Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

Presidential Election Brings Two Opposing Healthcare Policy Proposals

by Vera Gruessner

With the Presidential election heating up and the debate season upon us, last week The Commonwealth Fund detailed the stark differences seen between the two presidential candidates healthcare policy proposals in a new report. The research comes...

Medicare Advantage Premiums Drop 13% Due to Affordable Care Act

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) announced in a press release late last week that the average Medicare Advantage monthly premium will be 13 percent lower in 2017 than before the Patient Protection and Affordable Care Act...

Affordable Care Act Reduced Uninsurance Rate to 8.6% in 2016

by Vera Gruessner

The latest data from the National Center for Health Statistics shows that the uninsurance rate during the first three months of 2016 has decreased to 8.6 percent, or 27.3 million Americans, thanks to the continued impact of the Affordable...

Lawmakers Push for Public Option on Health Insurance Exchanges

by Vera Gruessner

A total of five senators and multiple organizations are looking to create a public option for healthcare coverage to be available among all Americans purchasing insurance through the Affordable Care Act’s health insurance exchanges. Senators...

2 Benefits and 2 Disadvantages of the Affordable Care Act

by Vera Gruessner

The Patient Protection and Affordable Care Act has had many critics as well as those who have praised the landmark healthcare legislation. While the Republican Party is looking to repeal the Affordable Care Act, others consider that a revision...

How Medical Consortium Handles Value-Based Care Reimbursement

by Vera Gruessner

Healthcare organizations around the country have been revamping their strategies to keep revenue stable in the midst of changing healthcare payment models. Reforms have been aimed at helping providers adopt value-based care reimbursement. With...

Rising Specialty Drug Prices Plague CMS, Medicare Beneficiaries

by Vera Gruessner

Even though the Obama administration’s Patient Protection and Affordable Care Act assisted Medicare beneficiaries by attempting to end a drug coverage gap called the “doughnut hole” through plan payments and drug manufacturer...

CMS Grants Navigators $63M to Boost Health Insurance Marketplace

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) announced in a press release earlier this week that it will be providing $63 million in grants to both new and older organizations returning to offer health plans through the public health...

Payer Concentration Challenges Health Insurance Exchanges

by Vera Gruessner

More and more research is pointing at the fact that consumers on the health insurance exchanges are being left with fewer health plan issuers. Part of this may be due to health payers such as UnitedHealthcare or Aetna leaving a large percentage...

Affordable Care Act Marketplace Consumers Face Fewer Choices

by Vera Gruessner

A hefty number of health insurance companies have been dropping out of the Affordable Care Act’s state exchanges in recent months including Humana, Aetna, and UnitedHealthcare. These actions would leave fewer health plans to choose from...

7% of Counties Retain One Payer on Health Insurance Exchanges

by Vera Gruessner

With more health payers such as UnitedHealthcare, Humana, and Aetna dropping out of a number of state health insurance exchanges, it is useful to analyze the differences of healthcare coverage between different regions and states around the country....

Medicare Shared Savings Program Saved $466 Million in 2015

by Vera Gruessner

The Centers for Medicare and Medicaid Services (CMS) announced last week the quality and financial results of the 2015 Medicare accountable care organizations. According to a press release from CMS, accountable care organizations operating under...

Public Health Insurance Marketplace Still Benefits Consumers

by Vera Gruessner

The public health insurance marketplace created through the Affordable Care Act (ACA) may have fewer and fewer health plans participating in the coming years since a number of major insurers have dropped out of the exchanges. This would lead...

Could Public Option Strengthen ACA Health Insurance Exchanges?

by Vera Gruessner

The ACA health insurance exchanges are facing greater risk now that a number of healthcare payers have decided to drop out of the marketplace. UnitedHealthcare was the first to announce its departure from the ACA health insurance exchanges. More...

Risk Pool Gains on Horizon for Health Insurance Marketplace

by Vera Gruessner

With a number of healthcare payers including UnitedHealthcare and Aetna dropping out of the Affordable Care Act’s health insurance marketplace, the Centers for Medicare & Medicaid Services (CMS) issued an annual Notice of Benefit and...

Presidential Election Shakes Employer-Sponsored Health Insurance

by Vera Gruessner

Healthcare policy of US presidential candidates depends on more than their perspective on the Affordable Care Act. With employer-sponsored health insurance still a major aspect of coverage among Americans since fewer are insured through Medicaid...

Prescription Drug Medical Costs Less Problematic due to ACA

by Vera Gruessner

Recently, criticism popped up against the pharmaceutical company Mylan from the Hillary Clinton presidential campaign for its significant price increase for the life-saving EpiPen product. The EpiPen is vital in an emergency when a person who...

Two Contrasting Opinions on Accountable Care Organizations

by Vera Gruessner

The Patient Protection and Affordable Care Act isn’t merely responsible for creating health insurance exchanges, eliminating pre-existing conditions or even expanding the Medicaid program. The Affordable Care Act also helped build the Medicare...

Did Aetna Need Merger to Stay in Health Insurance Exchanges?

by Vera Gruessner

More and more payers are slowly dropping out of the Affordable Care Act’s health insurance exchanges. Earlier this year, UnitedHealth formally announced the decision to discontinue selling plans on the health insurance exchanges. More recently,...

How Risk Adjustment Challenges the Health Insurance Market

by Vera Gruessner

Ever since the provisions of the Patient Protection and Affordable Care Act came into effect on January 1, 2014, healthcare payers have been unable to deny health insurance or charge larger premium costs to those with pre-existing conditions....

Continue to site...