News Briefs

The Center for Medicare & Medicaid Innovation on Dec. 17 rolled out a new demonstration model aimed at incentivizing Medicaid managed care organizations to coordinate and improve care for the population that is dually eligible for Medicare and Medicaid. By allowing MCOs to participate as direct contracting entities, CMS hopes to encourage them to take steps such as targeting care coordination resources toward dual-eligible beneficiaries at risk of high Medicare spending, training in-home aides on meal preparation for individuals with nutrition-sensitive conditions like diabetes, and entering into value-based purchasing arrangements with nursing facilities that factor in facilities’ hospitalization rates, among other actions. Read more at https://go.cms.gov/3al7Pfv.

The U.S. Dept. of Justice (DOJ) will require Tufts Health Plan to sell its commercial health insurance business in New Hampshire — called Tufts Health Freedom Plan Inc. — in order to proceed with its merger with Harvard Pilgrim Health Care. UnitedHealth Group, the nation’s largest insurer, will buy Tufts’ New Hampshire holdings, the DOJ said in a Dec. 14 press release. Tufts and Harvard Pilgrim, both of which are based in Massachusetts, announced their deal last year (HPW 8/19/19, p. 1), saying that a combined entity will be better positioned to “bring value to the communities we serve.” Read more about the settlement at https://bit.ly/2LHVnfv.

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AIS Health Staff

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