Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Policy and Regulation News

Vermont’s All-Payer Model Limits Medical Spending Growth

by

Vermont has been working on regulatory actions that would reform healthcare payment throughout the state specifically through an all-payer model. Last week, the Centers for Medicare & Medicaid Services (CMS) announced in a press release the...

Premium Rates on Affordable Care Act Exchanges Rise 25% in 2017

by

Monthly premium costs on the Affordable Care Act exchanges is expected to rise an average of 25 percent in 2017, according to a report from the Department of Health & Human Services (HHS). This percentage is based solely on the premiums for...

How a Public Option May Preserve Health Insurance Exchanges

by

Multiple healthcare payers have been struggling with operating successfully on the Affordable Care Act’s health insurance exchanges. Some experts and lawmakers suggest that establishing a public option on the health insurance exchanges...

Did HHS Act Illegally in Transitional Reinsurance Program?

by

At the end of September, the Government Accountability Office (GAO) announced in a briefing that the Department of Health & Human Services (HHS) does not have the authority to transfer funds from the collections within the transitional reinsurance...

HHS, CMS Announce Finalized Ruling for MACRA Legislation

by

The Department of Health & Human Services (HHS) announced in a press release the discharge of the final ruling on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The MACRA legislation replaces the flawed Sustainable Growth...

VT All-Payer Model Aligns Costs for Public, Private Insurers

by

The state of Vermont is moving forward with establishing an all-payer model that uses accountable care organizations and ensures a provider is reimbursed by an equal amount among all healthcare payers for a particular service. The Vermont government...

Revisions to Affordable Care Act May Improve Payer Performance

by

Health insurance executives have faced various regulatory challenges since the Patient Protection and Affordable Care Act was passed in 2010. Payers have had to participate in new health insurance marketplaces and face different restrictions...

Marketplace Instability May Cause Affordable Care Act Reforms

by

While the Patient Protection and Affordable Care Act has decreased uninsurance rates to historically low levels, the healthcare law also led to higher premium costs and insurance rates among health plans sold on the health insurance exchanges....

49M Americans Risk Losing Fixed Indemnity Health Insurance

by

A new proposed rule called Expatriate Health Plans, Expatriate Health Plan Issuers, and Qualified Expatriates; Excepted Benefits; Lifetime and Annual Limits; and Short-Term, Limited-Duration Insurance may negatively impact access to fixed indemnity...

Why Strengthening Affordable Care Act Could Cut Disparities

by

The Patient Protection and Affordable Care Act has significantly improved healthcare coverage and access throughout the country, but there are still some obstacles remaining to ensuring that every American has access to health insurance. While...

Presidential Election Brings Two Opposing Healthcare Policy Proposals

by

With the Presidential election heating up and the debate season upon us, last week The Commonwealth Fund detailed the stark differences seen between the two presidential candidates healthcare policy proposals in a new report. The research comes...

How MACRA Resolves Sustainable Growth Rate Formula Challenges

by

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will likely simplify and improve Medicare reimbursement processes due to the fact that it repeals the flawed sustainable growth rate (SGR) formula. The problems associated with...

Affordable Care Act Reduced Uninsurance Rate to 8.6% in 2016

by

The latest data from the National Center for Health Statistics shows that the uninsurance rate during the first three months of 2016 has decreased to 8.6 percent, or 27.3 million Americans, thanks to the continued impact of the Affordable...

Lawmakers Push for Public Option on Health Insurance Exchanges

by

A total of five senators and multiple organizations are looking to create a public option for healthcare coverage to be available among all Americans purchasing insurance through the Affordable Care Act’s health insurance exchanges. Senators...

2 Benefits and 2 Disadvantages of the Affordable Care Act

by

The Patient Protection and Affordable Care Act has had many critics as well as those who have praised the landmark healthcare legislation. While the Republican Party is looking to repeal the Affordable Care Act, others consider that a revision...

Affordable Care Act Marketplace Consumers Face Fewer Choices

by

A hefty number of health insurance companies have been dropping out of the Affordable Care Act’s state exchanges in recent months including Humana, Aetna, and UnitedHealthcare. These actions would leave fewer health plans to choose from...

Risk Pool Gains on Horizon for Health Insurance Marketplace

by

With a number of healthcare payers including UnitedHealthcare and Aetna dropping out of the Affordable Care Act’s health insurance marketplace, the Centers for Medicare & Medicaid Services (CMS) issued an annual Notice of Benefit and...

Presidential Election Shakes Employer-Sponsored Health Insurance

by

Healthcare policy of US presidential candidates depends on more than their perspective on the Affordable Care Act. With employer-sponsored health insurance still a major aspect of coverage among Americans since fewer are insured through Medicaid...

Prescription Drug Medical Costs Less Problematic due to ACA

by

Recently, criticism popped up against the pharmaceutical company Mylan from the Hillary Clinton presidential campaign for its significant price increase for the life-saving EpiPen product. The EpiPen is vital in an emergency when a person who...

How Risk Adjustment Challenges the Health Insurance Market

by

Ever since the provisions of the Patient Protection and Affordable Care Act came into effect on January 1, 2014, healthcare payers have been unable to deny health insurance or charge larger premium costs to those with pre-existing conditions....

Continue to site...