12 Aug Health Data News Roundup: CMS Proposed ACO Advance Payment Policies; Members Rarely Challenge Coverage Denials; and BCBS Louisiana Rebrands

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.

Members Rarely Challenge Coverage Denials, Surprise Billing
Despite efforts to reduce surprise billing, many Americans still receive unexpected bills or coverage denials and need better health literacy to challenge them, according to an issue brief from Commonwealth Fund.

Medicare Advantage Insurers Ranked by Prior Authorization Denial Rates
Medicare Advantage insurers denied 7.4 percent of prior authorization requests in 2022, according to data published by KFF based on data submitted to CMS by Medicare Advantage insurers in 2022.

How CMS Proposed ACO Advance Payment Policies Could Impact Palliative Care
The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed a new avenue of funding for Accountable Care Organizations (ACOs) with implications for palliative care providers, according to this recent Hospice News article.

LOINC Update Seeks to Advance Semantic Interoperability
Regenstrief Institute has announced its semiannual content update for the Logical Observation Identifiers Names and Codes data standard with the latest release including nearly 3,000 terminology updates across various domains, including social determinants of health (SDOH), diagnostics and public health reporting.

10 High-Value Use Cases for Predictive Analytics in Healthcare
Predictive analytics can support population health management, financial success, and better outcomes across the value-based care continuum, and here are 10 high-value use cases from Tech Target.

Novel AI Model May Enhance Health Data Interoperability
An AI model developed by Northwestern Medicine investigators improved the transformation of EHR data into standardized health resources more efficiently than current methods, according to a recent study published in the journal NEJM AI.

BCBS Louisiana Rebrands
Blue Cross Blue Shield of Louisiana will rebrand as Louisiana Blue. The BCBS affiliate will keep Blue Cross Blue Shield of Louisiana as its formal name, but use Louisiana Blue in marketing, promotions and public-facing material.