20 May Health Data News Roundup: IMAT Featured in Gartner CDI Report; Fixing Prior Authorization; and UnitedHealth Comfortable with Medicare Advantage

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.

IMAT Solutions Named in Gartner® How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability
IMAT Solutions was recently named in the Gartner report: “How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability.” You can download the full Gartner report here.

Pre-Approval Plan Proposed for Medicare Advantage Insurers
Medicare Advantage (MA) insurers that impose prior authorization requirements on doctors in accountable care organizations (ACOs) should have to get them pre-approved by CMS, Sen. Sheldon Whitehouse (D-R.I.) recently stated.

Fixing Prior Authorization: Clear Up What’s Required and When
Prior authorization is overused, and existing processes present significant administrative and clinical concerns. That is why fixing prior authorization is a critical component of the AMA Recovery Plan for America’s Physicians, as the AMA states here.

UnitedHealth ‘Really Comfortable’ with Medicare Advantage
UnitedHealth Group executives said they’re not planning any major shakeups to their Medicare Advantage business as other insurers plan to pull back their offerings in 2025, as highlighted in a recent investor presentation.

RAND: Hospital Prices 254 Percent Higher Than Medicare Rates
Employers and private payers pay significantly more for hospital-based services compared to Medicare, according to a new study from RAND Corporation that has hospitals riled up.

CMS Extends Waivers for the Medicaid Unwinding Process Again
CMS has extended the Medicaid unwinding waivers that it previously extended in December 2023, according to an informational bulletin from the agency.

PODCAST: Dan Trejo, AVP Sales for Payer Solutions at IMAT, Discusses How Health Payers Can Pivot Towards Value-Based Care
In our sixth episode of the Advancing Healthcare Through Data podcast series, Dan Trejo, AVP Sales for Payer Solutions at IMAT, discusses how IMAT can help health payers pivot towards value-based care.