Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Primers

Is Rising US Healthcare Spending Burdening the Economy?

by Vera Gruessner

Is healthcare spending in the United States too high? Are the financial aspects of running the medical system around the country burdening the US economy? The National Center for Policy Analysis insists that the viewpoint claiming that healthcare...

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...

$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...

Primary Care Payment Reform Targeted in Multi-Payer Initiative

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) are renovating how primary care is delivered throughout the United States. According to a news release from the agency, CMS is launching a program called the Comprehensive Primary Care Plus...

Arizona Declines Funding Children’s Health Insurance Program

by Vera Gruessner

Nearly 20 years ago, the Children’s Health Insurance Program (CHIP) was established in order to ensure the offspring of low-income families who didn’t qualify for the Medicaid insurance plan did have the right to healthcare coverage....

CMS Continues to Reform through Healthcare Bundled Payments

by Vera Gruessner

As of April 1, 2016, healthcare bundled payments have become a part of the reimbursement strategy of hospitals providing hip and knee replacement surgeries as well as the Centers for Medicare & Medicaid Services (CMS) itself. Through the...

Consumer Education Key for Health Insurance Marketplace Success

by Vera Gruessner

It seems that those residing in Texas who have purchased their healthcare coverage through the health insurance marketplace do not have as much understanding of certain terms as those who have medical insurance through their employer or via Medicaid...

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...

Is the Affordable Care Act Sufficient for Mental Healthcare?

by Vera Gruessner

There are specific provisions that the Patient Protection and Affordable Care Act has brought to the American people. This includes eliminating healthcare coverage restrictions such as the clause surrounding pre-existing conditions. Additionally,...

CMS Bundled Payment Model Reduced Hospital Stays to 2.9 Days

by Vera Gruessner

Slowly, healthcare providers are moving their reimbursement toward the bundled payment model across some of their medical services.  The Centers for Medicare & Medicaid Services (CMS)  along with commercial health  insurers...

How Medicaid Expansion Improves Behavioral Healthcare Access

by Vera Gruessner

When the Patient Protection and Affordable Care Act was passed into law, it established that Medicaid expansion across all 50 states would take place. However, a Supreme Court ruling created a clause that allowed Medicaid expansion to be optional...

Insurer Participation in Health Insurance Exchange Decreases

by Vera Gruessner

Health payers around the country may not be faring as well as hoped within the federal health insurance exchange. The Affordable Care Act may have had a negative impact on health insurance companies, as some are experiencing financial loss when...

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...

CMS Released Proposed Rule for Accountable Care Organizations

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would revise the formula used to analyze the performance of accountable care organizations participating in the Medicare Shared Savings Program....

CMS Published Final Rule for Surgical Bundled Payment Model

by Vera Gruessner

On January 15, 2016, the final rule for the Comprehensive Care for Joint Replacement model took effect, which is a new reimbursement program for orthopedic surgeries developed by the Centers for Medicare & Medicaid Services (CMS). High costs...

CMS Announced 121 New Accountable Care Organizations

by Vera Gruessner

On Monday, the Centers for Medicare & Medicaid Services (CMS) revealed that there will be 121 new accountable care organizations joining the ranks of Medicare ACOs and the Shared Savings Program. A press release from the Department of Health...

HHS Announces $157M for Accountable Health Communities Model

by Vera Gruessner

Earlier this week, the Department of Health and Human Services (HHS) announced new funds available of as much as $157 million to develop an Accountable Health Communities Model, which will show whether testing beneficiaries on social needs and...

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