Payer

By Heather Mack June 13, 2017
The ambitious vision of Portland, Oregon-based Zoom+ to offer a fully integrated, tech-enabled healthcare system under one roof appears to be more than the company could handle. The Federal Bureau of Investigation is looking into allegations of fraud Zoom+ may have committed in effort to avoid losing money from required risk adjustment payments. Allegedly, Zoom+ retroactively falsified medical...
By Heather Mack June 12, 2017
Health insurance startup Oscar Health has introduced a new tool to give doctors a more detailed overview of their patients: a virtual clinical dashboard that displays multiple steps of an Oscar member’s medical journey, with the goal being to offer a more readable profile of their health. Though it’s not quite an electronic health record in it’s own right, it’s more than just a user-friendly...
By Jonah Comstock May 15, 2017
A new survey from HealthMine of 750 insured consumers shows that 83 percent of those consumers report using digital health tools. But while the news is good for digital health, it's not as good for health plans, the group that the survey focused on. Seventy-three percent of respondents said their health plan doesn't seem to understand their health well and 60 percent called for more communication...
By Jonah Comstock May 12, 2017
Correction: A previous version of this article misstated who led the investment round. Clover Health, an insurance startup with a patient engagement bent, has raised $130 million in a round led by existing investor Greenoaks Capital Management. New investors Google Ventures, Palm Drive Capital, and Western Technology Investment and existing investors Sequoia Capital and First Round Capital also...
By Heather Mack May 10, 2017
From cost and coverage to time and convenience, there are many factors that can hinder healthcare access. And for an estimated 3.6 million Americans, the main obstacle in getting to their medical appointments involves an engine and a set of wheels. In effort to reduce the number of missed or delayed doctor’s appointments that are attributed to a lack of dependable transportation options, Blue...
By Jonah Comstock May 2, 2017
Twine Health, which offers software to manage coaching programs for wellness and disease management, has had some pretty robust efficacy data over the years. For instance, a hypertension trial saw a decrease in systolic blood pressure from 26.3 mm Hg to 16.0 mm Hg, and a diabetes trial saw an average 3.2 drop in HbA1C with Twine’s coaching, compared to a 1.0 drop for a control group. But even...
By Heather Mack April 27, 2017
While it is impossible to call any one method of patient engagement “tried and true,” texting as a means of getting people to play an active role in their healthcare has been a successful strategy in many cases, ranging from diabetes management to depression. That’s Encino, California-based mPulse Mobile’s forte, and the company has now attracted the attention of Harvard Medical School...
By Bill Siwicki April 26, 2017
The Center for Connected Health Policy has released the fifth edition of its State Telehealth Laws and Reimbursement Policies Report. CCHP uncovered many notable findings in the new report. Perhaps chief among those: 48 states and Washington, D.C., provide reimbursement for some form of live video in Medicaid fee-for-service.  Specifically, 13 states reimburse for store-and-forward delivered...
By Jonah Comstock April 25, 2017
Seattle-based healthcare quality transparency company Mpirica has raised $4.6 million in a round led by equity crowdfunding platform OurCrowd. An undisclosed Seattle-based private equity fund also contributed to the round. The company plans to use the funsing to support a national rollout to Medicare Advantage customers. With its team of data scientists and physicians, Mpirica uses claims data to...
By Jonah Comstock April 19, 2017
Payer moves in digital health in the first quarter mainly fell into one of two categories: employee wellness initiatives and reimbursement moves. The only major piece of payer news that didn’t fit into one or the other category was Humana’s partnering with digital health startup Quartet to bring mental health services to underserved communities in New Orleans. Employee Wellness Early in the...