In the News: Aug 1–8

Cigna Plans Big Medicare Advantage Expansion

A recent Forbes article highlights Cigna’s plans to offer Medicare Advantage (MA) plans to 37 new counties next year. Cigna currently offers health maintenance organization (HMO) plans in 260 counties in 16 states; this proposed expansion will increase Cigna’s MA footprint by 14%.

In addition to expanding geographically, Cigna also plans to introduce individual preferred provider organization plans, allowing patients to make more out-of-network provider choices; however, this often means greater cost to the consumer compared to current HMO offerings. Cigna will continue to remain much smaller than larger health plans, but their competitors are also looking to grow their MA business as well.

As the Medicare Advantage market continues to grow, it is crucial for health systems to understand its implications and develop a strategy that fits their market dynamics and their organization. For insights on key drivers of MA growth, as well as strategic options and essential competencies for MA success, please read the Sg2 report Medicare Advantage: Too Big to Ignore.

The FCC Will Reform Funding Distribution for Rural Health Care Program

A recent Modern Healthcare article describes how the Federal Communications Commission (FCC) issued a report and order for its Rural Health Care Program to provide financial support to assist rural health care providers in obtaining broadband and telecommunications services at discounted rates. Such services are used to offer virtual health care to rural patients who often face access challenges.

The FCC proposed several reforms, including prioritizing extremely rural counties (based on a rurality tier system) and medically underserved areas and streamlining how discounted rates are calculated. Despite these proposed reforms, critics believe the Rural Health Care Program still inadequately addresses overall funding needs and voiced concerns over continued funding of urban areas, as well as the Universal Service Administrative Co’s (an independent not-for-profit designated to administer telecommunications funding) competency in rate setting and properly assessing overall impact of calculation changes on funding beneficiaries.

Virtual health funding expansion and reform through federal entities (eg, the FCC) are just some ways key stakeholders are addressing health care access needs of rural patients. Health care provider organization leaders and planners can proactively work toward improving virtual access for rural consumers by matching their virtual health strategy to the needs of those patients within their System of CARE. To learn more about 4 key approaches to consider when exploring virtual health strategies for rural populations in your market, please read the Sg2 Expert Insight Help Rural Consumers and Fuel Downstream Growth With 4 Virtual Options.

Consumerism Plays a Growing Role in the Transition to Value-Based Care

A recent Patient Engagement HIT article discusses how health systems can navigate the shift toward value-based care while driving patient loyalty with consumer-centric strategies. Historically, hospitals have assessed patient loyalty and outreach initiatives based on new patient acquisition metrics. However, the shift from fee-for-service to value-based care has prompted many organizations to place greater emphasis on elevating the consumer experience.

Efforts to adopt digital solutions are playing a critical role in consumer experience, as technology solutions promote a more consumer-centric experience rooted in convenience and improved access. Many health systems are taking their lead from tech giant companies like Amazon that have interactive and convenient platforms. Health care consumers have responded positively to hospitals offering portals that easily identify physician availability and facilitate appointment scheduling across sites of care. Additionally, patients appreciate direct-to-consumer messages that serve as e-consult options.

As hospitals across the country evaluate and grow their consumer-centric strategies, it will be important to develop a digital strategy that addresses consumer needs. Please watch the on-demand Sg2 webinar Consumerism 3.0: The Era of Service Line Disruption to hear digital health opportunities and strategic insights on building initiatives that scale across the enterprise.

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