Jeff Lagasse

Author's posts

Million dollar claims increasing among employer plans

Million dollar claims per million covered employees rose 15% in the past year and 45% over the past four years, according to a new report from Sun Life. And one-fifth of employers had at least one member with more than $1 million in claims from 2018 th…

CVS plans free, community-based mental health screenings

CVS Health said this week it’s adding mental health screenings to Project Health, the company’s free, community-based health screening program. 
It will kick-start its mental health screenings in Greensboro, North Carolina and Petersburg, Virginia. Ove…

Humana teams with durable medical equipment organizations on home care

Humana has reached an agreement with two national organizations to provide Durable Medical Equipment (DME) services to help Humana Medicare Advantage HMO members receive home healthcare.
The national DME providers, AdaptHealth and Rotech Healthcare, wi…

OCR settles complaint with Florida provider over communication with deaf patient

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has reached an agreement with Florida-based MCR Health to resolve a disability discrimination complaint from a deaf patient who claimed she was not provided adequate supports.

AMA: Roughly one-third of physicians have been sued in their career

Almost one-third (31%) of physicians practicing in the U.S. have been hit with a medical liability claim at least once during their careers, with the risk of having a claim filed against them increasing the longer they practice, according to new survey…

Pediatric ER utilization algorithm hurts Black and Hispanic patients, study finds

A diagnosis claims-based algorithm used by payers to decide whether pediatric patients need to be taken to the emergency department has been promoted as a way to cut healthcare costs. But according to a new JAMA Network Open study, this algorithm will …

Health systems pledge to make 10% of new hires from disadvantaged communities

Seventeen health systems, including Cleveland Clinic and Advocate Health, have pledged a commitment to make 10% of all new hires “impact hires” – meaning employees hired from economically disadvantaged areas.

Most employers intend to keep preventive services even after Texas ACA ruling

At the tail end of March, a ruling by a federal judge in Texas invalidated much of the Affordable Care Act’s coverage of preventive care without cost sharing, but a new survey from the National Alliance of Healthcare Purchaser Coalitions showed that ab…

Oscar Health exiting California’s ACA exchange next year

Insurtech Oscar Health signaled during an earnings call on Tuesday that it will be exiting California’s individual market beginning next year, with CEO Mark Bertolini saying the plan has fallen short of the company’s goals.

Optum’s 25% revenue growth fuels UnitedHealth Group’s Q1 earnings

Thanks in part to a 25% increase in revenue for Optum, UnitedHealth Group saw $5.6 billion in earnings during the first quarter of the year, and $91.3 billion in revenue, both far and above other major insurers, according to the company’s financial res…