Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

1.5M Workers Gained Employer-Sponsored Healthcare Coverage

by Vera Gruessner

The number of employees who have gained healthcare coverage through employer-sponsored health plans has been rising in recent years as the economy recovered and more Americans gained a foothold in the workplace. With a stronger economy, the health...

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...

Why Value-Based Care Reimbursement Needs Risk Adjustment

by Vera Gruessner

The Patient Protection and Affordable Care Act is a very complex piece of legislation that covers a wide range of provider and payer issues. Several not commonly discussed factors include the ACA’s impact on risk adjustment and risk selection....

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...

Why GOP Should Hold Off on Replacing the Affordable Care Act

by Vera Gruessner

When the Patient Protection and Affordable Care Act was passed into law, it has had a variety of proponents as well as opposition from the GOP with many calling on the healthcare law to be repealed. However, repealing the Affordable Care Act...

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...

Why Payers Should Include Consumer Engagement in Health Plans

by Vera Gruessner

In order to ensure that the health insurance exchange successfully reduces healthcare spending, it may be necessary to strengthen consumer engagement and education so that policyholders continually purchase the right health coverage for their...

Republicans Release Plan to Replace the Affordable Care Act

by Vera Gruessner

It is well-known the the GOP base has attempted to repeal the Patient Protection and Affordable Care Act for years since its passage. However, the big question that everyone has always wondered is what the Republicans would replace the Affordable...

How the Affordable Care Act Influenced CORE Certification

by Vera Gruessner

Health plans, vendors, and providers will need to meet CORE certification requirements in order to comply with mandates under the Patient Protection and Affordable Care Act. CORE stands for Committee on Operating Rules for Information Exchange...

CMS Awards $22M for Cost Transparency Under Affordable Care Act

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced in a press release that $22 million of funds are available to help state regulators with issuer compliance according to consumer protections under the Affordable Care...

What Repealing the Affordable Care Act Would Mean for America

by Vera Gruessner

While the Patient Protection and Affordable Care Act was passed into law six years ago, there is still plenty of controversy that surrounds this landmark legislation. For instance, the Senate and House of Representatives passed a bill that would...

Affordable Care Act Brought Healthcare Coverage to Rural Areas

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a fair amount of healthcare access and coverage to the American people. This does not just include those living in urban areas or the suburbs. Recent research suggests that the Affordable...

Slavitt: Health Insurance Marketplace Boosts Patient Engagement

by Vera Gruessner

The federal government has taken a wide variety of steps to strengthen patient care and healthcare revenue systems throughout the country. Specifically, the Centers for Medicare & Medicaid Services (CMS) and the health insurance marketplace...

Payers Adopt Value-Based Care via Health Insurance Marketplace

by Vera Gruessner

The health insurance marketplace created through the Patient Protection and Affordable Care Act has had a variety of success ever since its inception. This new model of healthcare coverage has provided health insurance for an additional 20 million...

Affordable Care Act Brought 30% Drop for Texas Uninsured Rate

by Vera Gruessner

The Patient Protection and Affordable Care Act has made a significant difference for the average American citizen when it comes to ensuring greater medical coverage and healthcare access. The uninsured rate has been dropping steeply throughout...

Health Plan Solutions: Do Employers Choose Private Exchanges?

by Vera Gruessner

Today employers are searching for multiple solutions to meet their health plan needs in order to reduce costs and provide the optimal benefits to their employees. The multitude of healthcare regulations hitting the market today is making quite...

CMS Bundled Payment Program Reduces Costs for Consumer

by Vera Gruessner

At the end of last year, the Centers for Medicare & Medicaid Services (CMS) finalized their bundled payment rule for hip and knee replacement surgery. This type of bundled payment program will hold hospitals more accountable for patient health...

Medicare Advantage Plans Decrease Avoidable Hospitalizations

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) may be able to reduce healthcare spending by decreasing the number of hospitalizations, emergency room visits, and other expensive medical care services.  This could be done by bringing...

Is the Health Insurance Industry Heading on a ‘Death March?’

by Vera Gruessner

The health insurance industry has been undergoing tremendous reforms in recent years due to new federal regulations including the Affordable Care Act. Reimbursement between payers and providers have been changing as well. Coverage for the majority...

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