Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • Medicaid Reform Requires Outcomes-Based Innovation, Better Data

    August 22, 2017 - Medicaid has steadily provided low-income patients with quality healthcare coverage and could further improve by addressing problematic areas through outcomes-based innovation and data analytics infrastructure, according to commentary published in JAMA. Former CMS Administrators Andy Slavitt and Gail Wilensky recognized that current policy debate at the federal level has threatened Medicaid...

  • Can Healthcare Price Transparency Tools Cut Costs for Payers?

    August 11, 2017 - As out-of-pocket costs for patients continue to rise alongside payer spending on services, many health insurance companies are turning to online price transparency tools to help beneficiaries decide how to purchase low cost, high quality care.   While price transparency tools are generally viewed as a cost-effective way for payers to trim spending, they may not be as effective as they...

  • Latest Earnings Reports Show State of Health Payers in 2017

    August 7, 2017 - At the half-year mark, payers have a good sense of how well their efforts to promote value-based care have fared and the opportunity to make the necessary adjusts where they have not. As part of the business-facing side of value-based care, payers must stand out through effective marketing, extensive consumer choice, transparent pricing, consumer growth and retention, and other methods that...

  • Socioeconomic Data Improves Public Health, Payer Programs

    August 3, 2017 - CMS programs recognize that the social determinants of health (SDOH) play a large role in the health of their beneficiaries and, when neglected, can create negative health implications for beneficiaries covered by Medicare, Medicaid, and CHIP. Socioeconomic and environmental health factors including income, education level, language fluency, employment status, and level of healthcare access...


Today's Top Stories

Employer Reference Pricing Lowers Prescription Drug Expenses

As payers and employers learn to counter significant increases of prescription drug expenses, reference pricing may hold the key to lowering drug spending and increasing consumer purchases of lower cost drugs, according to research published...

Medicaid Reform Requires Outcomes-Based Innovation, Better Data

Medicaid has steadily provided low-income patients with quality healthcare coverage and could further improve by addressing problematic areas through outcomes-based innovation and data analytics infrastructure, according to commentary published...

Tufts Health Plan Launches Four Medicaid ACO Partnerships

Tufts Health Plan has signed contracts to form Medicaid accountable care organizations (ACOs) with Atrius Health, Beth Israel Deaconess Care Organization, Cambridge Health Alliance, and Boston Children’s Hospital ACO, according to a press...

Stop-Loss Insurance a Growing Market Opportunity for Healthcare

Even though payers may experience higher total revenues on commercial self-insurance, stop-loss and third-party protected insurance revenues have been growing at a higher rate with stronger market stability according to market research from AM...

CMS: Payers Will Have More Time to File 2018 Health Plan Rates

Payers still debating how uncertainty over cost-sharing reduction (CSR) subsidies will alter their insurance prices now have more time to submit 2018 health plan rates, CMS announced in a letter to insurers. While the letter says there's...

Explaining Out-of-Pocket Costs May Ease Cancer Care Stress

Patients who are not prepared for the magnitude of their out-of-pocket costs for cancer care are more likely to be distressed and less likely to pay their bills than other individuals, according to a research letter published in JAMA Oncology....

As ACA Debate Lingers, Non-Marketplace Members Present Risks

While much of the national debate over health insurance has focused on the options open to ACA marketplace enrollees, payers should be careful not to neglect coverage choices for their private plan customers, who tend to be healthier and wealthier,...

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