Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Medicare

The History and Evolution of CHIP and the Medicare Program

by Vera Gruessner

When the medical industry including diagnostics and treatment became more complex and sophisticated in the early 1900s, everyday citizens began to see a surge in the costs for healthcare services. With more complicated procedures,...

Drug Spending Dashboard Shows Lack of CMS Negotiating Power

by Vera Gruessner

Last week, the Centers for Medicare & Medicaid Services (CMS) announced the release of an online dashboard that reports the amount of funds Medicare spends on prescription drugs. The drug spending dashboard covers both Part B and Part...

Will the US Embrace the Affordable Care Act in Future Years?

by Vera Gruessner

The Patient Protection and Affordable Care Act has had many obstacles in the way when revolutionizing the healthcare insurance field and broadening access to medical care for the US population. What does the future hold for the Affordable...

Why Health IT is Critical for an Accountable Care Organization

by Vera Gruessner

In order to provide medical services under an Accountable Care Organization (ACO), a network of medical practices, specialty healthcare offices, and hospitals must contract with a health payer such as Medicare, Medicaid, commercial health...

CMS Stresses Informed Decision-Making in Performance Reports

by Vera Gruessner

Since the Affordable Care Act was initially created, the Centers for Medicare & Medicaid Services (CMS) have been focused on improving informed decision-making among payers, providers, the patient community, and other stakeholders. CMS...

Physician Compare Website Upgrades Benefit Medicare Population

by Vera Gruessner

Medicare and Medicaid beneficiaries along with consumers of plans via state health insurance exchanges gained an advantage last week when the Centers for Medicare & Medicaid Services (CMS) announced website improvements to the...

Prescription Drug Spending Growth Skyrocketed 13% in 2014

by Vera Gruessner

In 2014, the rise of prescription drug spending hit 13 percent while overall healthcare spending growth increased by 5 percent. This steep rise is causing concern among both federal agencies like the Centers for Medicare & Medicaid...

Top 4 Policy Changes Affecting the Health Payer Market in 2015

by Vera Gruessner

The last year has had a huge impact on the health payer market as well as the entire healthcare industry from providers and educational institutions to the federal government and the patient community. Below we will outline the top four...

CMS Innovation Center’s Role in Improving Value-based Care

by Vera Gruessner

As healthcare payers and providers look toward adopting value-based care and move away from fee-for-service payment models, the Centers for Medicare & Medicaid Services (CMS) Innovation Center has been pursuing a variety of new...

DC Tops Medicare List for Wasteful Healthcare Spending

by Vera Gruessner

When it comes to medical care reimbursement, one of the most pivotal issues is eliminating wasteful healthcare spending. The Council for Medicare Integrity released a report detailing wasteful healthcare spending throughout the Medicare...

CMS Releases Final Rulings for 2016 Healthcare Payment Models

by Vera Gruessner

Last Friday, the Centers for Medicare & Medicaid Services (CMS) announced its issuance of the final rules regarding Medicare payment in 2016 to physicians and healthcare professionals in an effort to further support patient-centered...

Are Bundled Payment Systems Suitable at Cutting Medicare Costs?

by Vera Gruessner

The bundled payment systems were initially developed in order to curb the rising costs of healthcare including Medicare spending. Providers and hospitals receive a single sum for providing a summary of services to treat one particular...

What to Consider During Medicare Open Enrollment Period

by Vera Gruessner

Health payers and consumers need to be aware that the Medicare open enrollment period begins this week on Thursday, October 15. This means that individuals aged 65 years old and older who have health insurance through Medicare will have...

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...

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...

CMS Announces Cost Reduction Medicare Advantage VBID Model

by Jacqueline DiChiara

The Medicare Advantage Value-Based Insurance Design (VBID) Model, announced by the Centers for Medicare & Medicaid Services (CMS), aims to advance the health of Medicare beneficiaries, decrease preventable high-cost care utilization,...

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