Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Out-of-pocket Healthcare Spending

Verma: Price Transparency Rule a “First Step” for Consumerism

January 11, 2019 - The hospital price transparency mandate that went into effect on January 1 is still ruffling feathers among healthcare providers, leading CMS Administrator Seema Verma to reiterate the importance of giving consumers access to pricing data. In a media call held on January 10, Verma stressed the foundational role of the informed consumer in containing national spending while improving...

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AHIP, Payer Groups Agree to Focus on Nixing Surprise Billing

by Jennifer Bresnick

Nine of the nation’s most influential payer organizations, including AHIP and the Blue Cross Blue Shield Association (BCBSA), have released a new set of guiding principles aimed at eliminating surprise billing. Unexpected medical...

Employers Working to Drive Down Rising Health Insurance Costs

by Kyle Murphy, PhD

The realization that consumers using less care but paying more to receive services and treatment is leading employers to rethink their approaches to providing health coverage to their employees, according to a recent report in The Wall...

High-Deductible Plans Lead Diabetics to Forgo, Delay Treatment

by Chuck Green

Workers with diabetes who switched to high-deductible health plans requiring additional out-of-pocket expenses are more apt to put off necessary check-ups, a new Annals of Internal Medicine study finds. A growing proportion of Americans...

Spending, Prescription Histories Identify Future High Cost Members

by Thomas Beaton

An individual’s healthcare spending and prescription drug histories are among the most accurate predictors of future high costs, according to a new Society of Actuaries (SOA) report. SOA used claims data collected by the Health Care...

Senators Propose Limits on Surprise Healthcare Billing

by Thomas Beaton

A bipartisan group of Senators has introduced legislation that aims to end surprise healthcare billing, a practice which can lead to extremely high out-of-pocket costs for consumers. The Protecting Patients from Surprise Medical Bills Act...

Consumers Struggle with Health Plan Finances, Healthcare Literacy

by Thomas Beaton

The majority of consumers with employer-sponsored health plans lack the necessary financial health literacy to optimally manage their health plan finances, according to a new report from Alegeus. As high-deductible health plans (HDHPs)...

Nearly 20% of Employees Have Inpatient Out-of-Network Claims

by Thomas Beaton

Approximately twenty percent of employees with insurance had at least one out-of-network claim for inpatient care, according to a Peterson-Kaiser Tracker analysis. Employees with out-of-network provider bills may experience increased...

Emergency Physician Group Sues Anthem for ED Payment Policies

by Thomas Beaton

The American College of Emergency Physicians (ACEP) and the Medical Association of Georgia (MAG) have filed a lawsuit against Anthem BCBS of Georgia contesting an emergency department payment policy that makes patients responsible for...

Soaring US Healthcare Spending Due to Technology, Drug Costs

by Vera Gruessner

Before the Patient Protection and Affordable Care Act came into play, the United States was spending much more money on healthcare than many other first world countries. Despite high levels of US healthcare spending, our nation experiences...


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