Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability


How to Prevent Healthcare Underuse in Bundled Payment Models

by Vera Gruessner

Value-based care reimbursement including bundled payment models or accountable care organizations may help medical providers and payers achieve the Triple Aim of Healthcare which is better patient care, stronger population health outcomes, and...

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...

End-of-Life Counseling Sessions Stall despite Medicare Payment

by Vera Gruessner

Starting in January 2016, the Centers for Medicare & Medicaid Services (CMS) began reimbursing physicians for conducting end-of-life and advanced care planning discussions with patients who are Medicare beneficiaries. Doctors are able to...

State Medicaid Expansion Should Reduce Emergency Room Visits

by Vera Gruessner

The Patient Protection and Affordable Care Act brought a variety of changes for the healthcare industry as well as individual states. For example, the Affordable Care Act called on for Medicaid expansion among the 50 states. However, a Supreme...

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...

Why Health Insurance Claims Data Needs Medical Device ID

by Vera Gruessner

If health insurance companies truly want to improve patient health outcomes including the quality of care and boost patient safety in an effort to reduce wasteful spending, it may be beneficial for health insurance claims data to include medical...

How the Affordable Care Act Strengthened Mental Health Parity

by Vera Gruessner

The Obama administration's Affordable Care Act has brought various benefits to the American people including greater health coverage through the health insurance exchange and Medicaid expansion. Young adults under 26 years of age can now...

Why Payers Should Improve Cost Transparency for Consumers

by Vera Gruessner

The health insurance industry could benefit from greater cost transparency, as it could bring new methods for lowering healthcare spending and create a more competitive market among providers. Federal and state regulators aiming at reducing healthcare...

How the Affordable Care Act has Impacted Health Payers

by Vera Gruessner

The Affordable Care Act has  brought a significant reform toward the health insurance industry. This particular legislation has given the majority of American people healthcare coverage, which has put greater strain on health insurers. For...

Could Electronic Processing Reduce Medical Spending Rates?

by Vera Gruessner

The US healthcare system is one of the most expensive around the world and the rising costs haven't diminished significantly in recent years. Today, health payers and providers have been working together to reduce medical spending around...

Concierge Medicine Model Impacts Population Health Management

by Vera Gruessner

The concierge medicine model is becoming more and more prominent around the nation, as healthcare providers continue to adopt the new payment system. While many hospitals and physicians are finding medical payment reform and the move toward value-based...

How Data, Value-Based Care Drives Down Health Insurance Costs

by Vera Gruessner

In today’s world, the average employee and business owner are seeing a rise in health insurance costs. Even through the health insurance exchange, premium prices are expected to rise this year while high-deductible plans are becoming more...

How One Health Payer Partnership Reduced Hospitalizations

by Vera Gruessner

Recently, the health payer Blue Cross and Blue Shield of Illinois (BCBSIL) announced in a press release that it will be extending its partnership with the American Lung Association of the Upper Midwest over the next two years. The specific partnership...

Bundled Payment Models Need to Align Payer, Provider Incentives

by Vera Gruessner

Bundled payment models are growing in popularity throughout the health insurance industry partially due to the Centers for Medicare & Medicaid Services (CMS) pushing forth alternative payment structures as well as the general goal of reducing...

‘The Future is Accountable Care,’ Population Health Management

by Vera Gruessner

Effective population health management remains a key aspect of running a successful accountable care network. As part of a stronger population health management program, the primary care physician’s referral system must be efficient in...

5 Elements Essential for Value-based Care Reimbursement

by Vera Gruessner

The health insurance industry has been undergoing significant changes ever since the Patient Protection and Affordable Care Act became law and rising healthcare spending brought a need for payment reform. More payers have been targeting value-based...

How Health IT Automation Improves Consumer Satisfaction

by Vera Gruessner

New technologies and health IT tools are becoming a necessary part of the health insurance industry, as innovative approaches like automation can largely benefit employees while portals could make a difference for health plan consumers. When...


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