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For Medicare Advantage (MA) plans, stricter quality thresholds from CMS continue to raise the bar for star ratings, making it harder for plans to achieve high scores. In 2025, the average MA Star Rating dropped from 4.07 in 2024 to 3.92, continuing a three-year downward trend. Additionally, only 40%...
13 Feb, 2025
As healthcare payers face increasing operational complexities and heightened member expectations, technologies like AI, data analytics, and core system modernization have become crucial areas of investment. Gartner’s 2025 CIO Agenda for Healthcare Payers: Insights for Strategic Planning* provides ac...
6 Feb, 2025
The coming evolution of Centers for Medicare & Medicaid Services (CMS) Star Ratings marks a fundamental change that demands immediate attention from Medicare Advantage (MA) plans. With an increased focus on clinical performance, beneficiary experience, and equitable care outcomes, the upcoming chang...
22 Jan, 2025
Artificial intelligence (AI) has undeniably become a game-changer in various aspects of healthcare, offering unprecedented efficiency and speed. Among its many applications, AI holds significant potential in streamlining the claims denial and prior authorization processes that healthcare payers mana...
14 Jan, 2025
The health payer industry continues to undergo a seismic shift, driven by evolving customer expectations, regulatory demands, and the rapid advancement of technology. For CIOs, 2025 represents a pivotal year to align their strategic priorities with these trends, ensuring their organizations stay com...
30 Dec, 2024
NEWPORT BEACH, Calif., December 10, 2024 – Vital Data Technology, a leading provider of AI-driven health data analytics and medical management solutions for health plans, announced an agreement with Mid-State Health Network (MSHN) to provide predictive data models as part of a grant from the Michiga...
10 Dec, 2024