22 Jan Health Data News Roundup: CMS Prior Authorization Final Rule; Hospitals and Medicare Advantage; and UnitedHealth Group Achieves Double-Digit Growth

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.

CMS Releases Interoperability and Prior Authorization Final Rule
Under this final rule released last week, impacted payers will be required to send prior authorization decisions within 72 hours for urgent requests and seven calendar days for standard requests.

Hospitals Aren’t Breaking Up With Medicare Advantage, According to UnitedHealth
Though some contract negotiations with providers came “down to the wire” last year, UnitedHealthcare executives said the payer did not see more contract splits than usual in 2023.

CMS Finalizes Payer Requirements to Streamline Prior Authorization
CMS has finalized requirements for payers to streamline the prior authorization process and improve the electronic exchange of health information to help limit patient care disruptions.

States Leverage Waivers To Support Medicaid Redetermination
States flocked toward ex parte renewals and contact information update waivers to support Medicaid redetermination processes after the coronavirus public health emergency ended, a KFF brief found.

What Utilization Management Strategies Do Payers Use to Lower Costs?
Utilization management strategies aim to lower healthcare costs and prevent low-value care but can have unintended consequences for patients, according to this recent Health Payer Intelligence.

Underserved MA Beneficiaries Opt for Plans with Supplemental Benefits
Black Medicare Advantage beneficiaries and those with lower income or educational attainment were more likely to choose health plans that include supplement benefits, such as dental and vision coverage, according to a new study.

UnitedHealth Group Posts $5.5B Profit in Fourth Quarter
UnitedHealth Group recorded double-digit growth in revenue year over year across its core lines of business at UnitedHealthcare and Optum, according to the company’s fourth quarter earnings report released January 12.