Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

Is the Affordable Care Act Leading Payers to Lose Profit?

by Vera Gruessner

The world of healthcare has often been a struggle between medical providers and the payers with one side looking to offset costs and make a profit while the other side concerns itself with the revenue of their patient care. With the federal government...

25% of Texans Lack Knowledge about Health Insurance Plans

by Vera Gruessner

New research shows that consumer education in terms of health insurance plans and healthcare access is becoming a necessity since many are unaware of some typical health insurance terms. Rice University’s Baker Institute for Public Policy...

Medicaid Coverage Expansion Boosts Healthcare Access in Flint

by Vera Gruessner

In April 2014, contamination in drinking water began in Flint, Michigan when the region transitioned its water source to the Flint River from its previous source of Lake Huron and the Detroit River. The problem at hand is that corrosion control...

Open Enrollment Dates Announced for Health Insurance Exchange

by Vera Gruessner

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released its yearly Notice of Benefit and Payment Parameters related to the coverage options on the federal health insurance exchange in 2017. The rulings outline ways...

Should Payers Question ACA’s Health Insurance Exchanges?

by Vera Gruessner

The health insurance exchanges have faced some significant challenges and even some questioning among the payer community, especially after the insurer UnitedHealthcare announced at the end of 2015 that it is considering whether to leave the...

Healthcare Bundled Payments, Silver Plan Changes Impact Payers

by Vera Gruessner

The federal government especially the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have targeted healthcare payment reform in an effort to reduce rising medical costs around the nation....

Will Health Insurance Mergers Stifle Market Competition?

by Vera Gruessner

Health insurance mergers and acquisitions have been a major topic within the payer industry lately. While companies that have pushed through with their mergers cite their potential cut of competition as a way to lower prices for the end consumer,...

HHS Pursues Higher Enrollment on Health Insurance Exchanges

by Vera Gruessner

The Department of Health and Human Services (HHS) is pleased with the most recent enrollment numbers in the Affordable Care Act’s health insurance exchanges. Department of Health and Human Services Secretary Sylvia M. Burwell stated in...

Payers Bear Monetary Losses in Health Insurance Exchanges

by Vera Gruessner

Several medical insurance companies have experienced losses and financial troubles within the federal and state health insurance exchanges. UnitedHealth Group, for example, has considered pulling out of the health insurance exchanges starting...

The Affordable Care Act could Decrease Chronic Disease Rates

by Vera Gruessner

Needless to say, healthcare reform and the Affordable Care Act have revolutionized many avenues of the health payer industry. The individual mandate along with Medicaid expansion and federal tax subsidies on the health insurance exchanges have...

12.7 Million Americans Enrolled in Health Insurance Exchanges

by Vera Gruessner

The last day to sign up for 2016 medical coverage during the open enrollment period through the state and federal health insurance exchanges was January 31 and the Department of Health and Human Services (HHS) announced in a press release that...

70% of Uninsured Texans Find Medical Coverage Costs too High

by Vera Gruessner

The Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation (EHF) found in a new report that nearly seven out of ten uninsured Texans cite the high costs of medical coverage as the reason for lacking insurance....

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...

Patient Engagement Cuts Healthcare Spending among Payers

by Vera Gruessner

Within both federal and state health insurance exchanges, payers are seeking methods for reducing cost in order to avoid profit loss and dropping out of the exchanges much like UnitedHealthcare’s move away from the marketplace. One method...

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...

HIV/AIDS Patients Struggle with High Healthcare Costs

by Vera Gruessner

The high costs within the healthcare industry are often associated with managing the health of patients living with chronic medical conditions. At the J.P. Morgan’s Healthcare Conference in early January, James L. Madara, the Executive...

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...

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