Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • Patient Wait Times Still High at Veterans Health Administration

    August 26, 2016 - While there have been few major problems within the federal Medicare program that have led to any defamation of the federal agency, Veterans Affairs and, specifically, the Veterans Health Administration often has had its fair share of critics. Often, the VA is cited for having long wait times and failing to provide care and coverage for the country’s veterans. Two years ago, the Veterans...

  • Did Aetna Need Merger to Stay in Health Insurance Exchanges?

    August 24, 2016 - More and more payers are slowly dropping out of the Affordable Care Act’s health insurance exchanges. Earlier this year, UnitedHealth formally announced the decision to discontinue selling plans on the health insurance exchanges. More recently, one of the country’s largest payers - Aetna - also declared that, next year, it will be pulling out of most of the exchanges it has been...

  • How Risk Adjustment Challenges the Health Insurance Market

    August 23, 2016 - Ever since the provisions of the Patient Protection and Affordable Care Act came into effect on January 1, 2014, healthcare payers have been unable to deny health insurance or charge larger premium costs to those with pre-existing conditions. Along with the public health insurance exchanges, patients with pre-existing conditions have a much easier time affording coverage today. However, other...

  • Cigna Boosts Outcomes Despite Affordable Care Act Obstacles

    August 18, 2016 - With many health payers experiencing significant challenges while operating through the health insurance exchanges and adhering to various provisions of the Patient Protection and Affordable Care Act, it grows more important than ever before to address what some payers are doing right in the turmoil as the country transitions to new forms of payment and coverage expansions. With Aetna and...


Today's Top Stories

Prescription Drug Medical Costs Less Problematic due to ACA

Recently, criticism popped up against the pharmaceutical company Mylan from the Hillary Clinton presidential campaign for its significant price increase for the life-saving EpiPen product. The EpiPen is vital in an emergency when a person who...

Patient Wait Times Still High at Veterans Health Administration

While there have been few major problems within the federal Medicare program that have led to any defamation of the federal agency, Veterans Affairs and, specifically, the Veterans Health Administration often has had its fair share of critics....

Top 3 Ways Payers and Providers Can Reduce Claim Denials

When it comes to medical claims management, healthcare payers and providers will need to communicate more effectively so that both parties are on the same page when it comes to claim denials. Healthcare payers should know that communication is...

Two Contrasting Opinions on Accountable Care Organizations

The Patient Protection and Affordable Care Act isn’t merely responsible for creating health insurance exchanges, eliminating pre-existing conditions or even expanding the Medicaid program. The Affordable Care Act also helped build the Medicare...

CMS Bundled Payment Models Address Cardiac Care, Hip Surgeries

The Centers for Medicare & Medicaid Services (CMS) have recently begun implementing additional alternative payment models centered on episodes of care. CMS has proposed new rules for managing the costs of care and coordination among Medicare...

Did Aetna Need Merger to Stay in Health Insurance Exchanges?

More and more payers are slowly dropping out of the Affordable Care Act’s health insurance exchanges. Earlier this year, UnitedHealth formally announced the decision to discontinue selling plans on the health insurance exchanges. More recently,...

UnitedHealth’s Value-Based Care Reimbursement Improves Outcomes

Value-based care reimbursement has been hitting both payers and providers as a surefire way to promote payment reform and reduce medical spending. The new models of payment are coming straight from public payers including the Centers for Medicare...

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