp and medical benefits programs to cut down on costs and alleviate the hassle of dealing with separate care silos. It’s possible, and its time has come.