Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

40% Health Plans Sold via Health Insurance Marketplace Overlap

by Vera Gruessner

Various health plans sold through the health insurance marketplace may actually overlapped with Medicaid coverage. The Association for Community Affiliated Plans (ACAP) released a study that shows about 40 percent of issuers providing Qualified...

Arizona Declines Funding Children’s Health Insurance Program

by Vera Gruessner

Nearly 20 years ago, the Children’s Health Insurance Program (CHIP) was established in order to ensure the offspring of low-income families who didn’t qualify for the Medicaid insurance plan did have the right to healthcare coverage....

How the Affordable Care Act Strengthened Mental Health Parity

by Vera Gruessner

The Obama administration's Affordable Care Act has brought various benefits to the American people including greater health coverage through the health insurance exchange and Medicaid expansion. Young adults under 26 years of age can now...

Consumer Education Key for Health Insurance Marketplace Success

by Vera Gruessner

It seems that those residing in Texas who have purchased their healthcare coverage through the health insurance marketplace do not have as much understanding of certain terms as those who have medical insurance through their employer or via Medicaid...

Is the Affordable Care Act Sufficient for Mental Healthcare?

by Vera Gruessner

There are specific provisions that the Patient Protection and Affordable Care Act has brought to the American people. This includes eliminating healthcare coverage restrictions such as the clause surrounding pre-existing conditions. Additionally,...

Insurer Participation in Health Insurance Exchange Decreases

by Vera Gruessner

Health payers around the country may not be faring as well as hoped within the federal health insurance exchange. The Affordable Care Act may have had a negative impact on health insurance companies, as some are experiencing financial loss when...

California Health Insurance Exchange Targets Costly Hospitals

by Vera Gruessner

The health insurance exchange from the state of California has some news to report. The exchange is considering the elimination of hospitals from its network that have shown subpar performance or had reported rising medical costs, according to...

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...

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