CAQH CORE, the Quiet Side of the Affordable Care Act

With health care exchanges dominating the news with regard to the Affordable Care Act (ACA), another piece of the health care reform legislation that will affect more people than the individual mandate or the public exchanges is being implemented with much less fanfare and media attention.

Those are the sections of the law that require administrative simplification and the development of standards for financial and administrative transactions. Sections 1104 and 10109 of ACA will impact nearly everyone who uses, pays for or delivers health care.

Essentially these sections of the law are aimed at bringing the health care industry (hospitals, health plans and other stakeholders) to a place that the financial services industry has been for years. That is having universal standards in place that allow financial institutions to communicate with one another in the same electronic language. It is what allows someone to use an ATM at a bank branch or at a gas station.  Continue reading