Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Primers

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....

House Introduces Bill to Delay CMS Hospital Star Ratings

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) hospital star ratings may be postponed due to a new bill introduced on Monday, July 25 by House Representatives Jim Renacci (R-OH) and Kathleen Rice (D-NY). The reasoning for the delay is...

Democratic Party’s Predictions for the Affordable Care Act

by Vera Gruessner

The future of the healthcare industry and the health insurance space is very much dependent on the upcoming presidential elections and the two parties' stances on the Patient Protection and Affordable Care Act. The Affordable Care Act has...

Arizona’s Children’s Health Insurance Program Back in Action

by Vera Gruessner

The state of Arizona has had a restriction on accepting funding for the Children’s Health Insurance Program (CHIP) for the last several years. Arizona’s CHIP program was known as KidsCare and offered health coverage for children of...

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...

Payers’ Perspective: Insurance Mergers Benefit Consumers

by Vera Gruessner

As previously reported, the Department of Justice (DOJ) has announced that it will be blocking the Anthem-Cigna and Aetna-Humana insurance mergers due to the potential harm it may bring to consumers along with employers, hospitals and providers....

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...

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...

DOJ May File Lawsuits against Health Insurance Acquisitions

by Vera Gruessner

The health insurance acquisitions between Anthem and Cigna along with Aetna and Humana is likely to be blocked by the Department of Justice (DOJ). According to the American Hospital Association (AHA), the Department of Justice will be filing...

NCQA Proposes New Changes to HEDIS Quality Measures in 2017

by Vera Gruessner

The National Committee for Quality Assurance (NCQA) is looking to broaden a number of HEDIS quality measures for the 2017 edition, according to a news release from NCQA. These changes include the addition of four new HEDIS quality measures and...

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...

How the MACRA Rule, Baby Boomers Impact Medicare Payment

by Vera Gruessner

Last month, Andrew Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), spoke at the American Medical Association 2016 Annual Meeting about new strategies to pay for Medicare and unlock opportunities for greater...

Health Insurance Mergers May Harm Consumer Interests

by Vera Gruessner

What does the future hold for the Cigna-Anthem and Aetna-Humana health insurance mergers? Currently, many experts point at the possibility that these health insurance mergers will face regulatory blockage and won’t continue. A large number...

President Obama Highlights Progress from Affordable Care Act

by Vera Gruessner

When it comes to the Patient Protection and Affordable Care Act, the media has reported on a variety of opinions among healthcare experts and regulators regarding the benefits and disadvantages of the ACA. However, there has not been much in...

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...

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),...

Patients with Pre-Existing Conditions Need Affordable Care Act

by Vera Gruessner

The Patient Protection and Affordable Care Act has undergone both an opposition and an embrace by healthcare experts and politicians around the country. Now that this healthcare law has become embedded within the healthcare delivery system, it...

17 Health Payers Participating in CMS Oncology Care Model

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is implementing a new payment and healthcare delivery system called the Oncology Care Model. This particular reimbursement program will involve multi-payer arrangements in which healthcare...

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...

X

Sign up for our free newsletter:

Our privacy policy

no, thanks