Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Latest News News

PA Seeks Increased Payer Coverage of Emergency Air Ambulances

April 25, 2017 - Emergency air ambulances save lives, but they can also leave patients in a mountain of debt.  Pennsylvania Insurance Commissioner Teresa Miller would like payers to shoulder more of the costs of these critical services, and has accordingly voiced her support for proposed federal legislation that would increase transparency and regulate coverage of emergency air transportation. The proposed...


Articles

Health Insurance Actuaries Propose Ways to Stabilize Market

by

A stable health insurance marketplace is good for payers and consumers. Speculation over potential payer mergers, repeal or modification of the ACA, and the future of high-risk and low income subsidy payments have left premium rates and coverage...

Independence Blue Cross, UPenn Partner to Enhance Care Delivery

by

A five-year partnership between Independence Blue Cross and the University of Pennsylvania Health Systems (UPHS) should help strengthen multiple aspects of care delivery for beneficiaries in the state. Both organizations are under contract to...

Aetna Will Exit Iowa ACA Health Insurance Exchange in 2018

by

Aetna has announced that it will stop participating in the Iowa health insurance exchange in 2018, citing financial losses and market instability as primary reasons to exit.   "Earlier today we informed the appropriate federal and state...

House Committee Passes Bill with Healthcare Merger Implications

by

The House Judiciary Committee has voted 16-10 in favor of a bill that would revise and standardize part of the process of reviewing mergers for potential antitrust violations.   The Standard Merger and Acquisition Reviews Through Equal Rules...

CMS: Payers May See 2.95% Rise in Medicare Advantage Revenue

by

CMS announced updates to the Medicare Advantage (MA) program and Part D Prescription Drug Program, including an expected 0.45 percent increase in revenues for payers and the potential for up to 2.95 percent in revenue growth. “Medicare...

Wellmark BCBS Latest to Exit ACA Health Insurance Exchanges

by

Wellmark Blue Cross Blue Shield, which operates in Iowa and South Dakota, will not renew or sell individual plans on the Affordable Care Act health insurance exchanges effective Jan 1, 2018. The decision follows three-year losses of approximately...

Prescription Drugs Account for 22% of Payer Premium Spending

by

Prescription drug costs consume the largest proportion of dollars spent on healthcare premiums, with 22 cents out of every dollar going to medication costs, says AHIP in a new data brief. Eighty percent of every dollar is spent on medical expenses,...

CMS Extends Pediatric Alternative Payment Model Comment Period

by

CMS will continue to take public comment on its pediatric alternative payment model (APM) initiatives until April 7, 2017.   In March, CMS issued a request for information (RFI) related to establishing an APM specifically focused on the...

House Republicans Propose Two New Bills to Replace ACA

by

On Monday, the House Ways and Means Committee and the House Energy and Commerce Committee proposed two bills that together will effectively repeal and replace the Affordable Care Act. Combined the bills comprise the American Health Care Act....

CMS Proposes New Rule to Stabilize Health Insurance Exchanges

by

CMS recently announced a proposed rule designed to help stabilize health insurance exchanges by promoting more coverage options and improving the risk pool for insurers. The proposed rule comes just one day after Humana publicized its decision...

Aetna, Humana Terminate Merger Deal After Court Defeat

by

Aetna and Humana have scrapped their merger plans after the Department of Justice blocked the deal due to antitrust concerns.  Aetna will pay Humana a $1 billion termination fee, included as part of the original agreement. The DOJ lawsuit,...

Shareholder Class Action Lawsuit Filed Against Aetna

by

A shareholder class action lawsuit has been filed against the national health insurance company Aetna Inc., according to a press release from the law firm of Kessler Topaz Meltzer & Check, LLP. The announcement came earlier this...

Congress Votes to Nominate Tom Price as HHS Secretary

by

On February 1, House Representative Tom Price, R-Ga., was officially nominated as the Secretary for the Department of Health & Human Services (HHS), according to the US News & World Report. The Senate Finance Committee moved forward with...

Federal Court Blocks Aetna-Humana Health Insurance Merger

by

Today, a federal judge ruled that the health insurance merger between the healthcare payers Aetna and Humana should be blocked on the grounds that it would create antitrust issues, according to The New York Times. The health insurance...

6.4 Million Enrollees Sign Up on Affordable Care Act Exchanges

by

As of December 21, a total of 6.4 million consumers have enrolled in health plans through the Affordable Care Act exchanges on HealthCare.gov, reported the Centers for Medicare & Medicaid Services (CMS) in a fact sheet. The number of enrollees...

CMS Halts on Changing Medicare Part B Prescription Guidelines

by

The American Hospital Association (AHA) reported on December 16 that a finalized rule for the prior proposal to test new models for prescription drug payments under Medicare Part B has been scrapped. The Centers for Medicare & Medicaid Services...

Senate, House of Representatives Pass 21st Century Cures Act

by

This week, Congress passed the 21st Century Cures Act. President Obama signed the legislation into law on Tuesday, December 13. The 21st Century Cures Act passed with bipartisan support 94-5 in the Senate and 392-26 in the House of Representatives....

How the 21st Century Cures Act will Impact Healthcare Payers

by

Last week, the House of Representatives passed the 21st Century Cures Act by 392-26 votes. The 21st Century Cures Act affects the health insurance market through a provision that establishes small business health reimbursement arrangements (HRAs),...

How to Fix Obama’s Affordable Care Act Without a Repeal

by

Now that a new President and a Republican-controlled Congress has been elected, what does the future for healthcare reform and the Affordable Care Act (ACA) look like? What will happen to the Affordable Care Act cannot be answered simply since...

Continue to site...