Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

HealthPayerIntelligence News

Kansas Lawmakers Vote for Medicaid Expansion Under the ACA

by

Kansas state lawmakers in the House and Senate have voted to approve Medicaid expansion under the Affordable Care Act, although the bill still faces the prospect of a veto from Governor Sam Brownback.   The 25-14 Senate vote on the Bridge...

GAO Report: VA Benefits Appeals Process in Need of Reform

by

The Government Accountability Office (GAO) has identified notable inefficiencies in the VA benefits appeals process which have resulted in an average processing wait time of three years.   In its report on the issue, GAO also makes several...

Medicare Limitations on Diabetes Supplies Endanger Patients

by

Medicare’s Competitive Bidding Program (CBP) may increase the risk of negative patient safety events or medication nonadherence for diabetics by limiting the variety of available diabetes testing supplies, finds a survey by the American...

Anthem Appeals Cigna Merger with Cost, Quality Arguments

by

Anthem has opened an appeal in the U.S District Court citing opportunities for increased consumer savings and quality of care weeks after the DOJ blocked its planned merger with Cigna. Anthem argued that the DoJ’s ruling neglected a possible...

House Votes to Boost Health Insurance Options for Businesses

by

The House of Representatives has voted 236-175 to move the Small Business Health Fairness Act of 2017 to the Senate in an effort to increase health insurance options for small businesses. The Act is designed to promote the growth of Association...

House GOP Leaders Pull American Health Care Act Before Vote

by

Before it could reach the House of Representatives for a vote, Republican party leaders pulled the American Health Care Act (AHCA). Because lawmakers could not agree on the structure or substance of the conservative healthcare framework, the...

Can Value-Based Purchasing Work with Pharmaceutical Companies?

by

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

by

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

by

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

by

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

by

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

by

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

by

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...

AHA Urges D.C Appeals Court to “Uphold Cigna-Anthem Ruling”

by

The American Hospital Association (AHA) released a public document urging the U.S Court of Appeals in Washington D.C, to affirm the block on the Cigna-Anthem merger. In an amicus barae, the AHA outlined various antitrust violations and inhibitions...

Healthcare Leaders Air Concerns about NQF SDS Trial Period

by

A group of healthcare organizations wrote a letter to the National Quality Forum (NQF) calling for a one-year extension of the Sociodemographic (SDS) Trial Period that evaluates how social factors impact a hospital's or provider’s ability...

Emergency Coverage Top Healthcare Consumer Demand For Payers

by

A new poll from the American College Of Emergency Physicians (ACEP) and Morning Consult found that 95 percent of healthcare consumers say payers should cover emergency services. Out of the 1,791 healthcare consumers surveyed, about 31 percent...

Patient Satisfaction Key for Payer Measurement of ACO Quality

by

An article from the American Journal of Managed Care reveals that patient satisfaction within an accountable care organization (ACO) is a strong indicator of the care quality level the organization delivers, giving payers an opportunity to use...

2017 ACA Open Enrollment Data Shows 12.2M Marketplace Signups

by

During the 2017 ACA Open Enrollment Period (OEP), more than 12.2 million healthcare consumers purchased or renewed insurance through Healthcare.gov or their local state exchanges, said CMS in a new data brief.   Marketplace consumers either...

Price, Verma Push for Better State Control of Medicaid Programs

by

As one of her first actions as CMS Administrator, Seema Verma collaborated with the Department of Health and Human Services (HHS) Secretary Tom Price to detail how the federal government plans to improve its state partnerships to enhance state...

Tom Price: American Health Care Act CBO Score is Inaccurate

by

HHS Secretary Tom Price, MD, released a statement that decried several findings from the Congressional Budget Office’s (CBO) score of the American Health Care Act (AHCA). The CBO estimates that over 14 million Americans will lose health...

X

Sign up for our free newsletter:

Our privacy policy

no, thanks