Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Policy

Medicaid Directors Voice Concerns for Graham-Cassidy Bill

by Thomas Beaton

The National Association of Medicaid Directors (NAMD) argues that a hasty passage of the Medicaid reforms presented in the Graham-Cassidy bill will have significant consequences for public payer programs and the health outcomes of their...

Planning for Individual Insurance Exchange Stabilization in WA

by Thomas Beaton

State health insurance markets and their individual insurance exchanges have faced regular instability in the form of payer exits, imbalanced risk pools, and rising premiums that push out new and returning insurance consumers. As premiums...

AHIP: Graham-Cassidy Bill a Poor Choice for Payers, Patients

by Thomas Beaton

AHIP believes that passage of the Graham-Cassidy Bill making the rounds in the Senate would adversely affect payer market through policies that destabilize the health insurance markets, reduce patient access to healthcare, and fail to meet...

More Payers, More Providers Increase Price Negotiation Power

by Thomas Beaton

Payers that operate within healthcare markets with a high concentration of payers and providers prices can negotiate the price of services up to 19 percent lower than those operating in low-concentration payer-provider markets, found a new...

Veterans Gained Coverage under ACA, but May Lose Big from Repeal

by Thomas Beaton

While the Affordable Care Act (ACA) produced significant coverage gains for veterans, currently proposed repeal actions could hit this population particularly hard, according to a study from RAND Corporation. Prior to the ACA, 9.1 percent...

AARP: Congress Must Take Action on ACA Market Stabilization Solutions

by Thomas Beaton

In order to protect healthcare consumers and stabilize the ACA marketplace, Congress must pass legislation that creates affordable and accessible coverage options, protects Medicaid and Medicare program funding, and expands prescription...

NY Medicaid Inspector General Assists in $125M Fraud Takedown

by Thomas Beaton

The New York Office of the Medicaid Inspector General (OMIG) assisted the Medicaid Fraud Strike Force in uncovering Medicaid fraud totaled $125 million, the office announced in a press release. OMIG and the Strike Force helped other law...

AHIP: Permanently Renew Medicare Advantage Special Needs Plans

by Thomas Beaton

Congress should consider a permanent renewal of the Medicare Advantage Special Needs Plans (SNPs) because of the consumer protections they provide and their market implications, AHIP wrote in a letter to the House of Representatives. A...

AHIP, AMA, AHA to Congress: Fund Cost Sharing Reductions to 2019

by Thomas Beaton

AHIP, AMA, and AHA and four other healthcare organizations urged Congress to continue funding cost sharing reductions (CSRs) through 2019, warning of continued instability in the health insurance marketplace and higher premiums if the CSRs...

GAO: Veterans Affairs Insurance Enrollment Standards Lacking

by Thomas Beaton

The Department of Veterans Affairs is one of the largest healthcare organizations that provides health benefits, but their enrollment standards and processes lead to delays and errors, according to a new report from the Government...

Governors Propose Health Insurance Market Stabilization Plan

by Thomas Beaton

Eight state governors have outlined their proposals for a health insurance market stabilization plan that would control premium increases and improve competition in the federal and state health insurance exchanges. In a letter sent to...

HHS to Spend $10M on Affordable Care Act Navigator Program

by Thomas Beaton

HHS and CMS announced that they will allocate $10 million to support the Affordable Care Act Navigator program, which helps health insurance consumers find coverage solutions during the Open Enrollment period. Launched in 2013, the...

20.5 Million More Insured Since Start of Affordable Care Act

by Thomas Beaton

20.5 million more individuals have gained health insurance coverage since the implementation of the Affordable Care Act (ACA) in 2010, according to a new report from the CDC and the National Center for Health Statistics (NCHS). In the...

Tiebreaker Vote in Senate Opens ACA Repeal, Replacement Debate

by Thomas Beaton

In a 50-50 procedural vote, Vice President Mike Pence broke the tie as the US Senate voted to open debate for a future vote on American Health Care Act (AHCA), and the possible addition of amendments to the bill. After failing to...

CBO Score Finds 22 Million People Will Lose Health Coverage

by Thomas Beaton

UPDATE: GOP Senators delayed the vote on the BCRA until after the July 4th congressional recess.  The Congressional Budget Office (CBO) released their revised cost estimate on the new ACA repeal bill, the Better Care and...

650 Medical Groups Sign On to Abolish Medicare Budget Panel

by Jesse Migneault

Over 650 medical organizations have signed a letter to Congress from the Healthcare Leadership Council (HLC) supporting the elimination of the Independent Payment Advisory Board (IPAB).  The HLC joins a chorus of support for two...

Cardiologists: Senate Must Ensure “Meaningful Insurance Coverage”

by Jesse Migneault

In a letter sent to Senate leadership, American College of Cardiology President Mary Norine Walsh, MD, advised lawmakers to ensure access to “meaningful insurance coverage and quality, cost-effective care” for the...

NY Senate Considers Proposal for Single Payer Healthcare

by Jesse Migneault

Since the future of the Affordable Care Act (ACA) remains unclear, and GOP plans to repeal and replace have stalled, states are taking the lead in finding solutions to the rising costs of health care.  New York has joined California...

Healthcare Payers Seek Passage of Bill to Lower Drug Costs

by Jesse Migneault

The recently introduced the Fair Access for Safe and Timely (FAST) Generics Act seeks to reduce the timeline of bringing generic prescriptions to market and enjoys the support of healthcare payers. The philosophy behind the bipartisan...

OK Legislature Keeps Interstate Health Insurance Bill Viable

by Thomas Beaton

A bill that would allow interstate health insurance options for Oklahoma residents is still on the table following a House committee vote. Senate Bill 478, or the Health Care Choice Act, would authorize Oklahoma’s Insurance...

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