Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Insurance

Medicaid Expansion Boosts Coverage, Quality at Health Centers

February 7, 2017 - Federally funded health centers in states that underwent Medicaid expansion through the Affordable Care Act faced higher levels of insured patients and improved care quality compared to their peers in non-expansion states, a recent Health Affairs study found. Using Health Resources and Services Administration (HRSA) data from 2011 to 2014, Brown University researchers revealed that uninsured...


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Medicaid Expansion Boosts Coverage, Quality at Health Centers

by Jacqueline Belliveau

Federally funded health centers in states that underwent Medicaid expansion through the Affordable Care Act faced higher levels of insured patients and improved care quality compared to their peers in non-expansion states, a recent Health Affairs...

ACA Health Insurance Exchanges Bring Challenges for 2017

by Vera Gruessner

The Affordable Care Act (ACA) health insurance exchanges will have some key differences next year. Health insurance companies have faced various obstacles when selling health plans through the exchanges. These challenges include a higher risk...

How a Public Option May Preserve Health Insurance Exchanges

by Vera Gruessner

Multiple healthcare payers have been struggling with operating successfully on the Affordable Care Act’s health insurance exchanges. Some experts and lawmakers suggest that establishing a public option on the health insurance exchanges...

Health Insurance Acquisitions Impede Competition in 24 States

by Vera Gruessner

The American Medical Association (AMA) announced today in a press release the results of a new study show that the health insurance acquisitions between Anthem-Cigna and Aetna-Humana would obstruct competition in the health insurance market throughout...

4 Motives Why Hospitals Adopt Provider-Sponsored Health Plans

by Vera Gruessner

Due to the many new transformations taking place within the healthcare industry today such as the transition from fee-for-service reimbursement to value-based care payments, the potential for creating provider-sponsored health plans has grown...

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...

Is Rising US Healthcare Spending Burdening the Economy?

by Vera Gruessner

Is healthcare spending in the United States too high? Are the financial aspects of running the medical system around the country burdening the US economy? The National Center for Policy Analysis insists that the viewpoint claiming that healthcare...

Why Payers Should Improve Cost Transparency for Consumers

by Vera Gruessner

The health insurance industry could benefit from greater cost transparency, as it could bring new methods for lowering healthcare spending and create a more competitive market among providers. Federal and state regulators aiming at reducing healthcare...

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...

How the Affordable Care Act has Impacted Health Payers

by Vera Gruessner

The Affordable Care Act has  brought a significant reform toward the health insurance industry. This particular legislation has given the majority of American people healthcare coverage, which has put greater strain on health insurers. For...

Could Electronic Processing Reduce Medical Spending Rates?

by Vera Gruessner

The US healthcare system is one of the most expensive around the world and the rising costs haven't diminished significantly in recent years. Today, health payers and providers have been working together to reduce medical spending around...

Plan Member Satisfaction Reduced in Less Competitive Markets

by Vera Gruessner

Due to the value-based care initiatives taking place at the Centers of Medicare and Medicaid Services (CMS), patient engagement and patient satisfaction have become imperative for the health payer industry. A report from J.D. Power called the...

How Data, Value-Based Care Drives Down Health Insurance Costs

by Vera Gruessner

In today’s world, the average employee and business owner are seeing a rise in health insurance costs. Even through the health insurance exchange, premium prices are expected to rise this year while high-deductible plans are becoming more...

Bundled Payment Models Need to Align Payer, Provider Incentives

by Vera Gruessner

Bundled payment models are growing in popularity throughout the health insurance industry partially due to the Centers for Medicare & Medicaid Services (CMS) pushing forth alternative payment structures as well as the general goal of reducing...

Price Transparency May Lower $27 Billion in Healthcare

by Vera Gruessner

Price transparency in the healthcare industry is becoming more and more pertinent and sought after. Research has shown that there is still insufficient price transparency within the medical field including hospital services. However, a new report...

How Health IT Automation Improves Consumer Satisfaction

by Vera Gruessner

New technologies and health IT tools are becoming a necessary part of the health insurance industry, as innovative approaches like automation can largely benefit employees while portals could make a difference for health plan consumers. When...

52% of Employers Offer High-Deductible Health Insurance Plans

by Vera Gruessner

Despite the fact that the health insurance exchanges and Medicaid expansion opened up more opportunities for Americans to obtain healthcare coverage without being dependent on employment, the health payer industry is still intertwined with the...

Hospitals Lagging Behind in Population Health Management

by Vera Gruessner

As most health payers know, population health management and value-based care payments go hand-in-hand. When it comes to effective population health management, data storage and analysis plays an integral role among payers and providers. As payers...

Precision Medicine is a ‘Whole New Ballgame for Insurers’

by Vera Gruessner

Recently, President Barack Obama has announced a national “Moonshot” program to put an end to cancer as a whole. Vice President Joe Biden has been appointed the main leader of this project, a White House news release stated. A total...

Bundled Payment Model, Lump Sum Insurance Plans Make Headway

by Vera Gruessner

As the healthcare industry especially the medical insurance space continues to seek methods for reducing ever-increasing costs, the bundled payment model shows more promise for payers and providers alike. The Centers for Medicare & Medicaid...

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