Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Policy

Experts Lay Out Strategy for Achieving Universal Coverage

by Thomas Beaton

Experts from the Harvard Business School, Duke University, and David Geffen School of Medicine at UCLA debate the viability of an individual mandate as a means of achieving universal coverage without a single payer. According to Regina Herzlinger,...

Bill Would Make Health Insurance Liable for Antitrust Laws

by Thomas Beaton

Proposed legislation supported by the American Hospital Association passed the House Judiciary Committee earlier that if approved by Congress make health insurance companies liable for anti-competitive business practices. The Competitive Health...

Researchers Expect ACA Repeal Adverse Effects on Uninsured

by Thomas Beaton

Authors of a recent viewpoint published in the Journal of the American Medical Association foresee health and financial risks the uninsured patient population following a partial or complete repeal of the Affordable Care Act (ACA). “The...

CMS Continues Extension of Transitional Coverage into 2018

by Thomas Beaton

The Centers for Medicare & Medicaid Services (CMS) has again extended its policy enabling states to permit health plans additional time to bring coverage into compliance with the Affordable Care Act. Jeff Wu, Acting Director of the Center...

Single-Payer Reform Purported to Save Estimated $504 Billion

by Thomas Beaton

A possible repeal of the ACA threatens to eliminate the coverage of 26 million Americans, but the authors of a recent commentary in the Annals of Internal Medicine contend that reforming to a single-payer system would allow for a Medicare expansion...

GOP Leaders Unveil Proposed ACA Repeal, Replacement Plans

by Thomas Beaton

GOP leaders have unveiled their latest proposal to repeal and replace the Affordable Care Act with new health insurance regulations. The outline includes cutting federal Medicaid expansion, moving more Medicaid control to the states, and restructuring...

Proposed ACA Replacement Moves Coverage Choices to the States

by Thomas Beaton

Several Republican lawmakers have introduced the “Patient Freedom Act” as a proposed replacement of the Affordable Care Act, emphasizing state authority and local decision-making in the health insurance market. Senators Bill Cassidy,...

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...

Affordable Care Act Replacement Seeks Automatic Enrollment

by Vera Gruessner

Since the Presidential election of Donald J. Trump, a number of differing viewpoints came out emphasizing how the Patient Protection and Affordable Care Act will be impacted. For the last several years, the Republican Party has attempted to repeal...

Healthcare Payers Face Challenges with Medical Loss Ratio

by Vera Gruessner

Under the Patient Protection and Affordable Care Act’s medical loss ratio, health payers are required to spend a minimum of 80 percent of their premium revenue on paying claims and boosting quality while the rest (20 percent) can be spent...

Private Payers Face Challenges on Health Insurance Exchanges

by Vera Gruessner

The health insurance exchanges created after passage of the Affordable Care Act may not serve as a truly effective marketplace for commercial payers since some national insurers like Aetna and UnitedHealthcare have been dropping out of operating...

Marketplace Instability May Cause Affordable Care Act Reforms

by Vera Gruessner

While the Patient Protection and Affordable Care Act has decreased uninsurance rates to historically low levels, the healthcare law also led to higher premium costs and insurance rates among health plans sold on the health insurance exchanges....

VT Agency Wrongly Allotted $13M for Health Insurance Marketplace

by Vera Gruessner

The Department of Vermont Health Access went against federal laws when it failed to allocate funds to establishment grants in order to create a public health insurance marketplace, the Office of the Inspector General (OIG) found in a new report....

Affordable Care Act Reduced Uninsurance Rate to 8.6% in 2016

by Vera Gruessner

The latest data from the National Center for Health Statistics shows that the uninsurance rate during the first three months of 2016 has decreased to 8.6 percent, or 27.3 million Americans, thanks to the continued impact of the Affordable...

Lawmakers Push for Public Option on Health Insurance Exchanges

by Vera Gruessner

A total of five senators and multiple organizations are looking to create a public option for healthcare coverage to be available among all Americans purchasing insurance through the Affordable Care Act’s health insurance exchanges. Senators...

Affordable Care Act Marketplace Consumers Face Fewer Choices

by Vera Gruessner

A hefty number of health insurance companies have been dropping out of the Affordable Care Act’s state exchanges in recent months including Humana, Aetna, and UnitedHealthcare. These actions would leave fewer health plans to choose from...

7% of Counties Retain One Payer on Health Insurance Exchanges

by Vera Gruessner

With more health payers such as UnitedHealthcare, Humana, and Aetna dropping out of a number of state health insurance exchanges, it is useful to analyze the differences of healthcare coverage between different regions and states around the country....

Public Health Insurance Marketplace Still Benefits Consumers

by Vera Gruessner

The public health insurance marketplace created through the Affordable Care Act (ACA) may have fewer and fewer health plans participating in the coming years since a number of major insurers have dropped out of the exchanges. This would lead...

New York, California Enact Rulings Against Surprise Medical Bills

by Vera Gruessner

Healthcare payers may find that they may no longer have to pass on extraneous costs to their consumers when out-of-network providers send more costly claims their way. New legislation in states like New York and California may soon put an end...

Presidential Election Shakes Employer-Sponsored Health Insurance

by Vera Gruessner

Healthcare policy of US presidential candidates depends on more than their perspective on the Affordable Care Act. With employer-sponsored health insurance still a major aspect of coverage among Americans since fewer are insured through Medicaid...

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