06 Mar Health Data News Roundup: Payers and Prior Authorization Proposed Rule; Blue Cross MN Focuses on Rural Members; and Humana to Focus on Public Plans

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.

What the Prior Authorization Proposed Rule Means for Payers
The CMS Advancing Interoperability and Improving Prior Authorization Processes proposed rule introduces new requirements for healthcare payers that aim to enhance patient data sharing and streamline the prior authorization process.

CareSource, Walmart Partner to Address Racial Health Disparities
CareSource has partnered with Walmart to address maternal and racial health disparities in underserved communities by leveraging the retail giant’s in-store community health workers.

Blue Cross MN Partnership Expands Value-Based Care for Rural Members
Blue Cross and Blue Shield of Minnesota (Blue Cross) has joined forces with value-based care provider Homeward to expand access to care for Medicare Advantage members living in rural Minnesota communities.

Humana Will Leave Employer Group Insurance Business to Focus on Public Plans
Humana has announced plans to leave the employer group insurance business and direct its focus toward its government-funded health plan offerings, including Medicare Advantage, Group Medicare and Medicare Supplement.

Value-Based Health Care at an Inflection Point: A Global Agenda for the Next Decade
After more than a decade of extraordinary progress, the international movement for value-based health care needs to embrace a new strategic ambition, according to this recent New England Journal of Medicine article.

Kaiser’s Health Plan Grows to 12.6 Million Members
Kaiser Foundation Health Plans, part of Oakland, Calif.-based Kaiser Permanente, added 36,000 members in 2022, putting it at more than 12.6 million members nationwide.

Alignment Healthcare Nears 100K Members
Alignment Healthcare is nearing 100,000 members, and its CEO is pushing the Medicare Advantage company to earn at least four and a half stars from CMS across all its markets.