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E-commerce Gateway for Determining Eligibility Recommended by Health IT Policy Committee Along with Prototype Algorithms/Portals

Posted Aug 26 2010 4:17pm

In the last couple of years this is a big deal for practices in keep current as many are changing plans and a big part of this is due to consumers looking a policies that are less expensive and have higher deductibles to get what they feel they can afford in today’s economic conditions.  image

Aggregating rather than building new data sets is the plan of action here and as mentioned above with constant change real time information is needed.  2014 is the year for healthcare insurance exchanges to all be in place (if we make that far) with all of our data issues and IT situations, as we have new stuff coming at us every day so the left curves we get every day are continuing too.  As mentioned below, other agencies are building data base programs such as the IRS and Homeland Security.  You can see now that our data is going to be expanded to potentially touch several more locations and thus here comes the coding. 

Also mentioned was a proto type portal/software application for the states so they would not have to start from scratch on their portions and have the pre-requisites for the algorithms to run up front.  There’s so much catching up here to do with so many years of a past administration that didn’t keep up with infrastructure.  BD  

WASHINGTON – The federal Health IT Policy Committee is backing a plan to build a federal database of business rules that states could use to help determine the eligibility for Medicaid and other federal health insurance programs.

The database would make enrollment data for insurance and healthcare programs accessible to all states. The states could use the data to build electronic health insurance exchanges required by the recent health reform law.

The exchanges would act as an e-commerce gateway to help insurance consumers who are not eligible for Medicaid- or employer-provided insurance find an alternative source of health coverage.

Having all state health program enrollment data in a single database would also keep states from having to rebuild data sets that have already been compiled elsewhere, said Aneesh Chopra, the White House's chief technology officer and chairman of the enrollment work group.

The Internal Revenue Service, the Social Security Administration and the Homeland Security departments are developing Web services that states can use to help determine eligibility for health and human service programs.

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