Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • House Republicans Propose Two New Bills to Replace ACA

    March 7, 2017 - On Monday, the House Ways and Means Committee and the House Energy and Commerce Committee proposed two bills that together will effectively repeal and replace the Affordable Care Act. Combined the bills comprise the American Health Care Act. Chairman Kevin Brady (R-TX) of the Ways and Means Committee released a bill that aims to dismantle ACA individual mandates and taxes, expand Health Savings...

  • AHA Questions CMS Medicare Advantage Risk Score Calculation

    March 6, 2017 - The American Hospital Association (AHA) has voiced concerns about the methodology the Centers for Medicare & Medicaid Services (CMS) intends to use to calculate risk scores for health plans under the Medicare Advantage and Part D prescription drug benefit programs in 2018. Last week, the association issued a written response to the federal agency’s 2018 Advance Notice and Draft Call...

  • Social Determinant Data Key to Successful Risk-Based Contracts

    February 28, 2017 - From bundled payment models to capitated healthcare payments, payers implement risk contracts to financially motivate providers to target high-cost and high-utilization patient populations to reduce overall healthcare costs. But increasing payer access to social determinant data is the key to creating more successful risk contracts, Jennifer Daley, MD, a Market Medical Executive at Cigna,...

  • Aetna, Humana Terminate Merger Deal After Court Defeat

    February 14, 2017 - Aetna and Humana have scrapped their merger plans after the Department of Justice blocked the deal due to antitrust concerns.  Aetna will pay Humana a $1 billion termination fee, included as part of the original agreement. The DOJ lawsuit, along with increased opposition from medical and political organizations, helped to end the merger. A class-action shareholder lawsuit followed the...


Today's Top Stories

Can Value-Based Purchasing Work with Pharmaceutical Companies?

The Network for Excellence in Health Innovation (NEHI) believes that developing value-based purchasing contracts between payers and pharmaceutical companies will be a critical next step for healthcare reform. Having payer and pharma companies...

Payers Face 9.6% Underwriting Loss on Health Insurance Exchange

Underwriting margins for payers selling individual plans on the health insurance exchange dropped from a 6 percent earned premium loss in 2014 to a 9.6 percent loss in 2015, Milliman recently reported. The financial losses stemmed from the Affordable...

House Reps Add Amendments to the American Health Care Act

House Republicans recently added 21 pages of  updates and changes to the American Health Care Act (AHCA) to push forward the potential Affordable Care Act (ACA) repeal and replace bill. Many of the legislation’s changes would make...

APMs, Health Data Exchange among Top Payer Reform Goals

The National Academy of Medicine (NAM) offered policymakers and stakeholders healthcare reform priorities, including alternative payment models (APMs) and health data exchange, that aim to lower overall healthcare costs and improve patient...

Out-Of-Pocket Healthcare Spending on the Decline Since 2000

The Agency for Healthcare Research and Quality (AHRQ) reported that out-of-pocket healthcare spending decreased for all age groups between 2000 and 2014. A statistical brief of the report presents data from the Household Component of the Medical...

HHS Launches Webpage Detailing ACA Repeal Actions

HHS created a new online resource that highlights the regulatory and administrative actions the federal department has taken for an Affordable Care Act (ACA) repeal. HHS believes that these actions are necessary to relieve burdens of the...

HFPP Provides New Resource for Payers to Combat Opioid Abuse

A new 64-page report from the Healthcare Fraud Prevention Partnership (HFPP), a public-private partnership which includes CMS, gives payers resources that treat, educate, and develop improvements for combating opioid harm to patients. CMS has...

View all stories

X

Sign up for our free newsletter:

Our privacy policy

no, thanks