Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Costs

Out-Of-Pocket Healthcare Spending on the Decline Since 2000

March 22, 2017 - 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 Expenditure Panel Survey (MEPS-HC) to examine out-of-pocket spending. These excluded payments on premiums, and only focused on care expenses not insured...


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Out-Of-Pocket Healthcare Spending on the Decline Since 2000

by Thomas Beaton

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...

Healthcare Leaders Air Concerns about NQF SDS Trial Period

by Thomas Beaton

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 Thomas Beaton

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...

Experts Lay Out Strategy for Achieving Universal Coverage

by Thomas Beaton

Experts from the Harvard Business School, Duke University, and David Geffen School of Medicine at UCLA debate the viability of an individual mandate as a means of achieving universal coverage without a single payer. According to Regina Herzlinger,...

Does Tiered Cost-Sharing Promote Appropriate Medication Use?

by Jacqueline Belliveau

Health plans have traditionally used tiered formulary cost-sharing arrangements to reduce healthcare spending and incentivize appropriate medication use. But a recent Journal of Managed Care & Specialty Pharmacy study found that stakeholders...

CMS Releases Final Rule for Medicare Physician Fee Schedule

by Vera Gruessner

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a final rule that updates a number of reimbursement policies and rates under the Medicare Physician Fee Schedule (PFS), a CMS press release states. The new payment policies...

Medicare Diabetes Prevention Program Saves $2,650 per Patient

by Vera Gruessner

In March 2016, the Department of Health & Human Services (HHS) proposed the expansion of Medicare coverage for the Diabetes Prevention Program. The funding for this program comes from the Affordable Care Act and research shows that Medicare...

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...

Why Aetna, Humana Argue in Favor of Health Insurance Merger

by Vera Gruessner

On July 21, the Department of Justice (DOJ) announced during a press conference that they would be filing a lawsuit against two health insurance mergers between Aetna-Humana and Cigna-Anthem. The DOJ claimed that these health insurance mergers...

Prescription Drug Medical Costs Less Problematic due to ACA

by Vera Gruessner

Recently, criticism popped up against the pharmaceutical company Mylan from the Hillary Clinton presidential campaign for its significant price increase for the life-saving EpiPen product. The EpiPen is vital in an emergency when a person who...

4 Motives Why Hospitals Adopt Provider-Sponsored Health Plans

by Vera Gruessner

Due to the many new transformations taking place within the healthcare industry today such as the transition from fee-for-service reimbursement to value-based care payments, the potential for creating provider-sponsored health plans has grown...

Is the ACA’s Health Insurance Provider Fee Unconstitutional?

by Vera Gruessner

Last year, six states including Texas, Wisconsin, Kansas, Louisiana, Indiana and Nebraska filed a lawsuit arguing that a provision within the Affordable Care Act requiring states to cover a Health Insurance Provider Fee is unconstitutional and...

Department of Justice Moves to Block Health Insurance Mergers

by Vera Gruessner

While there have been talks of the Department of Justice (DOJ) looking to block the Anthem-Cigna and Aetna-Humana health insurance mergers by filing lawsuits, the final decision was announced today at a press conference. The DOJ will proceed...

Affordability, Cost Transparency Key for Patient Satisfaction

by Vera Gruessner

The biggest healthcare reforms impacting health payers today include the movement toward consumer engagement and patient satisfaction. Patient advocacy groups are bringing more attention toward keeping the patient voice at the center of healthcare...

Healthcare Spending Growth Hits 5.8% Yearly from 2015-2025

by Vera Gruessner

Healthcare spending may not be rising as quickly as in previous years, but it is still moving upwards. The Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary (OACT) released a report last week that states the growth...

Cost Shifting to Consumers May Reduce Patient Satisfaction

by Vera Gruessner

Consumer choice, patient satisfaction, and out-of-pocket spending is becoming a more pressing issue in the new political climate caused due to a blossoming of healthcare reforms. Within this new landscape, a new coalition called Partners for...

DOJ Sees Continued Opposition to Health Insurance Mergers

by Vera Gruessner

Last month, a number of senators came forward with some significant reservations about the health insurance mergers taking place between Anthem and Cigna as well as Aetna and Humana. According to a news release, Senators Richard Blumenthal (D-CT),...

High-Deductible Health Plans Dominate Employer Offerings

by Vera Gruessner

Today, the consumer or employee is left with much higher out-of-pocket costs than in previous years. Within the Kaiser Family Foundation’s 2015 Employer Health Benefits Survey, statistics show that the number of workers with a standard...

Opposition Increases to Aetna, Anthem Health Insurance Mergers

by Vera Gruessner

The health insurance mergers between Aetna and Humana along with Anthem and Cigna seem to have a fair amount of opposition from both healthcare organizations as well as politicians around the country. The American Hospital Association (AHA) reported...

Consumer Healthcare Spending Trends Show Uptick in Engagement

by Vera Gruessner

Consumers today are becoming more and more responsible for covering the costs of healthcare services especially due to the greater proliferation of high-deductible health plans and out-of-pocket spending. What are the biggest healthcare spending...

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