News
Site-neutral payment: HOPDs and potential savings for Medicare
2+ hour, 46+ min ago (200+ words) Site-neutral payment: HOPDs and potential savings for Medicare'Medical Economics Changing the way Medicare pays for services could save the program into hundreds of millions of dollars. Christopher M. Whaley, Ph.D., is associate professor, health services, policy and practice, and associate director…...
CMS proposes near-flat 2027 Medicare Advantage, Part D payments
2+ week, 1+ day ago (485+ words) Advance notice projects 0.09% average increase as agency moves to tighten risk adjustment; insurer stocks drop. The U.S. Centers for Medicare & Medicaid Services (CMS) is proposing to hold Medicare Advantage and Part D payments essentially flat in 2027, while advancing risk-adjustment changes that…...
Follow the money: More room for improvement in Medicare policy
3+ week, 20+ hour ago (441+ words) Follow the money: More room for improvement in Medicare policy'Medical Economics Changing Medicare policy for payment for skin substitutes is a good start. But government regulators could do more to help accountable care organizations (ACOs) that aim to improve patient…...
WISeR spending or unneeded delays in health care? Prior authorizations, AI in Medicare prompt concerns
3+ week, 1+ day ago (634+ words) New Medicare payment model aims to take down wasteful spending, but Congress, analysts point out potential problems. A new Medicare model of value-based payment aims to crack down on waste in health care across six states. But advocates say it…...
Skin in the game: Medicare policy change is good, but more protections are needed for ACOs
3+ week, 6+ day ago (131+ words) The CEO of advocacy group Accountable for Health discusses what ACOs found in Medicare's massive spending on skin substitutes. The U.S. Centers for Medicare & Medicaid Services (CMS) have made big changes to how they pay for skin substitute treatments for wounds....
How 831(b) plans can protect your practice from unexpected, uninsured costs
1+ mon, 2+ week ago (610+ words) Gain peace of mind with a financial risk management tool for small businesses After five consecutive years of cuts, Medicare physicians can finally expect to see higher revenues in 2026. Following the passing of the One Big Beautiful Bill Act in…...
As health systems grow, low-income Medicare patients lose ground, RAND study finds | Medical Economics
3+ mon, 6+ day ago (540+ words) A RAND Corporation study published October 23 in JAMA Network Open finds that primary care groups affiliating with large health systems saw disparities in care widen for low-income Medicare patients who also qualify for Medicaid. The report suggests that, while consolidation…...
Why practices and hospitals will still drown in prior authorization, even after payers pledge key reforms | Medical Economics
3+ mon, 2+ week ago (359+ words) Prior auth reform sounds like a boon for health care, but the devil's in the details. Practices and hospitals will still face the fragmented, labyrinthine processes they always have. Here's why. Prior authorization has long been a costly burden for…...
AI hype versus reality in health care billing | Medical Economics
3+ mon, 2+ week ago (156+ words) Doug Marcey, CTO of Coronis Health, breaks down where AI fits into revenue cycle management " and why the right processes need to come first for automation to truly deliver results. THE CURRENT AI LANDSCAPE IN MEDICAL BILLING HOW TO UTILIZE…...