Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

Why GOP Should Hold Off on Replacing the Affordable Care Act

by Vera Gruessner

When the Patient Protection and Affordable Care Act was passed into law, it has had a variety of proponents as well as opposition from the GOP with many calling on the healthcare law to be repealed. However, repealing the Affordable Care Act...

Why Payers Should Include Consumer Engagement in Health Plans

by Vera Gruessner

In order to ensure that the health insurance exchange successfully reduces healthcare spending, it may be necessary to strengthen consumer engagement and education so that policyholders continually purchase the right health coverage for their...

CMS Awards $22M for Cost Transparency Under Affordable Care Act

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced in a press release that $22 million of funds are available to help state regulators with issuer compliance according to consumer protections under the Affordable Care...

Affordable Care Act Brought Healthcare Coverage to Rural Areas

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a fair amount of healthcare access and coverage to the American people. This does not just include those living in urban areas or the suburbs. Recent research suggests that the Affordable...

Slavitt: Health Insurance Marketplace Boosts Patient Engagement

by Vera Gruessner

The federal government has taken a wide variety of steps to strengthen patient care and healthcare revenue systems throughout the country. Specifically, the Centers for Medicare & Medicaid Services (CMS) and the health insurance marketplace...

Payers Adopt Value-Based Care via Health Insurance Marketplace

by Vera Gruessner

The health insurance marketplace created through the Patient Protection and Affordable Care Act has had a variety of success ever since its inception. This new model of healthcare coverage has provided health insurance for an additional 20 million...

What Health Insurance Exchanges Should Do to Cut Premium Costs

by Vera Gruessner

The costs of premiums sold on the state health insurance exchanges tend to vary greatly, finds a report from The Commonwealth Fund. For instance, in 2016, the state of Tennessee saw a 38 percent increase in their health insurance premium costs...

Health Plan Solutions: Do Employers Choose Private Exchanges?

by Vera Gruessner

Today employers are searching for multiple solutions to meet their health plan needs in order to reduce costs and provide the optimal benefits to their employees. The multitude of healthcare regulations hitting the market today is making quite...

Affordable Care Act Brought the Uninsured Rate to 9.1%

by Vera Gruessner

The Patient Protection and Affordable Care Act has made a tremendous impact on healthcare coverage among Americans. An extra 20 million people now have healthcare access  do due to the health insurance exchanges. The Centers for Disease...

Health Insurance Market Faces Restricted Provider Networks

by Vera Gruessner

Last week, Scott Gottlieb, MD, Resident Fellow at the American Enterprise Institute, spoke in front of the House Committee on Energy and Commerce Subcommittee on Health delivering key information about certain reforms for the health insurance...

Healthcare Affordability Difficult for Marketplace Consumers

by Vera Gruessner

Healthcare affordability remains a top issue throughout the United States. The Henry J. Kaiser Family Foundation released a brief discussing how many Americans still have difficulty with healthcare affordability since the price of premiums and...

Court Sides with Republicans on Affordable Care Act Provision

by Vera Gruessner

Once again, the Patient Protection and Affordable Care Act is receiving criticism from the Republican-led House of Representatives. House Republicans had filed a lawsuit claiming that the Obama administration does not have the authority to provide...

Health Insurance Exchange Consumers Satisfied with Health Plans

by Vera Gruessner

Despite the fact that the House of Representatives and the Senate attempted to repeal the Affordable Care Act at the end of 2015, consumers seem to be satisfied with their healthcare coverage options after purchasing health plans on the health...

The Biggest ACA Legal Challenges Facing Healthcare Industry

by Vera Gruessner

Ever since the Obama administration passed the healthcare law to reform many of the inequalities faced in this country, there have been a wide variety of ACA legal challenges that have stood in the way of this law progressing to reduce the rates...

What will the Future Bring for the Affordable Care Act?

by Vera Gruessner

The future of the Affordable Care Act and health insurance exchanges may not be as favorable as the Obama administration had hoped. Many fear that the major health insurer UnitedHealthcare leaving the state-based exchanges could lead other payers...

Health Insurance Exchange Displays 2 Consumer Engagement Tools

by Vera Gruessner

The health insurance exchange under the Affordable Care Act is undergoing some renovations over the next year, reports Kevin Counihan, CEO of HealthCare.gov and Dr. Patrick Conway, Principal Deputy Administrator of CMS. In The CMS Blog, Conway...

How the Affordable Care Act Impacts First Quarter Earnings

by Vera Gruessner

The health insurance industry has had a topsy turvy time learning how to function effectively in the new landscape the Affordable Care Act has brought to the medical field. When it comes to the financial well-being of top payers, the Affordable...

State Medicaid Expansion Should Reduce Emergency Room Visits

by Vera Gruessner

The Patient Protection and Affordable Care Act brought a variety of changes for the healthcare industry as well as individual states. For example, the Affordable Care Act called on for Medicaid expansion among the 50 states. However, a Supreme...

Consumer Engagement Vital in Health Insurance Exchanges

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a variety of changes for both insurers and healthcare providers with the establishment of health insurance exchanges holding a top place in reforming reimbursement between payers and...

Risk Adjustment Affects Plans on Health Insurance Exchanges

by Vera Gruessner

The trade association AMGA, which entails a large membership of medical groups and healthcare delivery systems, submitted comments last week to the Centers for Medicare & Medicaid Services (CMS) regarding its proposal to change risk adjustment...

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