Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Healthcare Policy

How Health Insurance Industry Faces the Presidential Elections

by Vera Gruessner

The upcoming US presidential elections may impact the future of the health insurance industry and the way healthcare costs are addressed in this country. Whether the Democrats or the Republicans take the White House, the continuing rise in the...

How Presidential Election will Impact the Affordable Care Act

by Vera Gruessner

For months now, the media has been broadcasting 24 hours per day, seven days a week news related to the upcoming presidential election. Many have postulated on how the nation will be impacted if either the Republican Party or the Democratic Party...

Why GOP Should Hold Off on Replacing the Affordable Care Act

by Vera Gruessner

When the Patient Protection and Affordable Care Act was passed into law, it has had a variety of proponents as well as opposition from the GOP with many calling on the healthcare law to be repealed. However, repealing the Affordable Care Act...

Patients with Pre-Existing Conditions Need Affordable Care Act

by Vera Gruessner

The Patient Protection and Affordable Care Act has undergone both an opposition and an embrace by healthcare experts and politicians around the country. Now that this healthcare law has become embedded within the healthcare delivery system, it...

Opposition Increases to Aetna, Anthem Health Insurance Mergers

by Vera Gruessner

The health insurance mergers between Aetna and Humana along with Anthem and Cigna seem to have a fair amount of opposition from both healthcare organizations as well as politicians around the country. The American Hospital Association (AHA) reported...

Republicans Release Plan to Replace the Affordable Care Act

by Vera Gruessner

It is well-known the the GOP base has attempted to repeal the Patient Protection and Affordable Care Act for years since its passage. However, the big question that everyone has always wondered is what the Republicans would replace the Affordable...

What Repealing the Affordable Care Act Would Mean for America

by Vera Gruessner

While the Patient Protection and Affordable Care Act was passed into law six years ago, there is still plenty of controversy that surrounds this landmark legislation. For instance, the Senate and House of Representatives passed a bill that would...

Affordable Care Act Brought Healthcare Coverage to Rural Areas

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a fair amount of healthcare access and coverage to the American people. This does not just include those living in urban areas or the suburbs. Recent research suggests that the Affordable...

Indiana, Florida Approve Anthem, Aetna Health Insurance Mergers

by Vera Gruessner

The major health insurance mergers taking place between Anthem-Cigna and Aetna-Humana have shown some progress of late. Recently, the Indiana Department of Insurance approved the acquisition between Cigna and Anthem, according to a press release...

Health Insurance Market Faces Restricted Provider Networks

by Vera Gruessner

Last week, Scott Gottlieb, MD, Resident Fellow at the American Enterprise Institute, spoke in front of the House Committee on Energy and Commerce Subcommittee on Health delivering key information about certain reforms for the health insurance...

Supreme Court Leaves Zubik v. Burwell Case to Lower Courts

by Vera Gruessner

On Monday, the Supreme Court unanimously called for the lower courts to rule on the Zubik v. Burwell case and to find a compromise. This particular court case argues on whether employers, specifically religious nonprofit groups, should be required...

Court Sides with Republicans on Affordable Care Act Provision

by Vera Gruessner

Once again, the Patient Protection and Affordable Care Act is receiving criticism from the Republican-led House of Representatives. House Republicans had filed a lawsuit claiming that the Obama administration does not have the authority to provide...

Audits against Medicare Advantage Organizations Found Subpar

by Vera Gruessner

In order to ensure government funding isn’t used to pay erroneous or fraudulent medical claims, the Centers for Medicare & Medicaid Services (CMS) conducts risk adjustment data validation (RADV) audits among Medicare Advantage organizations....

The Biggest ACA Legal Challenges Facing Healthcare Industry

by Vera Gruessner

Ever since the Obama administration passed the healthcare law to reform many of the inequalities faced in this country, there have been a wide variety of ACA legal challenges that have stood in the way of this law progressing to reduce the rates...

Is the Medicare Part B Proposed Rule ‘Bad Medicine’?

by Vera Gruessner

Two months ago, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would create new payment models meant to reimburse providers for assigning prescription drugs. This would change the payment structure of...

What will the Future Bring for the Affordable Care Act?

by Vera Gruessner

The future of the Affordable Care Act and health insurance exchanges may not be as favorable as the Obama administration had hoped. Many fear that the major health insurer UnitedHealthcare leaving the state-based exchanges could lead other payers...

Did the Affordable Care Act Lower Medicare Spending?

by Vera Gruessner

The Affordable Care Act and other regulatory changes were meant to reform the healthcare industry and save costs on wasteful spending. Recent results coming from the Department of Health and Human Services (HHS) show that the Affordable Care...

Long-Term Care has a Shorter Time Frame Due to ACA, CMS

by Vera Gruessner

The Affordable Care Act has impacted a variety of aspects of the health insurance landscape as well as the healthcare delivery system. The Patient Protection and Affordable Care Act also led to the Center for Medicare & Medicaid Innovation...

New Proposed MACRA Rule Renovates Information Technology Use

by Vera Gruessner

The Department of Health & Human Services (HHS) has proposed new rules regarding the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) which will essentially remove the meaningful use program and move forward in advancing health information...

Consumer Engagement Vital in Health Insurance Exchanges

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a variety of changes for both insurers and healthcare providers with the establishment of health insurance exchanges holding a top place in reforming reimbursement between payers and...

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