Also in the news: Veradigm, Cigna, Cone Health, Jefferson Health, and Hippocratic AI.
State officials said this week they are preparing in case Commonwealth Care Alliance collapses, in an effort to protect the health care of the struggling insurer’s nearly 50,000 elderly, disabled, and low-income members.
In case members must transfer to a more basic version of the state’s Medicaid program, MassHealth, the state has sought proposals from vendors who could take over the intensive work of coordinating patients’ care, a service that Commonwealth Care provided but MassHealth‘s basic platform typically does not. (Bartlett, 3/19)
[Possibly clients of the failing Commonwealth Care Alliance might be better served if the organization had focussed on its mission of care rather than the woke DEI nonsense featured on their website, such as “CCA Supports Equal Justice for Everyone” and “CCA Commits to Being an Ally for Social Justice.” – Ed.]
Veradigm, a healthcare data company, confirmed on Tuesday it overstated its revenue in prior year-end financial statements. The company found discrepancies in its financial statements from 2020-2022, overstating revenue in 2020 and 2022 while understating revenue in 2021. It blamed the errors on “internal control failures.” (Turner, 3/19)
Blue Cross and Blue Shield licensee Health Care Service Corp. has closed its $3.3 billion purchase of Cigna’s Medicare operations, the companies announced Wednesday. The deal, which includes Medicare Advantage, Medicare Part D and Medicare supplement assets along with the CareAllies consulting unit, quadruples Health Care Service Corp.’s Medicare Advantage membership to about 800,000 and closes the book on Cigna’s Medicare plan business. (Berryman, 3/19)
Cone Health President and CEO Dr. Mary Jo Cagle is stepping down May 31 due to a family health matter. Interim Chief Operating Officer Bernard “Bernie” Sherry will serve as interim CEO starting June 1, and a new COO will be named in the coming weeks, according to a Wednesday news release. The health system is conducting a nationwide search for a permanent CEO, the release said. (Hudson, 3/19)
Jefferson Health is making changes to its leadership team’s responsibilities as the system integrates with Lehigh Valley Health Network. Jefferson President Dr. Baligh Yehia is expanding his role to oversee the combined system’s growth and clinical integration across three legacy Jefferson regions and two legacy Lehigh Valley regions. Dr. Brian Nester, chief operating officer at Jefferson and former president and CEO at Lehigh Valley, is COO of the enterprise. (Hudson, 3/19)
Hippocratic AI is launching its next generation of artificial intelligence models as it aims to stand out in an increasingly competitive space. The generative AI company said Wednesday it’s planning to add multiple features focused on customer service to its suite of AI tools for health systems, payers and pharmaceutical companies. The models will triple-check patients’ labs and medications as well as help route patients to a human when needed. (Turner, 3/19)
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