Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • Payers, Providers Collaborate to Combat Opioid Abuse, Addiction

    April 17, 2017 - Insufficient control of opioid prescriptions is one of the key reasons why opioid abuse and addiction have risen dramatically over the past few years.    To mitigate the epidemic, payers have developed programs to directly establish contact with the healthcare providers who are writing those prescriptions. The core of the payer strategy to battle opioid addictions relies on...

  • Healthcare Payers Seek Passage of Bill to Lower Drug Costs

    April 13, 2017 - The recently introduced the Fair Access for Safe and Timely (FAST) Generics Act seeks to reduce the timeline of bringing generic prescriptions to market and enjoys the support of healthcare payers. The philosophy behind the bipartisan bill is simple — increase competition by allowing more generics to hit the market faster and help lower prescription drug prices. Introduced last week,...

  • OK Legislature Keeps Interstate Health Insurance Bill Viable

    April 12, 2017 - A bill that would allow interstate health insurance options for Oklahoma residents is still on the table following a House committee vote. Senate Bill 478, or the Health Care Choice Act, would authorize Oklahoma’s Insurance Commissioner to pursue insurance compacts with other states. Those compacts then allow other state insurers to sell specified coverage within Oklahoma, not needing...

  • House Republicans Propose Two New Bills to Replace ACA

    March 7, 2017 - On Monday, the House Ways and Means Committee and the House Energy and Commerce Committee proposed two bills that together will effectively repeal and replace the Affordable Care Act. Combined the bills comprise the American Health Care Act. Chairman Kevin Brady (R-TX) of the Ways and Means Committee released a bill that aims to dismantle ACA individual mandates and taxes, expand Health Savings...


Today's Top Stories

Medicaid Service Equals or Surpasses Private Health Payers

A new report by the Commonwealth Fund found that Medicaid provides equal or better quality health coverage to private health insurance plans.  The Commonwealth Fund’s 2016 Biennial Health Insurance Survey measured statistics related...

Provider-Owned Health Plans Adopt Interoperability Standards

Three provider-owned health plans have recently completed the fourth phase of CAQH CORE certification.  This achievement places the provider-owned health plans at a level that supersedes present regulatory requirements for interoperability...

Population Health Approach to Prenatal Care Cuts Payer Costs

Health insurance payers can improve patient outcomes and reduce spending by expanding the use of population health management models for expectant mothers.  Early intervention and preventive care can lower costs in high-risk birth situations,...

PA Seeks Increased Payer Coverage of Emergency Air Ambulances

Emergency air ambulances save lives, but they can also leave patients in a mountain of debt.  Pennsylvania Insurance Commissioner Teresa Miller would like payers to shoulder more of the costs of these critical services, and has accordingly...

Senator Calls for Scrutiny of Health Payers, Medicare Fraud

Senator Chuck Grassley (R-Iowa) is asking federal officials to investigate charges that Medicare Advantage plans were overcharged by health payers. In a letter to CMS Acting Administrator Seema Verma, Grassely cited an improper...

Health Insurance Actuaries Propose Ways to Stabilize Market

A stable health insurance marketplace is good for payers and consumers. Speculation over potential payer mergers, repeal or modification of the ACA, and the future of high-risk and low income subsidy payments have left premium rates and coverage...

OR May Cut ACA Medicaid Expansion Funds to Favor State Budget

The Oregon state legislature is considering a retraction of Medicaid expansion and benefits to address an anticipated $1.8 billion budget shortfall between 2017 and 2019.  The move to cut back Medicaid could potentially leave more than 355,000...

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