Author: DesignWorks

13 Mar Health Data News Roundup: Providers and 2024 Medicare Advantage Rates; NCQA Recognizes UnitedHealthcare; and Interoperability Progress Report

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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. Providers Join Payers in Urging CMS to Halt Proposed...

09 Mar Delivering Critical Health Data Infrastructure for Provider-Sponsored Health Plans

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Rise of Value-Based Care Models Advancing Need for Better Financial Performance With today’s providers realizing that additional revenue streams are needed in the face of the rise of value-based care, many are considering launching their own Provider-Sponsored Health Plans (PSHP). PSHPs are health insurance companies owned by a health system, physicians group, or a hospital. The model encompasses the entirety of the continuum of care, from funding to care delivery, as well as connecting the payer and...

06 Mar Health Data News Roundup: Payers and Prior Authorization Proposed Rule; Blue Cross MN Focuses on Rural Members; and Humana to Focus on Public Plans

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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. What the Prior Authorization Proposed Rule Means for Payers The...

02 Mar How Health Payers Can Achieve True Digital Optimization in 2023

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Healthcare payers must continually evolve digital capabilities in line with ever-changing business requirements, which can be achieved through continual IT optimization strategies. .ytvideo { aspect-ratio: 16 / 9; width: 100%; } While many payers are beginning to make strides in implementing digital-first member services, many are challenged with compliance hurdles, economic uncertainty and expanded expectations for enhancing overall member care. These are the key highlights of Gartner’s “Healthcare and Life Science Digital Optimization and Modernization Primer for...

27 Feb Health Data News Roundup: Medicare Advantage Enrollment at 31 Million; ONC and Clinical Decision Support; and UnitedHealth Closes LHC Group Merger

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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 Data: Medicare Advantage Enrollment Now More Than 31 Million Enrollment...

22 Feb Helping Health Payers to Reimagine How They Do Business

Posted at 09:00h in Payers, Uncategorized by DesignWorks 0 Comments

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As with any industry sector these days, the U.S. health payer arena faces some significant challenges from unlikely players. For example, technology giant Amazon, CVS Health, Walgreens, and other retailers are becoming healthcare industry staples, and a significant competitive threat. In fact, in an effort to eliminate administrative complexities in healthcare, Amazon aims to be the first claims-free payer by 2026. In addition, many payers still rely on cumbersome legacy processes in the face of rising regulatory...

20 Feb Health Data News Roundup: Health Payers and IT Modernization; Humana and BCBS Health Equity Efforts; and Cigna Launches Rebrand

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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. The Role of Medicaid Managed Care Organizations in the...

15 Feb Supporting Innovative Health Data Exchange Efforts in California

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The IMAT Data-as-a-Service (DaaS) Offering Enables Comprehensive Source Interoperability for Meeting 2024 Deadline Late last year, the State of California introduced its California Health and Human Services Agency (CalHHS) Data Exchange Framework to support statewide implementation among healthcare and human services organizations. With $50 million allotted, this effort mandated the signing of a data-sharing agreement to expand the exchange of health information among health care entities, government agencies, and social service programs beginning in 2024. To date, more...

13 Feb Health Data News Roundup: Future of Medicare Advantage Risk Adjustment Data Validation; Quality of Care When Assess Plans; and California Health Data Exchange News

Posted at 09:00h in Payers by DesignWorks 0 Comments

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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. Medicare Advantage Plans Rejected 2M Prior Authorization Requests in...

08 Feb How Clinical Health Data Can Help Life Insurance Providers

Posted at 19:21h in Uncategorized by DesignWorks 0 Comments

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In the life insurance sector, actuaries play a critical role in leveraging statistical analysis for developing annuity and life insurance policies for individuals and groups. This involves analyzing and estimating how long someone is expected to live, based on a wide-range of factors – with the goal of minimizing the risk for the life insurance provider. When it comes to analyzing the health of a potential new policyholder, life insurance actuaries typically leveraged data from health...