Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

Did the Affordable Care Act Lower Medicare Spending?

by Vera Gruessner

The Affordable Care Act and other regulatory changes were meant to reform the healthcare industry and save costs on wasteful spending. Recent results coming from the Department of Health and Human Services (HHS) show that the Affordable Care...

Long-Term Care has a Shorter Time Frame Due to ACA, CMS

by Vera Gruessner

The Affordable Care Act has impacted a variety of aspects of the health insurance landscape as well as the healthcare delivery system. The Patient Protection and Affordable Care Act also led to the Center for Medicare & Medicaid Innovation...

How the Affordable Care Act Impacts First Quarter Earnings

by Vera Gruessner

The health insurance industry has had a topsy turvy time learning how to function effectively in the new landscape the Affordable Care Act has brought to the medical field. When it comes to the financial well-being of top payers, the Affordable...

How the ACA Increased Enrollment in Medicaid and CHIP Programs

by Vera Gruessner

Last Friday, the Centers for Medicare & Medicaid Services (CMS) released a report covering the state Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment data for the month of February. This type of information...

State Medicaid Expansion Should Reduce Emergency Room Visits

by Vera Gruessner

The Patient Protection and Affordable Care Act brought a variety of changes for the healthcare industry as well as individual states. For example, the Affordable Care Act called on for Medicaid expansion among the 50 states. However, a Supreme...

Consumer Engagement Vital in Health Insurance Exchanges

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a variety of changes for both insurers and healthcare providers with the establishment of health insurance exchanges holding a top place in reforming reimbursement between payers and...

CMS Rule Renovates Coverage beyond ACA’s Medicaid Expansion

by Vera Gruessner

The Medicaid program has greatly changed since the passage of the Obama administration’s Affordable Care Act. Most importantly, more than half of the states throughout the nation have implemented Medicaid expansion, which means that more...

40% Health Plans Sold via Health Insurance Marketplace Overlap

by Vera Gruessner

Various health plans sold through the health insurance marketplace may actually overlapped with Medicaid coverage. The Association for Community Affiliated Plans (ACAP) released a study that shows about 40 percent of issuers providing Qualified...

64% of Polled Doctors Plagued by Rising Medical Spending

by Vera Gruessner

The health insurance industry needs to continue addressing rising healthcare costs and the increases in spending among hospitals and the pharmaceutical field. Many stakeholders within the healthcare space find that high rates of medical spending...

How the Affordable Care Act Strengthened Mental Health Parity

by Vera Gruessner

The Obama administration's Affordable Care Act has brought various benefits to the American people including greater health coverage through the health insurance exchange and Medicaid expansion. Young adults under 26 years of age can now...

Consumer Education Key for Health Insurance Marketplace Success

by Vera Gruessner

It seems that those residing in Texas who have purchased their healthcare coverage through the health insurance marketplace do not have as much understanding of certain terms as those who have medical insurance through their employer or via Medicaid...

CMS Ruling Changes Medicare Advantage and Part D Programs

by Vera Gruessner

Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced in a press release new changes taking place for the Medicare Advantage and Part D Prescription Drug Program starting in 2017. Essentially, these deviations are meant...

How the Affordable Care Act has Impacted Health Payers

by Vera Gruessner

The Affordable Care Act has  brought a significant reform toward the health insurance industry. This particular legislation has given the majority of American people healthcare coverage, which has put greater strain on health insurers. For...

Is the Affordable Care Act Sufficient for Mental Healthcare?

by Vera Gruessner

There are specific provisions that the Patient Protection and Affordable Care Act has brought to the American people. This includes eliminating healthcare coverage restrictions such as the clause surrounding pre-existing conditions. Additionally,...

How Medicaid Expansion Improves Behavioral Healthcare Access

by Vera Gruessner

When the Patient Protection and Affordable Care Act was passed into law, it established that Medicaid expansion across all 50 states would take place. However, a Supreme Court ruling created a clause that allowed Medicaid expansion to be optional...

Insurer Participation in Health Insurance Exchange Decreases

by Vera Gruessner

Health payers around the country may not be faring as well as hoped within the federal health insurance exchange. The Affordable Care Act may have had a negative impact on health insurance companies, as some are experiencing financial loss when...

HHS Issues Medicare Coverage Expansion for Diabetes Prevention

by Vera Gruessner

One of the most common chronic medical conditions found today is that of diabetes. Healthcare providers and payers need to work together to find ways that could help reduce the rates of diabetes nationwide. Recently, the Department of Health...

California Health Insurance Exchange Targets Costly Hospitals

by Vera Gruessner

The health insurance exchange from the state of California has some news to report. The exchange is considering the elimination of hospitals from its network that have shown subpar performance or had reported rising medical costs, according to...

Affordable Care Act Kindles Employer Narrow Network Plans

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought major reforms and deviations for the health insurance industry as well as hospitals and clinics. Along with the healthcare field, consumers and the patient community has been affected...

Plan Member Satisfaction Reduced in Less Competitive Markets

by Vera Gruessner

Due to the value-based care initiatives taking place at the Centers of Medicare and Medicaid Services (CMS), patient engagement and patient satisfaction have become imperative for the health payer industry. A report from J.D. Power called the...

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