Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Payers

Major Iowa Insurer Joins Obamacare Health Insurance Exchange

by Vera Gruessner

The Patient Protection and Affordable Care Act under the Obama administration, which is colloquially known as Obamacare, set up a health insurance exchange platform that enables consumers to pick and choose which type of healthcare coverage is...

Will New Model of Accountable Care Organizations Cut Costs?

by Vera Gruessner

There are a variety of policy changes and healthcare reforms that have taken place since the Patient Protection and Affordable Care Act was passed in 2010. The development of Accountable Care Organizations (ACOs) is one such reform. With the...

Will the Move to ICD-10 Medical Coding Delay Claims Processing?

by Vera Gruessner

The health insurance space is about to have a major transformation in medical coding that could potentially cause financial barriers and claims processing issues. If the transition to ICD-10 medical coding is not properly managed, a variety of...

Issues Surround Health Insurance Marketplace despite ACA

by Vera Gruessner

The health insurance marketplace underwent tremendous transformations with the passage of the Obama administration’s Patient Protection and Affordable Care Act. New regulations have required everyday citizens to purchase health insurance...

Do All Health Insurance Exchanges Follow Federal Regulations?

by Vera Gruessner

Ever since President Barack Obama and his administration passed the Patient Protection and Affordable Care Act, the development of the health insurance marketplace was born. The law requires every individual to purchase health insurance or else...

ICD-10 Implementation Deadline Affects Claims Processing

by Vera Gruessner

Healthcare payers have a wide variety of concerns with regard to the coming ICD-10 implementation deadline and will need to be prepared for any potential issues that may pop up after the October 1, 2015 deadline. With a mere six days left, those...

NCPA Urges Policymakers Promote Medicare Price Sensitivity

by Jacqueline DiChiara

If policymakers fail to advance price sensitivity among beneficiaries, Medicare spending will only escalate, confirms a new study from Devon M. Herrick, PhD, Health Economist and Senior Fellow with the National Center for Policy Analysis (NCPA)....

Accountable Care Organizations Cut Costs by $411 Million

by Vera Gruessner

The medical industry has been focused on improving coordinated care across the spectrum of healthcare delivery. With ongoing healthcare reforms taking place around the country and the federal government taking a stronger role in improving patient...

ACA Medicaid Expansion Leads to Decreased Uninsurance Rates

by Sara Heath

As a result of Medicaid expansion as a part of the Affordable Care Act, many previously uninsured patients are shifting to Medicaid as their health insurer. A recent study by Kaiser Family Foundation shows that this shift in payer is decreasing...

Healthcare Insurance Rates Rise by 2.9% in 2014, Census Says

by Jennifer Bresnick

The rate of uninsured Americans decreased by 2.9 percent between 2013 and 2014, says the latest data from the US Census Bureau, thanks to higher rates of coverage for private and government payers.  In 2014, only 33 million Americans lacked...

GAO Report Uncovers 2015 Healthcare Premium Range Variation

by Jacqueline DiChiara

The United States Government Accountability Office (GAO) has released a report providing new information about 2014 and 2015 healthcare premium ranges and plan availability. GAO examined levels of disparity among health plan options and premiums,...

Insurance Mergers Will Not Benefit Consumers, AHA CEO Says

by Sara Heath

Health insurance mergers continue to raise antitrust concerns for the American Hospital Association (AHA). On September 10, AHA President and CEO Rick Pollack testified before the House Judiciary Committee panel regarding the association’s...

AMA: Insurer Mergers Expand Market Power, Reduce Competition

by Sara Heath

Healthcare mergers have been of great discussion as of late, as  Aetna announced its $37 billion acquisition of Humana, and Anthem its acquisition of Cigna. Although Aetna and Anthem officials state that these mergers will benefit the healthcare...

$67M ACA Funds to Help Affordable Health Insurance Enrollees

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) announced yesterday an abundant $67 million in Affordable Care Act (ACA) grant awards to aid outreach initiatives and help those individuals confused about health coverage and financial assistance...

6 Steps for Continued Accountable Care Organization Success

by Jacqueline DiChiara

Accountable Care Organizations (ACOs) – collaborative clusters of physicians, hospitals, and other healthcare providers voluntarily uniting to offer better coordinated care – are spreading like wildfire within the healthcare realm....

Patient Engagement High Priority for Millennial Patients

by Sara Heath

Patient engagement proves to be of high priority in the ever-evolving healthcare landscape, and providers and payers are seeing shifts in how patients purchase healthcare and health insurance because of patient engagement. This shift is due to...

3 ICD-10 Implementation Concentrations for Healthcare Payers

by Jacqueline DiChiara

As healthcare payers adjust their business models to more cleanly align with the continuously evolving ICD-10 landscape, immediate concern is being placed upon where payers should be focusing next as the healthcare industry...

Insurance Coverage Grows as Consumers Explore Payer Options

by Sara Heath

Attitudes toward healthcare coverage and healthcare reform have been reshaped in recent years. New avenues of healthcare coverage have come to light, and they are opening more options for how consumers may receive their coverage. Between the...

Bundled Payments Benefit Payers, Increase Quality of Care

by Sara Heath

Bundled payment systems are creating a lot of buzz in the healthcare industry as payers move away from fee-for-service payments and toward value-based payments. But what are bundled payments, and what effects do they have on the healthcare industry?...

Florida Hospitals Audited for Medicaid Payment Rate Limits

by Jacqueline DiChiara

The Florida Agency for Health Care Administration (AHCA) will audit 31 hospitals sprawled throughout Florida to assess whether or not their Medicaid managed-care plan contracts are indeed compliant with state law. Liz Dudek, AHCA Secretary, urged...

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