Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

How Health Insurance Exchange Database Handles Enrollment

by Vera Gruessner

The health insurance exchange system set up through healthcare.gov needs to be a robust technological platform in order to manage the vast amount of information and high enrollment numbers associated with the insurance marketplace. The MarkLogic...

Enrollment through Health Insurance Exchange Continues to Rise

by Vera Gruessner

The deadline to apply for healthcare coverage through the federal health insurance exchange – healthcare.gov – is this Sunday, January 31. Currently, approximately 8.9 million people have either enrolled in a health insurance plan...

Affordable Care Act Brings Greater Health Coverage to Texas

by Vera Gruessner

The Patient Protection and Affordable Care Act may have done its job in one particular state with regard to expanding health coverage options and providing federal subsidies on the health insurance exchange. A study from Rice University’s...

Co-ops on Health Insurance Exchanges Need Greater Surveillance

by Vera Gruessner

The Patient Protection and Affordable Care Act has influenced greater health coverage among American citizens through establishing state health insurance exchanges. However, when creating this platform, a number of Democratic congressmen were...

Medicaid Managed Care Spending Rose to $107 Billion in 2014

by Vera Gruessner

One area in which the federal government has put in excessive amounts of funds is the managed care arena. The reasoning may be due to the growing elderly population of baby boomers. The US Government Accountability Office released a report showing...

How Presidential Nominees May Change World of the Health Payer

by Vera Gruessner

The future of the healthcare industry hangs in the balance as the presidential nominees within the United States have their own plans for how to improve the consumer experience and the world of the health payer. Some of the most transformative...

Guaranteed Renewability Key to Replacing Affordable Care Act

by Vera Gruessner

Even though President Barack Obama vetoed the Budget Reconciliation bill aimed at repealing the Affordable Care Act, there is still the potential that, if a Republican nominee wins the presidential election by the end of the year, new proposals...

Top 3 Difficulties Facing State Health Insurance Exchanges

by Vera Gruessner

Once the Patient Protection and Affordable Care Act was passed into law, a tide of legal challenges came crashing against the legislation. In particular, the state and federal health insurance exchanges faced several differing lawsuits. Legal...

UPDATE: House Passes Bill to Repeal Obama’s Affordable Care Act

by Vera Gruessner

The House of Representatives voted 240 to 181 in favor of the Budget Reconciliation bill, which would repeal large parts of the Patient Protection and Affordable Care Act as well as take away funding from Planned Parenthood for one year, The...

3 Policy Challenges Health Insurance Exchanges Face

by Vera Gruessner

Health insurance exchanges have faced a number of legal challenges in recent months, as some key provisions of the Patient Protection and Affordable Care Act have found opposition. Last June, the Supreme Court ruled on the King v. Burwell court...

Why State Medicaid Expansion May be Worthwhile for All

by Vera Gruessner

When the Supreme Court ruled that Medicaid expansion under the Patient Protection and Affordable Care Act is voluntary among the states, this set a precedence that allowed individual states to play partisan politics and withhold from financing...

The Impact of Medicare Advantage Plans, ACOs, Payment Reform

by Vera Gruessner

Now that the New Year is upon us, the Medicare program may be undergoing some significant changes that could affect patients and healthcare services. One ongoing transformative characteristic is the rise in enrollment in Medicare Advantage plans....

8.2 Million Applied for Coverage on Health Insurance Exchanges

by Vera Gruessner

Open enrollment via the health insurance exchanges has seen a dramatic rise in popularity since the starting date of November 1, as more than 8.2 million consumers signed up for health coverage on HealthCare.gov or had their plans renewed, according...

Medicaid Expansion Brought More Cancer Screenings among Women

by Vera Gruessner

Several years ago, the Supreme Court ruled that state Medicaid expansion under the Patient Protection and Affordable Care Act is to be optional for each region. This led a large number of states to forego expanding their Medicaid program for...

Top 3 Recent Outcomes of the Affordable Care Act in 2015

by Vera Gruessner

The Obama administration’s Patient Protection and Affordable Care Act has dealt with a multitude of opposition since its passage and this past year has been no different. There are still partisan politics at play when it comes to the healthcare...

Top 4 Factors Necessary for Bundled Payment Model Contract

by Vera Gruessner

In today’s healthcare climate, payers are working to develop value-based reimbursement contracts with their provider network. Lately, payer and provider contract negotiations are often based around alternative payment methods such as the...

Will the US Embrace the Affordable Care Act in Future Years?

by Vera Gruessner

The Patient Protection and Affordable Care Act has had many obstacles in the way when revolutionizing the healthcare insurance field and broadening access to medical care for the US population. What does the future hold for the Affordable Care...

Blue Shield, Accountable Care Organization Saved $325 Million

by Vera Gruessner

In recent years, there has been plenty of concern about whether or not Accountable Care Organizations (ACOs) bring significant cost savings to the healthcare industry. However, one health payer and ACO have proven that it is possible to make...

2016 Premiums on Health Insurance Exchanges Expected to Soar

by Vera Gruessner

Health payers managing plans through the state health insurance exchanges will need to work toward maintaining superior customer relations due to the rise in premium costs expected in 2016. The Robert Wood Johnson Foundation released datasets...

CMS Stresses Informed Decision-Making in Performance Reports

by Vera Gruessner

Since the Affordable Care Act was initially created, the Centers for Medicare & Medicaid Services (CMS) have been focused on improving informed decision-making among payers, providers, the patient community, and other stakeholders. CMS announced...

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