Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Revenue Cycle Management

Pediatric Care Out-of-Pocket Spending Rose 5.5% in 2014

May 16, 2016 - Both public and private health payers have been searching for ways to reduce healthcare spending as a whole, but rising prices may be making it more difficult to combat medical care expenditure. The Health Care Cost Institute (HCCI) released a report showing that the spending related to pediatric care had grown in 2014 due to rising prices instead of greater healthcare utilization,...


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Healthcare Cost Variation Differs Twofold between States

by Vera Gruessner

Those who have spent time in a doctor’s office or emergency room may have seen that the prices of healthcare services tend to vary drastically among separate medical facilities. New findings from the Health Care Cost Institute (HCCI)...

Is Rising US Healthcare Spending Burdening the Economy?

by Vera Gruessner

Is healthcare spending in the United States too high? Are the financial aspects of running the medical system around the country burdening the US economy? The National Center for Policy Analysis insists that the viewpoint claiming that...

64% of Polled Doctors Plagued by Rising Medical Spending

by Vera Gruessner

The health insurance industry needs to continue addressing rising healthcare costs and the increases in spending among hospitals and the pharmaceutical field. Many stakeholders within the healthcare space find that high rates of medical...

Will Changes in Medicare Part B Drug Prescribing Cut Costs?

by Vera Gruessner

The Centers for Medicare & Medicaid Services announced last week that new healthcare payment models would be utilized in Medicare Part B drug prescribing practices. These innovative reimbursement strategies are expected to bring down...

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...

Price Transparency May Lower $27 Billion in Healthcare

by Vera Gruessner

Price transparency in the healthcare industry is becoming more and more pertinent and sought after. Research has shown that there is still insufficient price transparency within the medical field including hospital services. However, a new...

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...

Is Health Information Technology ‘Imperative for Payers’?

by Vera Gruessner

Health information technology remains a key aspect of maneuvering the health payer industry toward automating workflows and improving medical claims management. However, some insurers are still having difficulty with adhering to member...

Will Health Insurance Mergers Stifle Market Competition?

by Vera Gruessner

Health insurance mergers and acquisitions have been a major topic within the payer industry lately. While companies that have pushed through with their mergers cite their potential cut of competition as a way to lower prices for the end...

Healthcare Payment Reform May Need the Employer Perspective

by Vera Gruessner

At the Healthcare Financial Management Association (HFMA) National Payment Innovation Summit taking place February 10 to 12 in Memphis, Tennessee, a multitude of stakeholders gathered to share ideas and innovations related to healthcare...

Precision Medicine is a ‘Whole New Ballgame for Insurers’

by Vera Gruessner

Recently, President Barack Obama has announced a national “Moonshot” program to put an end to cancer as a whole. Vice President Joe Biden has been appointed the main leader of this project, a White House news release stated. A...

Cost Transparency, ‘Consumer-driven Healthcare’ Impacts Payers

by Vera Gruessner

Cost transparency remains a vital aspect of healthcare reform among both providers and payers. Uninsured consumers and those who have employer-sponsored health coverage are continually finding the costs of premiums, deductibles, and...

Why Payers Need Robust Health Information Technology

by Vera Gruessner

Health information technology continues to be an elusive field for the payer industry, as some insurers still have difficulty with adhering to key technological advancements and data security protocols. For example, the health insurer...

AHA Claims Stark Law Harms Value-based Care Reimbursement

by Vera Gruessner

The American Hospital Association (AHA) has encouraged Congress, specifically the House Committee on Ways and Means, to put an end to regulatory obstacles standing in the way of value-based care reimbursement. In a letter sent to Chairmen...

Payers, Providers Use Population Health Management to Cut Costs

by Vera Gruessner

Health payers and providers of today are working more closely together to develop effective care management strategies meant to reduce medical costs, improve quality of care, and ensure better patient health outcomes. For example, more...

How ACO Providers Could Integrate Specialty Care with PCPs

by Vera Gruessner

Healthcare providers and payers working together to develop an effective accountable care organization (ACO) and a strong contract will need to consider the importance of including specialty care, an article from the Health Affairs...

HIV/AIDS Patients Struggle with High Healthcare Costs

by Vera Gruessner

The high costs within the healthcare industry are often associated with managing the health of patients living with chronic medical conditions. At the J.P. Morgan’s Healthcare Conference in early January, James L. Madara, the...

How Paid Sick Leave Could Reduce Patients’ Financial Burden

by Vera Gruessner

One of the most looming issues within the healthcare industry has been the medical debt that many citizens around the nation incur if they are struck with a serious acute or chronic illness. A report published in the Journal of the...

Key Steps toward Affordable Health Insurance Platforms

by Vera Gruessner

The average insured consumer is facing a whole new landscape when it comes to managing the costs of care. The prices surrounding health insurance plans and coverage options are rising steadily while wages and inflation rates remain...

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