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News
Patient Coverage Disruption Guide for Providers
6+ hour, 23+ min ago (14+ words) Protecting patient care through coverage disruption Modern Healthcare Protecting patient care through coverage disruption...
CMS stars redo lifts big Medicare Advantage insurers
4+ day, 10+ hour ago (33+ words) Modern Healthcare CMS stars redo lifts big Medicare Advantage insurers UnitedHealthcare, Humana and Aetna are among the insurers that secured larger Medicare Advantage quality bonuses....
Medicare inpatient pay rules: Here’s what to expect for 2027
5+ day, 10+ hour ago (41+ words) Modern Healthcare Medicare inpatient pay rules: Hereâs what to expect for 2027 The Centers for Medicare and Medicaid Services proposed a regulation that would limit a key Medicaid financing tool....
Why CMS’ Shared Savings proposals matter for ACO growth
1+ week, 10+ hour ago (38+ words) Modern Healthcare Why CMSâ Shared Savings proposals matter for ACO growth Hospitals are turning to outside revenue cycle vendors as staffing shortages and documentation complexity make AI tools attractive....
Bipartisan bill to boost Medicare doctor pay unveiled
1+ week, 5+ day ago (32+ words) Modern Healthcare Bipartisan bill to boost Medicare doctor pay unveiled Elevance Health will avoid federal sanctions on its Medicare Advantage operations, executives said Wednesday....
Elevance slides as profit guidance raise fails to impress
1+ week, 5+ day ago (37+ words) Modern Healthcare Elevance slides as profit guidance raise fails to impress HCA took a $550 million hit on exchange coverage losses in the first half of the year....
Medicare doctor pay would dip slightly under proposed rule for 2027
1+ week, 5+ day ago (47+ words) Modern Healthcare Medicare doctor pay would dip slightly under proposed rule for 2027 The federal government in September 2024 sued the countryâs three largest pharmacy benefit managers for allegedly inflating the list price of insulin drugs....
CMS reports strong ACO REACH savings before model sunsets
2+ week, 3+ day ago (44+ words) Modern Healthcare CMS reports strong ACO REACH savings before model sunsets Results published this week from the Centers for Medicare and Medicaid Services show ACO REACH closed out 2024 with strong savings and quality performance....
Memorial Hermann to exit commercial insurance business
2+ week, 4+ day ago (31+ words) Memorial Hermann Health Plan to exit commercial insurance business Modern Healthcare Memorial Hermann to exit commercial insurance business CVS Health plans to sell its Omnicare pharmacy services subsidiary to GenieRx Holdings....
Exchange insurers owe $11.2B in ACA risk-adjustment payments
3+ week, 10+ hour ago (38+ words) Modern Healthcare Exchange insurers owe $11.2B in ACA risk-adjustment payments The Centers for Medicare and Medicaid Services plans to recalculate 2026 Medicare Advantage star ratings for all insurers....