Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

Drop Outs in Exchanges, Health Insurance Merger Block Hit Market

by Vera Gruessner

The health insurance market seems to be heading toward more and more consolidation as the major payers Humana and Aetna along with Cigna and Anthem seem to be bent on merging, which would essentially reduce competition and create consolidation...

Cigna Boosts Outcomes Despite Affordable Care Act Obstacles

by Vera Gruessner

With many health payers experiencing significant challenges while operating through the health insurance exchanges and adhering to various provisions of the Patient Protection and Affordable Care Act, it grows more important than ever before...

Both Political Parties Seek to Replace the Affordable Care Act

by Vera Gruessner

As previously reported, the major health payer Aetna is leaving the majority of health insurance exchanges it is currently operating in. Some critics have pointed at the failure of the Affordable Care Act to sustain payers within the public exchanges...

Aetna Leaving Health Insurance Exchanges Due to DOJ Lawsuit

by Vera Gruessner

The latest news coming from the major health payer Aetna is its move to drop out of the majority of the health insurance exchanges it had been participating in this year. According to a press release from Aetna, it will leave most of the public...

Affordable Care Act’s Reinsurance Programs Keep Market Stable

by Vera Gruessner

One way that health payers can compete more effectively in the current destabilized environment is by investing resources in reinsurance programs. Reinsurance is a method in which a payer can buy a policy from other insurers in order to manage...

Affordable Care Act, Accountable Care Display Success

by Vera Gruessner

With fairly large sects of the political spectrum opposing various provisions of the Patient Protection and Affordable Care Act as many as six years after its passage, it grows vital to examine whether or not this landmark healthcare legislation...

Kentucky Governor Proposes Waiver for Medicaid Expansion

by Vera Gruessner

The status of Medicaid expansion has floundered around the nation ever since the Supreme Court ruled that individual states will have the option to choose whether or not to expand their Medicaid programs as called for under the Patient Protection...

Affordable Care Act Payment Program Boosts Care, Cuts Costs

by Vera Gruessner

The Patient Protection and Affordable Care Act has a wide variety of reforms that have been implemented to improve care for American citizens. One of these reforms includes a payment model called the Independence at Home Demonstration operated...

Affordable Care Act, Exchanges Challenge Health Payers

by Vera Gruessner

Ever since the passage of the Patient Protection and Affordable Care Act (ACA), a number of opponents have found factors to criticize within the landmark healthcare law. But has it truly brought more problems for the healthcare industry? From...

Is the ACA’s Health Insurance Provider Fee Unconstitutional?

by Vera Gruessner

Last year, six states including Texas, Wisconsin, Kansas, Louisiana, Indiana and Nebraska filed a lawsuit arguing that a provision within the Affordable Care Act requiring states to cover a Health Insurance Provider Fee is unconstitutional and...

How Health Insurance Industry Faces the Presidential Elections

by Vera Gruessner

The upcoming US presidential elections may impact the future of the health insurance industry and the way healthcare costs are addressed in this country. Whether the Democrats or the Republicans take the White House, the continuing rise in the...

ACA, Mergers, Value-Based Care Dominated Payer News in July

by Vera Gruessner

Last month, the news cycle was busy for the health insurance industry. Some of the key areas that seemed to make the biggest splash for the health insurance market includes the ongoing disputes regarding the Affordable Care Act and the Department...

How Presidential Election will Impact the Affordable Care Act

by Vera Gruessner

For months now, the media has been broadcasting 24 hours per day, seven days a week news related to the upcoming presidential election. Many have postulated on how the nation will be impacted if either the Republican Party or the Democratic Party...

Democratic Party’s Predictions for the Affordable Care Act

by Vera Gruessner

The future of the healthcare industry and the health insurance space is very much dependent on the upcoming presidential elections and the two parties' stances on the Patient Protection and Affordable Care Act. The Affordable Care Act has...

Arizona’s Children’s Health Insurance Program Back in Action

by Vera Gruessner

The state of Arizona has had a restriction on accepting funding for the Children’s Health Insurance Program (CHIP) for the last several years. Arizona’s CHIP program was known as KidsCare and offered health coverage for children of...

Does Blocking Health Insurance Mergers Impact ACA Exchanges?

by Vera Gruessner

Last week, the Department of Justice announced that it will be filing lawsuits against the Anthem-Cigna and Aetna-Humana health insurance mergers. The issue at hand is that these health insurance mergers would increase concentration and hurt...

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....

Continue to site...