Jim Rechtin - Humana | LinkedIn (original) (raw)
Denver, Colorado, United States
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A healthcare industry veteran, I am currently serving as CEO and President at Humana…
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Humana
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DePauw University Board of Visitors
Jul 2018 - Dec 2022 4 years 6 months
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It's stories like Mr. Coleman, a Humana Medicare Advantage member and CenterWell Senior Primary Care patient, that show how we're making a difference…
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Excited to team up with a world-class community partner like Walmart and support more seniors with quality and convenient healthcare.
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Humana’s job is to ensure access to quality, affordable health care. That includes reducing prior authorization and doing a better job of helping…
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No goodbyes for me. Bruce will forever be a part of the Humana family and a friend and mentor to me personally. That’s what happens when you provide…
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- Long-Term Quality Alliance Four years into implementation, nearly 40% of #MedicareAdvantage plans offer expanded primarily health-related benefits (EPHRB) or Special Supplemental Benefits for the Chronically Ill (#SSBCI). ATI Advisory and LTQA's report, "An Evaluation Framework for Assessing the Progress of Nonmedical Supplemental Benefit Development and Implementation in Medicare Advantage," supported by The SCAN Foundation, dives into the significant growth of these benefits, including in-home support services, food, and transportation to address health-related social needs (#HRSNs). Despite the growth, better data on access, utilization, and outcomes is crucial to understand their true impact on #Medicare beneficiaries' health and wellbeing. As policymakers and stakeholders navigate this evolving landscape, this report is a critical resource for enhancing these essential benefits. Read the full publication: https://lnkd.in/dHChUjF5 ATI Advisory, The SCAN Foundation
- Certifi, Inc The Medicare Advantage (MA) market, while experiencing significant growth, is facing increasing headwinds. The Medicare Hospital Insurance (HI) trust fund is projected to be depleted by 2036, prompting potential government intervention in the form of increased taxes or reduced payments to providers and health plans. To navigate these challenges, health plans should focus on several key strategies: - Product Optimization and Portfolio Management - Tailored offerings: Develop products that resonate with specific member segments, focusing on key factors like price, network, pharmacy benefits, and supplemental offerings. - Profitable growth: Analyze product performance to identify high-performing segments and adjust the product mix accordingly. The $0 PPO product has been particularly successful, but profitability should be carefully monitored. - Network expansion: Offer broader networks to compete with HMO plans, especially considering consumer preference for choice and flexibility. Learn more: https://hubs.ly/Q02JhGFm0
- Argentum Advocates Argentum applauds Health Affairs for publishing this important article by such an esteemed team of researchers, which underscores the critical role private capital investment plays in ensuring access to high-quality assisted living options for our nation's seniors. The authors’ findings support our long-held position that private investment in assisted living is distinct from investment in other healthcare providers. Assisted living primarily operates as a private pay model, unlike healthcare entities that are reliant on Medicare, Medicaid and commercial health insurance reimbursements. This model reduces the incentive to cut costs at the expense of quality, because assisted living communities compete to attract residents by offering high quality care and services that align with consumers’ preferences. Key points from the op-ed include: · There is no evidence to date that PE investment in assisted living negatively impacts resident care. · PE firms can provide capital, technological advancements, and operational innovations to assisted living communities, potentially improving efficiency and quality. The emphasis on building a strong brand and reputation encourages maintaining high standards of care. · Unlike PE investments in other healthcare sectors that often involve direct management, PE investment in assisted living is more analogous to real estate investment. The management and daily operations are almost always handled by separate entities, which stands in contrast with PE involvement in ambulatory settings and nursing homes, where firms have become directly involved in operations. That involvement has sometimes resulted in observed changes in care delivery. · Policymakers should pause and consider the unique structure, financing and history of assisted living before applying the same scrutiny and regulation as other healthcare sectors, stressing that it would be premature to assume that examples of PE acquisitions in other healthcare sectors, including nursing homes, is directly applicable to assisted living. Importantly, the study highlights the lack of federal investment in assisted living infrastructure, meaning private investment is crucial for the continued existence and growth of this vital care option. The assisted living care setting exists solely because of private investment. Given our rapidly aging population, assisted living providers will need access to capital—including capital from PE. As the authors suggest, “if implemented, the policies currently being proposed as solutions to PE investment in other healthcare settings may compromise that access. In so doing, such policies could have profound unintended consequences —all without critical nuance or basis in evidence.”
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