Revenue Cycle and Payer News – July 23, 2025

CareSource Georgia collaborates with Georgia Family Connection Partnership to improve maternal and infant health across rural Georgia
CareSource Georgia, a nonprofit managed care organization, has announced a collaboration with Georgia Family Connection Partnership (GaFCP), an organization that brings local and state-level leaders, and resources together to improve the well-being of children and families. CareSource awarded GaFCP a $100,000 grant to improve maternal and infant health outcomes in rural Georgia through technology-driven engagement and community-based collaboration.

Aeroflow Health Announces Virtual Nutrition Services are Now Available to Cigna Patients Across the Country
Aeroflow Health, a pioneering healthcare company that leverages cutting-edge technology to support the delivery of medical products and services, announced the nationwide partnership with health insurance provider, Cigna, to provide patients with nutrition services via telehealth with qualified dieticians to utilize food to improve overall health.

Humana Accelerates Efforts to Eliminate Prior Authorization Requirements to Ensure a Faster, More Seamless Process
Humana Inc., a health and well-being company, announced accelerated efforts to approve care requests as quickly as possible and reduce the administrative burden for physicians associated with prior authorization. These actions will reduce the number of prior authorization requirements and make the process faster and more seamless, while preserving the system of checks and balances that protects patient safety by ensuring the most high-cost, high-risk treatments are reviewed and approved before care is delivered.

Peach State Health Plan’s $27.7M Investment Shows Strong Commitment to Member Wellness
Peach State Health Plan (PSHP) has invested $27.7 million in additional Medicaid benefits from 2022 through 2024. Known as Value-Added Benefits (VABs), this includes services and activities designed to encourage healthy behaviors, strengthen care connections, and improve overall access to support. They are meaningful, real-life resources that help the health plan’s most vulnerable members stay covered, well, and supported. Some restrictions and limitations may apply.

Philadelphia Phillies and Independence Blue Cross team up to launch new community support program
The Philadelphia Phillies and Independence Blue Cross (IBX) announce an exciting new phase of their decades-long partnership focused on giving back to communities across our region. Phillies and IBX Give Back is a year-long series of monthly volunteer and community engagement initiatives highlighting both organizations’ commitment to fostering connections, supporting health and well-being, and strengthening our region through volunteerism. The Police Athletic League (PAL) of Philadelphia is the first beneficiary of Phillies and IBX Give Back with IBX associates, Phillies front-office staff, and the community all invited to participate in a toy drive.

Blue Cross and Blue Shield of New Mexico Celebrates 85 Years of Service
This year marks a significant milestone for Blue Cross and Blue Shield of New Mexico as it celebrates its 85th anniversary. For over eight decades, BCBSNM has been dedicated to enhancing the health and well-being of New Mexicans with programs and services that have positively impacted communities across the state, including:

Humana Simplifies Access to Coverage and Care Information
Humana Inc. announced its latest collaboration with healthcare software company Epic, becoming the first health insurer to integrate health plan information directly into the MyChart accounts patients may already use with their healthcare providers.

Independence Blue Cross Post-Acute Care Program improves recovery outcomes, lowers costs, and earns national BCBSA award
Independence Blue Cross (IBX) is helping to improve recovery outcomes for its Medicare Advantage members after they leave the hospital and reduce costs with its Post-Acute Care Program. The program combines predictive analytics, proactive case management, and a focus on home-based recovery, to ensure members receive the right care at the right time after a stay at the hospital.

One Big Beautiful Bill Act brings sweeping changes to health coverage by HealthInsurance.org – The One Big Beautiful Bill Act (OBBBA) – or H.R. 11 – has set the stage for sweeping changes to U.S. health coverage, many of which won’t take effect until 2027 or later. But some changes are happening much sooner – starting right now, later in 2025 and early 2026 – and will significantly impact Medicaid enrollees, Marketplace consumers, and low-income immigrants.

The pediatric health system’s second medical dog, Ina, is made possible by a gift from Medica to the mental health and medical dog programs – Children and adolescents receiving acute mental health care at Children’s Minnesota have a new four-legged expert on their care team. Medical dog Ina recently joined the team in the pediatric health system’s inpatient mental health and partial hospitalization programs thanks to a three-year, $350,000 gift from Medica, a non-profit community driven health plan headquartered in Minnesota.

AHIP / Optum
When: Tuesday, July 29, 2025  1:00 pm ET
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LinkedIn: AHIP

Join this session to discover how to streamline the medical review process for Medicare beneficiaries while ensuring adherence to the latest CMS regulations. We’ll provide an overview of Medicare Content Navigator and InterQual® Transparency, which are designed to help you align with the Medicare Advantage final rule (CMS-4201-F). You’ll also get an exclusive sneak peek of the InterQual team’s product development initiatives that will support compliance with the CMS Interoperability and Prior Authorization final rule (CMS-0057-F), effective January 1, 2026.

AHIP / ProviderTrust
When: Tuesday, August 12, 2025  12:00 pm ET
Register for this event.
LinkedIn: AHIP

This webinar will unpack the key areas where credentialing processes will need to change, offering digestible explanations and concrete ways to meet the new guidelines. After we diving deeper into the guidelines, we’ll wrap up with a high-level view of DynamicNPI, our data-forward solution designed to help payers easily meet and exceed the NCQA guidelines while improving the quality of their provider data.