Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

Cigna Boosts Outcomes Despite Affordable Care Act Obstacles

by Vera Gruessner

With many health payers experiencing significant challenges while operating through the health insurance exchanges and adhering to various provisions of the Patient Protection and Affordable Care Act, it grows more important than ever before...

Both Political Parties Seek to Replace the Affordable Care Act

by Vera Gruessner

As previously reported, the major health payer Aetna is leaving the majority of health insurance exchanges it is currently operating in. Some critics have pointed at the failure of the Affordable Care Act to sustain payers within the public exchanges...

Aetna Leaving Health Insurance Exchanges Due to DOJ Lawsuit

by Vera Gruessner

The latest news coming from the major health payer Aetna is its move to drop out of the majority of the health insurance exchanges it had been participating in this year. According to a press release from Aetna, it will leave most of the public...

Affordable Care Act’s Reinsurance Programs Keep Market Stable

by Vera Gruessner

One way that health payers can compete more effectively in the current destabilized environment is by investing resources in reinsurance programs. Reinsurance is a method in which a payer can buy a policy from other insurers in order to manage...

Affordable Care Act, Exchanges Challenge Health Payers

by Vera Gruessner

Ever since the passage of the Patient Protection and Affordable Care Act (ACA), a number of opponents have found factors to criticize within the landmark healthcare law. But has it truly brought more problems for the healthcare industry? From...

Aetna Cancels its Expansion in Health Insurance Exchange

by Vera Gruessner

The national health payer Aetna continues to make headlines in the month of August after the public learned last month about the Department of Justice’s move to block Aetna’s major health insurance merger with Humana. On August 2,...

Aetna, UnitedHealth Take On California’s Medicaid Program

by Vera Gruessner

The two major health payers UnitedHealth and Aetna plan to join California’s Medicaid program called Medi-Cal managed care, according to Kaiser Health News. Aetna and UnitedHealth will serve residents of the San Diego and Sacramento counties....

Does Blocking Health Insurance Mergers Impact ACA Exchanges?

by Vera Gruessner

Last week, the Department of Justice announced that it will be filing lawsuits against the Anthem-Cigna and Aetna-Humana health insurance mergers. The issue at hand is that these health insurance mergers would increase concentration and hurt...

California’s Health Insurance Exchange Premiums May Spike 13%

by Vera Gruessner

Premium rates on the state health insurance exchanges are expected to continue rising over the next year due to some of the provisions of the Affordable Care Act (ACA). Since the ACA has brought more coverage options and a greater number of covered...

Minnesota’s Biggest Payer Leaves Health Insurance Exchanges

by Vera Gruessner

State health insurance exchanges are likely to see more disruption in the health insurance market with some payers either leaving the individual consumer marketplace or limiting their offerings in the coming year. The health payer UnitedHealthcare...

Why GOP Should Hold Off on Replacing the Affordable Care Act

by Vera Gruessner

When the Patient Protection and Affordable Care Act was passed into law, it has had a variety of proponents as well as opposition from the GOP with many calling on the healthcare law to be repealed. However, repealing the Affordable Care Act...

Why Payers Should Include Consumer Engagement in Health Plans

by Vera Gruessner

In order to ensure that the health insurance exchange successfully reduces healthcare spending, it may be necessary to strengthen consumer engagement and education so that policyholders continually purchase the right health coverage for their...

CMS Awards $22M for Cost Transparency Under Affordable Care Act

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced in a press release that $22 million of funds are available to help state regulators with issuer compliance according to consumer protections under the Affordable Care...

Affordable Care Act Brought Healthcare Coverage to Rural Areas

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a fair amount of healthcare access and coverage to the American people. This does not just include those living in urban areas or the suburbs. Recent research suggests that the Affordable...

Slavitt: Health Insurance Marketplace Boosts Patient Engagement

by Vera Gruessner

The federal government has taken a wide variety of steps to strengthen patient care and healthcare revenue systems throughout the country. Specifically, the Centers for Medicare & Medicaid Services (CMS) and the health insurance marketplace...

Payers Adopt Value-Based Care via Health Insurance Marketplace

by Vera Gruessner

The health insurance marketplace created through the Patient Protection and Affordable Care Act has had a variety of success ever since its inception. This new model of healthcare coverage has provided health insurance for an additional 20 million...

What Health Insurance Exchanges Should Do to Cut Premium Costs

by Vera Gruessner

The costs of premiums sold on the state health insurance exchanges tend to vary greatly, finds a report from The Commonwealth Fund. For instance, in 2016, the state of Tennessee saw a 38 percent increase in their health insurance premium costs...

Health Plan Solutions: Do Employers Choose Private Exchanges?

by Vera Gruessner

Today employers are searching for multiple solutions to meet their health plan needs in order to reduce costs and provide the optimal benefits to their employees. The multitude of healthcare regulations hitting the market today is making quite...

Affordable Care Act Brought the Uninsured Rate to 9.1%

by Vera Gruessner

The Patient Protection and Affordable Care Act has made a tremendous impact on healthcare coverage among Americans. An extra 20 million people now have healthcare access  do due to the health insurance exchanges. The Centers for Disease...

Health Insurance Market Faces Restricted Provider Networks

by Vera Gruessner

Last week, Scott Gottlieb, MD, Resident Fellow at the American Enterprise Institute, spoke in front of the House Committee on Energy and Commerce Subcommittee on Health delivering key information about certain reforms for the health insurance...

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