11 Nov Health Data News Roundup: Market Share of Leading Payers; More Medicare Advantage Lawsuits; and Addressing TEFCA Misconceptions

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.

Market Share of Leading Health Insurance Companies in the United States
In 2022, UnitedHealth Group Inc was the market leader and had a 14 percent share of the U.S. health insurance market. Elevance Health and CVS (Aetna) followed with a market share of 12 percent and 11 percent, respectively, according to this Statistica analysis.

California Report Assesses Data-Sharing Landscape for Community-Based Providers
A new study has found that although California’s state agencies have created robust IT systems that serve as the system of record for community-based service providers, those systems do not readily interface with EHRs to facilitate cross-sector care coordination.

Elevance Health Sues HHS Over Medicare Advantage Star Ratings
Elevance Health is the latest in a parade of health payers suing HHS over its 2025 Medicare Advantage star ratings — alleging federal regulators used an “arbitrary and capricious” method to calculate the quality scores.

ACA Open Enrollment For 2025: What You Need to Know
CMS recently shared its approach to ACA open enrollment for the 2025 enrollment season and how any adjustments aim to benefit consumers, and is continuing many of the strategies that have worked in the past and returning to some previously successful approaches.

TEFCA is Live – Clarifying Common Misperceptions from eHealth Exchange
Jay Nakashima, President at eHealth Exchange, addresses some of the most common misperceptions about TEFCA, in this recent Healthcare IT Today guest article.

Medicaid Redeterminations Hurt Payer Profits
Insurance companies are cutting earnings expectations following Medicaid redeterminations, according to this recent Healthcare Brew analysis that shines a light on this challenge for payers.