07 Oct Health Data News Roundup: Top Quality Measures Trends; Providers Say Claims Denials Are Increasing; and Manifest MedEx Progress

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.

Top Health Insurance Trends Based on Quality Measures
The 2024 NCQA Health Plan Ratings revealed quality measure performance trends that could guide payers’ decisions on major topics like health equity and diabetes care going forward, according to this recent Health Payer Intelligence article.

Survey: Providers Say Claims Denials Are Increasing
Providers’ struggles with claims denials have worsened compared with two years ago in 2024 — prior authorizations and missing or inaccurate data were the leading reasons — according to Experian Health’s 2024 State of Claims survey released last week.

Premera Blue Cross Exits Medicare Advantage
Premera Blue Cross will no longer offer Medicare Advantage plans in 2025. The exit was driven by “changing market conditions and financial pressures,” according to Becker’s Payer Issues.

Q&A: Manifest MedEx CEO Erica Galvez on California’s Interoperability Progress
Erica Galvez is CEO of Manifest MedEx, the largest nonprofit health data network in California and one of nine Qualified Health Information Organizations under the state’s new Data Exchange Framework, shares her insights on interoperability progress in this Healthcare Innovation Q&A.

Epic Calls on Carequality to Release Particle Dispute Resolution
Responding to an antitrust lawsuit the company faces from Particle Health, Epic Systems is asking the Carequality interoperability network to share some further information about the dispute, according to Healthcare IT News.

Employer Health Plan Costs to Rise 5.8 Percent in 2025
Despite inflation cooling down, employer health plan costs are heating up, according to the 2024 National Survey of Employer-Sponsored Health Plans, which includes data from more than 1,800 US employers.