Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

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...

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...

What the Health Insurance Marketplace Should Expect in 2016

by Vera Gruessner

With January 1, 2016 only days away, it is useful to review next year’s predictions for the healthcare insurance industry. Both the costs of monthly premiums and the health insurance marketplace set up by the Patient Protection and Affordable...

Top 4 Predictions for Healthcare Payer Industry in 2016

by Vera Gruessner

As the year comes to a close, while many are off to celebrate the holidays, those within the healthcare payer industry would be wise to look ahead to the New Year and prepare for the coming trends and challenges of 2016. Below we outline four...

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...

Medicaid Expansion, State Exchanges Led to Drop in Uninsured

by Vera Gruessner

Ever since the Supreme Court ruled that one stipulation within the Patient Protection and Affordable Care Act is not fully constitutional, states around the nation have taken the court’s decision to heart and truly shown that Medicaid expansion...

Data Sharing Among Payers Advances Population Health Management

by Vera Gruessner

When it comes to data collection and data sharing, payers should inform beneficiaries exactly how their information is used such as public health reporting requirements or among healthcare providers. The federal government offers a background...

How Payers Can Improve Websites of Health Insurance Exchanges

by Vera Gruessner

In order to better serve their customer base, state health insurance exchanges along with the federal website HealthCare.gov could take a number of steps to improve their web pages and expedite the purchasing of health insurance plans. The Clear...

Will Health Insurance Exchange Remain Intact Despite Hurdles?

by Vera Gruessner

What will happen to the health insurance exchange created by the Patient Protection and Affordable Care Act? Will it continue on as originally planned by the Obama administration? Or will new legislation and the decisions of insurance companies...

The Senate Passes Bill to Repeal Chunks of Affordable Care Act

by Vera Gruessner

On Thursday, the United States Senate voted 52 to 47 in passing a legislation that would gut major provisions within the Patient Protection and Affordable Care Act. This is the first time the Senate has approved such a bill and has the opportunity...

Is UnitedHealthcare Leaving a ‘Death Spiral’ for Exchanges?

by Vera Gruessner

The insurer UnitedHealthcare has recently announced that it would consider moving away from the Affordable Care Act’s health insurance exchanges due to significant profit losses. The actions of this large health payer could be an indication...

State Health Insurance Exchanges Face Many Challenges

by Vera Gruessner

The creation of health insurance exchanges throughout individual states after the passage of the Affordable Care Act has not been an easy process. Many state health insurance exchanges have experienced a variety of challenges over the last few...

Medical Loss Ratio Provision Led to $2.4 Billion in Rebates

by Vera Gruessner

A new report shows that consumers have received more than $2.4 billion in premium rebates since 2011 because of the passage of the Patient Protection and Affordable Care Act. The Medical Loss Ratio provision under the Affordable Care Act gives...

How Value-Based Care Payment Models Could Reduce Costs

by Vera Gruessner

Did you know that 8 million people gained private insurance through the health insurance exchange and 3 million young adults gained coverage since the Affordable Care Act was passed? In recent years, the health insurance market and the medical...

Insurance Mergers and Acquisitions May Increase Premiums

by Vera Gruessner

Mergers and acquisitions are popping up all over the healthcare industry from drug makers and hospital systems to health insurers. The year 2015 has been a beehive of activity for the consolidation of a large number of medical companies. The...

CMS Releases Doctor Lookup Pilot on Health Insurance Exchange

by Vera Gruessner

The health insurance exchange has a new feature that should bring more interest from consumers. The Centers for Medicare & Medicaid Services (CMS) announced yesterday that Healthcare.gov, the website that offers coverage plans on the health...

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