Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Policy

California Health Insurance Exchange Targets Costly Hospitals

by Vera Gruessner

The health insurance exchange from the state of California has some news to report. The exchange is considering the elimination of hospitals from its network that have shown subpar performance or had reported rising medical costs, according to...

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...

How New Policies Impact Healthcare Spending and Access

by Vera Gruessner

The Health Care Cost Institute (HCCI) announced today the publication of six different policy briefs entailing how state and federal regulations are affecting healthcare spending and patient services. Independent researchers used HCCI’s...

Healthcare Bundled Payments, Silver Plan Changes Impact Payers

by Vera Gruessner

The federal government especially the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have targeted healthcare payment reform in an effort to reduce rising medical costs around the nation....

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...

More Part D Beneficiaries Gain Access to Cost-Sharing Pharmacies

by Vera Gruessner

Healthcare access among Medicare and Medicaid beneficiaries remains a top priority for the Centers for Medicare & Medicaid Services (CMS). In 2015, CMS listened to the concerns of many beneficiaries and discovered that many do not have efficient...

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...

Precision Medicine is a ‘Whole New Ballgame for Insurers’

by Vera Gruessner

Recently, President Barack Obama has announced a national “Moonshot” program to put an end to cancer as a whole. Vice President Joe Biden has been appointed the main leader of this project, a White House news release stated. A total...

Health Insurance Company Couldn’t Lay Claim to Personal Assets

by Vera Gruessner

The health payer industry has seen its share of legal battles when it comes to keeping businesses afloat financially. One particular health insurance company – the National Elevator Industry Health Benefit Plan – paid $120,000 in...

Medicare Spending May Increase $500 Billion over Next Decade

by Vera Gruessner

The Congressional Budget Office (CBO) has released information showing growing deficits that are expected to increase by more than $100 billion in 2016 and expand to $1 trillion by 2022. The Committee for a Responsible Federal Budget released...

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...

How Paid Sick Leave Could Reduce Patients’ Financial Burden

by Vera Gruessner

One of the most looming issues within the healthcare industry has been the medical debt that many citizens around the nation incur if they are struck with a serious acute or chronic illness. A report published in the Journal of the American Medical...

How Presidential Nominees May Change World of the Health Payer

by Vera Gruessner

The future of the healthcare industry hangs in the balance as the presidential nominees within the United States have their own plans for how to improve the consumer experience and the world of the health payer. Some of the most transformative...

Guaranteed Renewability Key to Replacing Affordable Care Act

by Vera Gruessner

Even though President Barack Obama vetoed the Budget Reconciliation bill aimed at repealing the Affordable Care Act, there is still the potential that, if a Republican nominee wins the presidential election by the end of the year, new proposals...

CMS, AMA Delve into Past and Future of Healthcare Market

by Vera Gruessner

Yesterday, representatives from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association came together to provide an overview of the current healthcare market in a presentation called “A Discussion with...

UPDATE: House Passes Bill to Repeal Obama’s Affordable Care Act

by Vera Gruessner

The House of Representatives voted 240 to 181 in favor of the Budget Reconciliation bill, which would repeal large parts of the Patient Protection and Affordable Care Act as well as take away funding from Planned Parenthood for one year, The...

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