01 Apr Health Data News Roundup: New ACO Payment Model; Most Innovative Health Payers; and Carequality Celebrates 10th Anniversary

Welcome to the Health Data Weekly News Roundup from IMAT Solutions. As the power of data continues to grow in the healthcare arena, today’s care organizations need to be on the forefront of all news and trends to help ensure that their data analytics efforts deliver accountable and informed care. Each week, we will provide you with the actionable news you need to meet these goals.

Carequality Interoperability Network Celebrates 10 Years of HIE
Carequality, a national interoperability trusted exchange framework for health information exchange (HIE), is celebrating its tenth anniversary since The Sequoia Project, a nonprofit advocate for nationwide HIE, first launched the initiative.

Medicare Debuts Another Primary Care-Focused Accountable Care Model
Medicare launched another ACO payment model that would pay organizations that participate in Medicare’s Shared Savings Program a monthly fee that would be distributed to the ACO’s primary care practices.

Primary Care Delivery is Similar Across All Medicare Patient Mixes
Care delivery, care coordination, and administrative challenges were similar across primary care physicians serving traditional Medicare patients and those serving Medicare Advantage patients, a Commonwealth Fund brief found.

CMS Final Rule Aims to Simplify Medicaid, CHIP Enrollment, Coverage
A new CMS final rule, the “Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” rule, aims to modernize and optimize the Medicaid enrollment process.

Medicare Advantage Plan Challenges Star Ratings Methodology
A Medicare Advantage insurer facing termination of one of its contracts from the program is suing CMS over the methodology it uses to calculate star ratings. In its complaint, the company alleged CMS made a “serious error” in calculating its star rating for 2024.

The Six Most Innovative Health Payers
Out of the 200 companies named by Fortune as the most innovative in 2024, six are health insurers. Humana, UnitedHealth Group, Cigna Group, Elevance Health, Health Care Service Corp. and Centene all made the list.

Health Equity Investment Slated to Continue Into 2024
Health equity efforts will almost certainly maintain their pace over the next year, as healthcare leaders assert that equitable care and closing of heath disparities is a social, ethical, and political priority, according to a new report.