Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Costs

Payer Housing Partnership Addresses Social Determinants of Health

by Thomas Beaton

Health Partners Plans (HPP) and two community programs in Philadelphia announced a partnership to address housing-related social determinants of health by connecting homeless individuals to healthcare services, free clinics, free meals,...

Ongoing Payer Consolidation Leads to Consumer Premium Hikes

by Thomas Beaton

The four largest payers in the US have continued to get bigger over the past few years, said Leemore S. Dafny, a professor of the Bruce V. Rauner Professor of Business Administration at Harvard Business School, during a House Energy and...

National Healthcare Expenditures Expected to Reach $5.5T by 2026

by Thomas Beaton

The CMS Office the Actuary forecasts that national healthcare expenditures will reach $5.5 trillion by 2026 due to a 5.5 percent yearly growth rate. CMS said that the anticipated average growth rate of healthcare spending is lower than...

Employer Guide Offers Strategies for Wellness Program Success

by Thomas Beaton

An employer guide developed by The Transamerica Center for Health Studies (TCHS) and the Interdisciplinary Center for Healthy Workplaces (ICHW) determined that employers may need a better understanding of the factors that inhibit wellness...

71% of Workers Satisfied with Employer-Sponsored Health Plans

by Thomas Beaton

Over 70 percent of employees are generally satisfied with their employer-sponsored health plans, but are concerned with rising health plan costs, an AHIP study found. Employer sponsored health plans have provided fair premium and...

Alaska Bill to Alter Emergency Room Payment Rules Brings Concern

by Thomas Beaton

A bill in the Alaska Senate intended to repeal protections around emergency room payments has drawn significant concern from the state’s chapter of the American College of Emergency Physicians (ACEP).  The bill would remove a...

How All-Payer Claims Databases Can Identify Wasteful Spending

by Thomas Beaton

An all-payer claims database (APCD) can hold data on millions of patients and the services they receive, giving payers, providers, and related stakeholders the ability to identify wasteful spending and develop strategies to cut costs and...

Member Incentives for Lower Cost Health Services Saved Payer $3.2M

by Thomas Beaton

Commercial payers struggling to curb costs and encourage their members to make smarter financial choices may be able to save millions of dollars each year by investing in modest member incentives. Offering small financial rewards for...

Amazon, JP Morgan, Berkshire Hathaway Form Healthcare Company

by Thomas Beaton

Amazon, JP Morgan Chase & Co., and Berkshire Hathaway have announced a long-term partnership to form an independent company that focuses on cost-effective healthcare for employees. The company will aim to remove profit-making...

Consumer-Directed Care, High Deductibles Popular for Employees

by Thomas Beaton

Consumer-directed care, high-deductible health plans (HDHPs), and financial benefits related to healthcare spending have increased in popularity and demand by employees from 2017 to 2018, according to a new report from Benefitfocus. The...

DE Shifts Managed Medicaid Contracts to Value-Based Agreements

by Thomas Beaton

Delaware’s Department of Health and Social Services (DHSS) announced it is translating the state’s managed Medicaid Contracts into value-based agreements to improve the outcomes and costs of the state’s public healthcare...

Health Insurance Costs Placing Stress on Majority of Americans

by Thomas Beaton

Sixty-nine percent of Americans with an income of $50,000 a year or more cited the cost of health insurance as a major stressor and 63 percent of Americans with incomes less than $50,000 per year cited insurance costs as a major life...

High Care Costs Driving Employer-Sponsored Insurance Spending

by Thomas Beaton

The Health Care Cost Institute (HCCI) found that high care costs were the primary driver of increased employer-sponsored insurance spending in 2016, which grew by 4.6 percent and exceeded any rate between 2012 and 2015. A HCCI report of...

Humana Expands Long-Term Social Health Determinant Investments

by Thomas Beaton

Humana, and its philanthropic arm the Humana Foundation, announced changes to their grant making processes that provide long-term investments into community programs that address the social determinants of health (SDOH). The new...

Payers Support Integrated Care Services for NC Medicaid Patients

by Thomas Beaton

Payers and provider organizations that support integrated care systems can help lower healthcare costs by addressing the healthcare concerns of vulnerable patient populations, including Medicaid beneficiaries. Several commercial payers...

Considerations for Designing Consumer-Directed Health Plans

by Thomas Beaton

Employers and health plans are rapidly adopting consumer-directed health plans (CDHPs) as a way to lower benefit costs and encourage cost-effective care utilization among beneficiaries. CDHPs are becoming part of many US employers’...

Expanding Air Ambulance Service May Help Payers Control Costs

by Thomas Beaton

Expanding air ambulance benefits may help payers lower beneficiary premiums and help beneficiaries avoid several thousand dollars in out-of-pocket healthcare spending. An air ambulance costs between $12,000 to $25,000 per flight to...

Wellness, Preventive Care to Drive Employer Health Plans in 2018

by Thomas Beaton

Employer-sponsored health plans are expected to widely embrace value-based purchasing agreements and patient engagement technologies that improve employee wellness programs and preventive care, according to the National Business Group on...

Healthcare Insurance Market Profits May Hold Steady in 2018

by Thomas Beaton

Certain segments of the healthcare insurance market, including employer-sponsored insurance and Medicare Advantage (MA), will help to stabilize payer profitability in 2018, predicts a report by A.M. Best. The gains from these sectors are...

Member Engagement, Medicare Advantage Growth Top 2018 Payer Trends

by Thomas Beaton

2018 is a year in which payers are likely to implement strategies aimed at improving growth in Medicare Advantage markets, increasing the use of the social determinants of health  to improve outcomes, and expanding member engagement...

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