Interoperability

HHS, payers meet to address Change Healthcare cyberattack response

March 20, 2024 - Officials from the Department of Health and Human Services (HHS) met with 15 health insurance companies, including major payers and organizations like UnitedHealth Group, Elevance Health, and AHIP, to discuss payers’ Change Healthcare cyberattack response, HHS reported. During the meeting, HHs reviewed the results of a payer survey...


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4 Key Strategies to Promote Effective Payer, Provider Alignment

by Victoria Bailey

Strong payer-provider alignment makes life easier for all healthcare stakeholders. While providers administer services to individuals, payers are responsible for reimbursing providers and ensuring members have coverage for their care....

Key Strategies for Transitioning a Health Plan into Cloud Computing

by Kelsey Waddill

Updated 08/14/2023: This article has been updated to reflect a few timeline discrepancies. Additionally, Lisa Davis's position was formerly listed as "senior vice president," which was her role when she was hired at Blue...

Best Vendors for Healthcare Payer Services, Software Needs

by Kelsey Waddill

As the US enters a post-pandemic era with the end of the public health emergency, healthcare payers will want to choose the right partners to take them into the next stage. They might locate new...

ACHP Addresses Proposed Rule on Substance Use Disorder Patient Data

by Kelsey Waddill

The Alliance of Community Health Plans (ACHP) was among around 50 organizations—including AHIP and Blue Cross Blue Shield Association—to sign a letter to HHS that supported fully aligning...

ERIC: Allow Employer Sponsored Health Plans to Electronically Deliver AEOB

by Kelsey Waddill

The ERISA Industry Committee (ERIC), a nonprofit that represents the largest employers who are sponsors of employer sponsored health plans, responded to the request for information on the advanced...

AHIP Envisions Race, Ethnicity Data Collection Standardization Improvements

by Kelsey Waddill

AHIP has introduced race and ethnicity data collection standardization recommendations for demographic data collection with the aim of empowering health equity efforts nationwide. “Robust,...

CAQH Shares Interoperability and Patient Access Rule Compliance

by Kelsey Waddill

More than two-thirds of payers have published a patient access point in compliance with the Final Interoperability and Patient Access Rule, according to a study from the Council for Affordable Quality...

Value-Based Care Models That Could Lower Maternal Care Costs

by Kelsey Waddill

Maternal healthcare costs in the US are too expensive, but value-based care may provide a solution, according to a brief from AHIP. “Americans need and deserve safe, high-quality, equitable and...

AHIP Shares Privacy, Cybersecurity Goals To Protect Consumer Data

by Kelsey Waddill

AHIP has shared its goals and priorities for upholding health IT security and privacy around consumer data in two press releases issued by the AHIP board of directors and the organization’s chief...

How Payers Help Tackle Substance Use Disorders, Other Conditions

by Kelsey Waddill

The National Quality Forum’s (NQF) Opioids and Behavioral Health committee brought together healthcare leaders from across the nation to explore an under-represented subject: strategies around substance use disorders with...

CMS Retreats from 2022 Payer-to-Payer Data Exchange Enforcement

by Kelsey Waddill

Updated 9/20/21: This article has been updated to include comments from Alexander Dworkowitz, partner at Manatt Health. CMS announced in its interoperability guidance that it would not be...

ACHP: Extend Transparency, Interoperability Compliance Deadlines

by Victoria Bailey

The Alliance of Community Health Plans (ACHP) has asked CMS to reassess surprise billing, cost transparency, and interoperability compliance deadlines and health data exchange policies that are putting...