Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

Is the Affordable Care Act Leading Payers to Lose Profit?

by Vera Gruessner

The world of healthcare has often been a struggle between medical providers and the payers with one side looking to offset costs and make a profit while the other side concerns itself with the revenue of their patient care. With the federal government...

Aetna, Mount Sinai Invest in Accountable Care Organizations

by Vera Gruessner

Since the Affordable Care Act was passed and the Center for Medicare & Medicaid Service Innovation established the Medicare Shared Savings Program, the development of accountable care organizations began to blossom quickly. Along with CMS,...

25% of Texans Lack Knowledge about Health Insurance Plans

by Vera Gruessner

New research shows that consumer education in terms of health insurance plans and healthcare access is becoming a necessity since many are unaware of some typical health insurance terms. Rice University’s Baker Institute for Public Policy...

4 Health Payer Industry News Items Revealed at HIMSS16

by Vera Gruessner

With the 2016 HIMSS Conference and Exhibition closing its doors, it grows important to address how the health payer industry remains vital to both the ongoing technology advancements in medicine and patient care in general. Below we outline some...

Medicaid Coverage Expansion Boosts Healthcare Access in Flint

by Vera Gruessner

In April 2014, contamination in drinking water began in Flint, Michigan when the region transitioned its water source to the Flint River from its previous source of Lake Huron and the Detroit River. The problem at hand is that corrosion control...

Open Enrollment Dates Announced for Health Insurance Exchange

by Vera Gruessner

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released its yearly Notice of Benefit and Payment Parameters related to the coverage options on the federal health insurance exchange in 2017. The rulings outline ways...

Should Payers Question ACA’s Health Insurance Exchanges?

by Vera Gruessner

The health insurance exchanges have faced some significant challenges and even some questioning among the payer community, especially after the insurer UnitedHealthcare announced at the end of 2015 that it is considering whether to leave the...

Sanders’ Universal Healthcare Coverage May Have Pitfalls

by Vera Gruessner

In the coming Presidential election, health payers have plenty to consider, as most candidates propose significant policy changes from universal healthcare coverage to repealing the Patient Protection and Affordable Care Act. One candidate that...

Will Health Insurance Mergers Stifle Market Competition?

by Vera Gruessner

Health insurance mergers and acquisitions have been a major topic within the payer industry lately. While companies that have pushed through with their mergers cite their potential cut of competition as a way to lower prices for the end consumer,...

HHS Pursues Higher Enrollment on Health Insurance Exchanges

by Vera Gruessner

The Department of Health and Human Services (HHS) is pleased with the most recent enrollment numbers in the Affordable Care Act’s health insurance exchanges. Department of Health and Human Services Secretary Sylvia M. Burwell stated in...

The Affordable Care Act could Decrease Chronic Disease Rates

by Vera Gruessner

Needless to say, healthcare reform and the Affordable Care Act have revolutionized many avenues of the health payer industry. The individual mandate along with Medicaid expansion and federal tax subsidies on the health insurance exchanges have...

HHS Cites Affordable Care Act Led to Prescription Drug Savings

by Vera Gruessner

Yesterday the Department of Health and Human Services (HHS) announced that millions of Medicare beneficiaries continue to see benefits from the Affordable Care Act especially with regard to their savings with prescription drugs. Approximately...

12.7 Million Americans Enrolled in Health Insurance Exchanges

by Vera Gruessner

The last day to sign up for 2016 medical coverage during the open enrollment period through the state and federal health insurance exchanges was January 31 and the Department of Health and Human Services (HHS) announced in a press release that...

70% of Uninsured Texans Find Medical Coverage Costs too High

by Vera Gruessner

The Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation (EHF) found in a new report that nearly seven out of ten uninsured Texans cite the high costs of medical coverage as the reason for lacking insurance....

23% of Voters Find Affordable Care Act ‘Extremely Important’

by Vera Gruessner

The Henry J. Kaiser Family Foundation released the January Kaiser Health Tracking Poll last week showing that the Affordable Care Act did not make it past 23 percent of those surveyed stating that it’s ‘extremely important’...

How Health Insurance Exchange Database Handles Enrollment

by Vera Gruessner

The health insurance exchange system set up through healthcare.gov needs to be a robust technological platform in order to manage the vast amount of information and high enrollment numbers associated with the insurance marketplace. The MarkLogic...

Enrollment through Health Insurance Exchange Continues to Rise

by Vera Gruessner

The deadline to apply for healthcare coverage through the federal health insurance exchange – healthcare.gov – is this Sunday, January 31. Currently, approximately 8.9 million people have either enrolled in a health insurance plan...

Affordable Care Act Brings Greater Health Coverage to Texas

by Vera Gruessner

The Patient Protection and Affordable Care Act may have done its job in one particular state with regard to expanding health coverage options and providing federal subsidies on the health insurance exchange. A study from Rice University’s...

Co-ops on Health Insurance Exchanges Need Greater Surveillance

by Vera Gruessner

The Patient Protection and Affordable Care Act has influenced greater health coverage among American citizens through establishing state health insurance exchanges. However, when creating this platform, a number of Democratic congressmen were...

Medicaid Managed Care Spending Rose to $107 Billion in 2014

by Vera Gruessner

One area in which the federal government has put in excessive amounts of funds is the managed care arena. The reasoning may be due to the growing elderly population of baby boomers. The US Government Accountability Office released a report showing...

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