Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Policy

Supreme Court Leaves Zubik v. Burwell Case to Lower Courts

by Vera Gruessner

On Monday, the Supreme Court unanimously called for the lower courts to rule on the Zubik v. Burwell case and to find a compromise. This particular court case argues on whether employers, specifically religious nonprofit groups, should be required...

Court Sides with Republicans on Affordable Care Act Provision

by Vera Gruessner

Once again, the Patient Protection and Affordable Care Act is receiving criticism from the Republican-led House of Representatives. House Republicans had filed a lawsuit claiming that the Obama administration does not have the authority to provide...

Audits against Medicare Advantage Organizations Found Subpar

by Vera Gruessner

In order to ensure government funding isn’t used to pay erroneous or fraudulent medical claims, the Centers for Medicare & Medicaid Services (CMS) conducts risk adjustment data validation (RADV) audits among Medicare Advantage organizations....

The Biggest ACA Legal Challenges Facing Healthcare Industry

by Vera Gruessner

Ever since the Obama administration passed the healthcare law to reform many of the inequalities faced in this country, there have been a wide variety of ACA legal challenges that have stood in the way of this law progressing to reduce the rates...

Is the Medicare Part B Proposed Rule ‘Bad Medicine’?

by Vera Gruessner

Two months ago, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would create new payment models meant to reimburse providers for assigning prescription drugs. This would change the payment structure of...

What will the Future Bring for the Affordable Care Act?

by Vera Gruessner

The future of the Affordable Care Act and health insurance exchanges may not be as favorable as the Obama administration had hoped. Many fear that the major health insurer UnitedHealthcare leaving the state-based exchanges could lead other payers...

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...

New Proposed MACRA Rule Renovates Information Technology Use

by Vera Gruessner

The Department of Health & Human Services (HHS) has proposed new rules regarding the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) which will essentially remove the meaningful use program and move forward in advancing health information...

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...

Proposed Rule in Oklahoma Impacts Costs of Prescription Drugs

by Vera Gruessner

In recent months, scandals associated with the costs of prescription drugs have made headlines. About seven out of 10 Americans are currently enrolled in a health insurance plan that covers costs of prescription drugs. Prescription drug plans...

CMS Releases Medicare Data for Quality-Based Metrics

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is further attempting to innovate and improve medicine through quality-based metrics, as the CMS Office of Minority Health has released new data that provides more information on the quality...

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...

$120 Million Settlement Ends Medical Claims Processing Failure

by Vera Gruessner

One medical claims processing technological project has been put to rest in the state of California. This project began in 2007 and has still failed to be completed, according to the California Healthline publication. The medical claims processing...

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...

How CMS Could Boost Operation of Accountable Care Organizations

by Vera Gruessner

Accountable care organizations (ACOs) have become a more mainstream method for improving care coordination and the quality of medical services while providing an opportunity for reducing wasteful spending. For instance, St. John Health System’s...

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...

Could Electronic Processing Reduce Medical Spending Rates?

by Vera Gruessner

The US healthcare system is one of the most expensive around the world and the rising costs haven't diminished significantly in recent years. Today, health payers and providers have been working together to reduce medical spending around...

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...

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