Prime Health Services Announces Acquisition of InterWest Health

Prime Health Services, Inc., a national cost management solutions company, announced Wednesday it has acquired, closed, and integrated InterWest Health, LLC, the most comprehensive network available in the Mountain Region of the United States. This acquisition allows Prime Health Services to strengthen its provider network in Montana, Idaho, North Dakota, South Dakota, Washington, and Wyoming. Over 25,000 physicians, hospitals, and other health care providers in this service area will now be available for clients utilizing the Prime Health Services PPO network.

U.S. Supreme Court Rejects Republican Challenge to Obamacare Law

The U.S. Supreme Court on Thursday rejected a Republican bid that had been backed by former President Donald Trump’s administration to invalidate the Obamacare healthcare law, ruling that Texas and other challengers had no legal standing to file their lawsuit. The 7-2 ruling authored by liberal Justice Stephen Breyer did not decide broader legal questions raised in the case about whether a key provision in the law, which is formally called the Affordable Care Act, was unconstitutional and, if so, whether the rest of the statute should be struck down.

Kinderhook’s MHH Healthcare, LLC to Acquire Medical Card System, Inc. (MCS), a Leading Healthcare Services Organization in Puerto Rico

MHH Healthcare, LLC (“MHH Healthcare”), a platform company formed by Kinderhook Industries, LLC (“Kinderhook”) to invest in health plans, health maintenance organizations (“HMOs”), and healthcare services organizations, announced today that a subsidiary of MHH Healthcare has entered into a definitive agreement to acquire Medical Card System, Inc. (“MCS” or the “Company”), a leading Puerto Rico-based healthcare services organization. Headquartered in San Juan, Puerto Rico, MCS is a leading healthcare services organization offering a variety of insurance plans and managing care for Medicare Advantage and Commercial members throughout Puerto Rico.

How the Medicare Advantage Landscape Has Evolved for Home Care Providers

The Medicare Advantage (MA) opportunity isn’t one that has happened overnight for home care providers, with some industry insiders even describing it as a “slow burn.” In more recent years, a shift has begun to take place, however.

Health Enterprise Partners Completes Recapitalization of AllyAlign Health

Health Enterprise Partners (“HEP”), a healthcare private equity firm, today announced that it has completed a significant recapitalization of its portfolio company AllyAlign Health (“AAH”) by an investment syndicate led by New Enterprise Associates, Inc. AllyAlign Health is a Medicare Advantage insurance company focused on improving the health and wellbeing of residents of senior housing communities. AAH is working to establish a healthcare ecosystem in senior housing that creates better outcomes and experience for senior housing residents, senior housing communities, physicians, and other caregivers.

UnitedHealthcare Delays New ED Claims Denial Policy

UnitedHealthcare on Thursday said it will delay implementing its new policy that would retroactively deny patients’ claims of emergency department visits that are considered non-emergent. The insurer stated in a tweet that it has decided to wait on the policy until “at least the end of the national public health emergency period” due to feedback from its provider partners and conversations with various medical societies.

Northlane Capital Partners Invests in The Difference Card

Northlane Capital Partners (“NCP”) announced Wednesday that it has made an investment in EBS, Inc. d/b/a The Difference Card (“The Difference Card”), a leading provider of healthcare cost containment solutions. Founded in 2001, The Difference Card enables employers to reduce healthcare costs without reducing employees’ benefit levels or increasing employees’ out-of-pocket expenses. The Difference Card typically targets small and mid-sized businesses and serves nearly 800 employers across the U.S. in various end markets.

TCS Healthcare Announces Acquisition of DataSmart Solutions

CS Healthcare Technologies, the leading provider of managed care solutions designed by clinicians, today announced its acquisition of Montana-based DataSmart Solutions, LLC, a predictive risk analytics software company. The transaction was supported by follow-on funding from HCAP Partners, a California-based private equity firm and nationally recognized impact investor. TCS software solutions are designed to support the needs of health plans, TPAs, ACOs, and other risk-bearing organizations by optimizing clinical outcomes, maintaining compliance, and improving financial and operational excellence.

Cross Country Healthcare Completes Asset Acquisition of Workforce Solutions Group, Inc.

Cross Country Healthcare, Inc., (NASDAQ: CCRN), a leading provider of advisory and workforce solutions, including contingent staffing, permanent placement, and other consultative services for healthcare clients, announced Tuesday the asset acquisition of Workforce Solutions Group, Inc. (WSG). Based in California, WSG primarily works with local and national healthcare plans and managed care providers to coordinate in-home care services for participants. WSG also provides a range of consulting and talent management solutions to its healthcare clients, including home care staffing, recruitment process outsourcing, contingent workforce evaluation, and talent acquisition.

Icario Expands Consumer Engagement and Health Action Platform with Acquisition of ChipRewards

Icario, the healthcare industry’s largest health action company, today announced it has acquired ChipRewards, a leading SaaS platform used by health plans and employers to configure and manage consumer engagement programs. With this acquisition, Icario adds self-service configurability and management capabilities that empower health plan teams to customize their approaches to engagement across enrollment, targeted health actions, retention, satisfaction and overall experience initiatives.