Clover, Walmart launch Medicare Advantage plans in Georgia

“A new health insurance plan will include Walmart’s Health Centers as a feature. The retailer is teaming up with insurance startup Clover to offer Medicare Advantage plans across the state of Georgia. The “Live Healthy” plans will be structured as a PPO — consistent with Clover’s other MA plans in the eight states where it operates. Members will have access to Walmart Health’s clinics across the state, which offer primary care, dental, hearing, x-rays and other services. [..] The plans have no copay for primary care visits, lab tests, and preventive dental exams. They also include other benefits, including $100 … Read More

Pharmacists in Ohio managing care as providers—and getting paid for it too

“Franklin Pharmacy is part of a UnitedHealthcare experiment in Ohio to put community pharmacists on the team of clinicians who care for a patient in hope of controlling chronic conditions and reducing hospital readmissions. The insurer is paying pharmacists to have these conversations, uncover any health and medication issues, and then do something about them. “We tend to have better results in getting people care when we’re working with them within their communities,” said Michael Roaldi, who leads UnitedHealthcare’s Medicaid business in the state. “It occurred to us that pharmacies—community pharmacies and chain pharmacies—are literally thousands of examples of medical … Read More