DFS Approves HealthNow New York Inc.’s Affiliation with Highmark Subject to Conditions to Protect New Yorkers

The Department of Financial Services (DFS) announced Wednesday it has approved Highmark Inc. and Highmark Health’s application to affiliate with HealthNow New York Inc., a New York not-for-profit Article 43 organization (BlueCross BlueShield of Western New York and BlueShield of Northeastern New York), following an extensive review of the application by DFS in collaboration with the New York State Department of Health. DFS approved the affiliation subject to a number of conditions to which Highmark and HealthNow have agreed, including employee protections and a $10 million commitment to improve racial and health inequities in Western New York and Northeastern New York.

CVC Capital Partners Fund VII to Invest in MedRisk

CVC Capital Partners (“CVC”) announced Tuesday that CVC Fund VII has signed a definitive agreement to acquire a majority interest in MedRisk (“MedRisk” or “the Company”). MedRisk is a leading provider of managed physical medicine services for the workers’ compensation industry in the U.S. The Carlyle Group, MedRisk’s current majority owner, will retain a significant stake and maintain joint control in partnership with CVC. Founded in 1994 and headquartered in King of Prussia, Pennsylvania, MedRisk consistently delivers clinically superior patient outcomes via the coordination and active management of physical medicine services for workers’ compensation patients.

J. Berg & Associates Partners with Integrity

Integrity Marketing Group, LLC (“Integrity”), the nation’s largest independent distributor of life and health insurance products, today announced it has acquired J. Berg & Associates, a leading insurance marketing organization (“IMO”) based in St. Louis, Missouri. J. Berg & Associates was founded in 1952 by Missouri native Jerry Berg, who was deeply committed to ensuring the success of his agents. The agency specializes in providing insurance coverage to the senior market, including Medicare, long-term care, home health care, hospital indemnity and life insurance products.

Behavioral Unicorn Lyra Health Eyes More Corporate Customers, Continued Growth in 2021

As COVID-19 continues to wreak havoc on the economy, funding for digital behavioral health companies has remained robust, largely because the nation’s mental health has worsened amid the pandemic. For Lyra Health, a mental health care benefits startup with unicorn status, not only has the company weathered the headwinds of the economic downturn, but thrived in them as well. Behavioral Health Business recently spoke with Andrew McCarthy, head of corporate marketing, to learn more about the company’s 2021 growth targets and unicorn status.

Allied Benefit Systems Announces Strategic Investment from Stone Point Capital

Allied Benefit Systems, LLC (“Allied” or the “Company”), a leading independent third-party administrator of group health benefits to self-insured employers, today confirmed that it has received a strategic investment from funds managed by Stone Point Capital LLC (“Stone Point”). Stone Point was attracted to Allied based on its leading market position, strong track record of organic growth and best-in-class member service. Founded in 1980, Allied provides customized benefits solutions, medical management and cost control strategies to over 9,000 self-insured employer groups across the U.S.

Will More Payers Buy ASCs?

ASC industry leaders expect more consolidation in the coming years as the cost and risk of owning independent centers increases. How often will the buyer be a payer? Naya Kehayes, principal at ECG Management Consultants, expects more payer investments in the future. Payers with ownership in ASCs have access to the center’s data and can directly funnel patients into the surgery center.

WEX Signs Definitive Agreement to Acquire Certain HSA Assets of HealthcareBank

WEX Inc. (NYSE:WEX), a leading financial technology service provider, announced Thursday the signing of an agreement to acquire certain health savings account (“HSA”) assets of HealthcareBank, the custodian bank for customers of WEX’s Health division. “This asset purchase expands WEX’s role in the attractive consumer-directed healthcare ecosystem and aligns with our growth strategy,” said Robert Deshaies, President of WEX’s Health division. Pursuant to the terms of the agreement, WEX will pay an initial cash consideration of approximately $200 million, with two additional deferred cash payments of $25 million in July 2023 and January 2024.

Is the Payer Outlook Bright or Dark for ASCs?

While some ASC administrators have seen payers become more accepting of outpatient surgeries and drive cases to the ASC, others report continued challenges in contract negotiations.

Top Clinical Conditions Targeted by Medicare Advantage Plans under SSBCI

The number of health plans offering some kind of innovative supplemental benefit skyrocketed in the past year, reflective of health care’s increasingly strong focus on the home and social determinants of health. That’s according to a new data brief from actuarial consulting firm Milliman, commissioned by the Better Medicare Alliance (BMA). Supplemental benefits like vision exams, dental coverage or fitness perks have been an important differentiator among MA plans since the program’s inception, the data brief notes. Over the past few years, however, such benefits have become even more important to the MA world.

Health Payment Systems, Inc. Welcomes SV Health Investors as New Lead Investor

Health Payment Systems, Inc. (HPS, the “Company”), an innovator in the healthcare payments space, today announced that SV Health Investors, LLC (“SV”) acquired a majority stake and provided growth financing to the Company. With this transaction, SV adds to its portfolio of growing healthcare technology investments. Hexagon, Inc., a private investment company and one of SV’s limited partners, invested in HPS alongside SV. Since its inception, HPS has helped self-funded employers in the Upper Midwest reduce the cost of healthcare, while maintaining high levels of provider and patient satisfaction.