Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Insurance

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....

23% of Voters Find Affordable Care Act ‘Extremely Important’

by Vera Gruessner

The Henry J. Kaiser Family Foundation released the January Kaiser Health Tracking Poll last week showing that the Affordable Care Act did not make it past 23 percent of those surveyed stating that it’s ‘extremely important’...

Enrollment through Health Insurance Exchange Continues to Rise

by Vera Gruessner

The deadline to apply for healthcare coverage through the federal health insurance exchange – healthcare.gov – is this Sunday, January 31. Currently, approximately 8.9 million people have either enrolled in a health insurance plan...

Health Insurance Company Couldn’t Lay Claim to Personal Assets

by Vera Gruessner

The health payer industry has seen its share of legal battles when it comes to keeping businesses afloat financially. One particular health insurance company – the National Elevator Industry Health Benefit Plan – paid $120,000 in...

Affordable Care Act Brings Greater Health Coverage to Texas

by Vera Gruessner

The Patient Protection and Affordable Care Act may have done its job in one particular state with regard to expanding health coverage options and providing federal subsidies on the health insurance exchange. A study from Rice University’s...

‘Patient Voice’ Missing from Healthcare Spending Conversation

by Vera Gruessner

Chronic disease continues to lead to heavy healthcare spending and health payers have aimed their sights on better understanding methods for preventing and addressing chronic medical conditions. Both private and public payers such as the Medicaid...

Co-ops on Health Insurance Exchanges Need Greater Surveillance

by Vera Gruessner

The Patient Protection and Affordable Care Act has influenced greater health coverage among American citizens through establishing state health insurance exchanges. However, when creating this platform, a number of Democratic congressmen were...

Top 3 Difficulties Facing State Health Insurance Exchanges

by Vera Gruessner

Once the Patient Protection and Affordable Care Act was passed into law, a tide of legal challenges came crashing against the legislation. In particular, the state and federal health insurance exchanges faced several differing lawsuits. Legal...

Key Steps toward Affordable Health Insurance Platforms

by Vera Gruessner

The average insured consumer is facing a whole new landscape when it comes to managing the costs of care. The prices surrounding health insurance plans and coverage options are rising steadily while wages and inflation rates remain relatively...

Why a Competitive Health Insurance Plan Matters to Employees

by Vera Gruessner

It seems that benefits and a health insurance plan majorly influence employment decisions of many Americans. An online survey completed by Harris Poll on behalf of the software company Collective Health shows that more than 75 percent of US citizens...

AAI Asks DOJ to “Just Say No” to Health Insurance Mergers

by Vera Gruessner

The latest news regarding the Aetna-Humana and Anthem-Cigna mergers revolves around a new letter sent to the Department of Justice Antitrust Division by the American Antitrust Institute. The letter states it concerns about the impending mergers...

20% of Insured Americans Struggle with Paying Medical Bills

by Vera Gruessner

A new report from Rice University’s Baker Institute for Public Policy and the Episcopal Health Foundation (EHF) shows that 3.8 percent fewer Texans found problems paying their medical bills in September 2015 when compared to the results...

America’s Health Insurance Plans Loses Aetna Membership

by Vera Gruessner

The major health payer Aetna has recently withdrawn its membership from one of the nation’s largest insurance lobbying group America’s Health Insurance Plans (AHIP). The lobbying group is now under new leadership. Former administrator...

8.2 Million Applied for Coverage on Health Insurance Exchanges

by Vera Gruessner

Open enrollment via the health insurance exchanges has seen a dramatic rise in popularity since the starting date of November 1, as more than 8.2 million consumers signed up for health coverage on HealthCare.gov or had their plans renewed, according...

Why are Bundled Payment Systems Difficult to Adopt?

by Vera Gruessner

While bundled payment systems have been advocated as a means to reduce the costs of medical care by the Centers for Medicare & Medicaid Services (CMS), many health insurers and providers are still stuck on fee-for-service payment models....

How Care Management Strategies Could Reduce Medical Costs

by Vera Gruessner

When it comes to managing the treatment and financial implications of complex medical conditions, health payers and providers will need to work together and have effective cross-industry communication. A strong relationship between payers and...

New Framework for MACRA’s Alternative Payment Models Released

by Vera Gruessner

Earlier this year, the federal government passed the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), which reforms the Medicare program by abolishing the Sustainable Growth Rate (SGR) formula, developing a more effective value-based...

75% of Providers Drop Out of CMS Bundled Payments Model

by Vera Gruessner

The Innovation Center belonging to the Centers for Medicare & Medicaid Services (CMS) created the Bundled Payments for Care Improvement (BPCI) program, which consists of setting aside a previously agreed-upon set of funds for several healthcare...

Value-based Care, Member Incentives May be Payers’ ‘Holy Grail’

by Vera Gruessner

The healthcare payer industry is expected to change drastically over the coming years as more insurance companies adopt new business models and focus on value-based care. Moving away from fee-for-service, federal agencies and many payers are...

2016 Premiums on Health Insurance Exchanges Expected to Soar

by Vera Gruessner

Health payers managing plans through the state health insurance exchanges will need to work toward maintaining superior customer relations due to the rise in premium costs expected in 2016. The Robert Wood Johnson Foundation released datasets...

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