Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

6.4 Million Enrollees Sign Up on Affordable Care Act Exchanges

December 28, 2016 - As of December 21, a total of 6.4 million consumers have enrolled in health plans through the Affordable Care Act exchanges on HealthCare.gov, reported the Centers for Medicare & Medicaid Services (CMS) in a fact sheet. The number of enrollees is higher by 400,000 people when compared to 2015 during the same time period. Consumers looking to sign up for health plans through the Affordable...


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6.4 Million Enrollees Sign Up on Affordable Care Act Exchanges

by Vera Gruessner

As of December 21, a total of 6.4 million consumers have enrolled in health plans through the Affordable Care Act exchanges on HealthCare.gov, reported the Centers for Medicare & Medicaid Services (CMS) in a fact sheet. The number of enrollees...

ACA Health Insurance Exchanges Bring Challenges for 2017

by Vera Gruessner

The Affordable Care Act (ACA) health insurance exchanges will have some key differences next year. Health insurance companies have faced various obstacles when selling health plans through the exchanges. These challenges include a higher risk...

How 4 Healthcare Payers Fare in 2016’s Health Insurance Market

by Vera Gruessner

The health insurance market has gone through significant changes in 2016. A number of payers have pulled back from the health insurance exchanges such as UnitedHealth and Humana. The Department of Justice has also filed lawsuits against the mergers...

Patient Engagement Helps Payers on Affordable Care Act Exchanges

by Vera Gruessner

Many health insurance companies selling health plans through the Affordable Care Act exchanges have been seeing higher and higher rates of financial losses. Some payers such as Aetna, Humana, and UnitedHealth Group have even pulled back from...

Payers See High Financial Losses on Health Insurance Exchanges

by Vera Gruessner

Healthcare payers have been facing significant financial losses on the health insurance exchanges in recent years. UnitedHealth Group lost $475 million in 2015 and was predicting a loss of $650 million in 2016, according to Kaiser Health News....

Payers Continue to Drop Out of the Health Insurance Exchanges

by Vera Gruessner

Healthcare payers have seen significant obstacles when it comes to operating on the public health insurance exchanges with large, national insurance companies losing money through this marketplace. Below we outline some key insurers that have...

How Health Payers Could Help Reduce High Out-of-Pocket Costs

by Vera Gruessner

A major problem still impacting consumers within the health insurance market is the potential for seeing high out-of-pocket costs. Many individuals are still underinsured despite the significant decrease in the uninsured rate around the country...

Affordable Care Act Replacement Seeks Automatic Enrollment

by Vera Gruessner

Since the Presidential election of Donald J. Trump, a number of differing viewpoints came out emphasizing how the Patient Protection and Affordable Care Act will be impacted. For the last several years, the Republican Party has attempted to repeal...

Anthem-Cigna Health Insurance Merger Suit Starts on November 21

by Vera Gruessner

The lawsuit against the Anthem-Cigna health insurance merger had its first pretrial conference this past Monday, according to The Coalition to Protect Patient Choice. Judge Amy Berman Jackson said that the two parties met to have a discussion...

Health Insurance Exchanges Require Engagement, Narrow Networks

by Vera Gruessner

Since some private health payers are struggling with enrollment and the ability to make a profit on the health insurance exchanges, engaging consumers, reducing the administrative burden, and creating a narrow provider network will become an...

Blue Cross to Expand Value-Based Care Reimbursement in 2017

by Vera Gruessner

The coming years will further position the medical industry including payers to adopt value-based care reimbursement models and new healthcare delivery systems partially due to the reforms that came about from the Patient Protection and Affordable...

How Payers Could Compete in Midst of Health Insurance Mergers

by Vera Gruessner

Among the payers facing a Department of Justice lawsuit against their health insurance mergers, Aetna and Humana have requested sanctions due to the government allegedly delaying the release of documents the two insurers need. The Motion for...

High-Deductible Health Plan Consumers Seek Price Transparency

by Vera Gruessner

Families and individuals who have purchased healthcare coverage on the ACA health insurance exchanges may have seen that monthly premium rates are expected to rise 25 percent in 2017, but should be aware that those eligible for tax subsidies...

Premium Rates on Affordable Care Act Exchanges Rise 25% in 2017

by Vera Gruessner

Monthly premium costs on the Affordable Care Act exchanges is expected to rise an average of 25 percent in 2017, according to a report from the Department of Health & Human Services (HHS). This percentage is based solely on the premiums for...

Private Payers Face Challenges on Health Insurance Exchanges

by Vera Gruessner

The health insurance exchanges created after passage of the Affordable Care Act may not serve as a truly effective marketplace for commercial payers since some national insurers like Aetna and UnitedHealthcare have been dropping out of operating...

How a Public Option May Preserve Health Insurance Exchanges

by Vera Gruessner

Multiple healthcare payers have been struggling with operating successfully on the Affordable Care Act’s health insurance exchanges. Some experts and lawmakers suggest that establishing a public option on the health insurance exchanges...

Revisions to Affordable Care Act May Improve Payer Performance

by Vera Gruessner

Health insurance executives have faced various regulatory challenges since the Patient Protection and Affordable Care Act was passed in 2010. Payers have had to participate in new health insurance marketplaces and face different restrictions...

Health Insurance Marketplaces Call for Plan Standardization

by Vera Gruessner

Healthcare payers are being instructed to offer standardized plan and benefit designs as the  federally facilitated health insurance marketplace is working to improve consumers’ ability to compare varying health plans during the next...

Marketplace Instability May Cause Affordable Care Act Reforms

by Vera Gruessner

While the Patient Protection and Affordable Care Act has decreased uninsurance rates to historically low levels, the healthcare law also led to higher premium costs and insurance rates among health plans sold on the health insurance exchanges....

Why Strengthening Affordable Care Act Could Cut Disparities

by Vera Gruessner

The Patient Protection and Affordable Care Act has significantly improved healthcare coverage and access throughout the country, but there are still some obstacles remaining to ensuring that every American has access to health insurance. While...

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