EBRI data show employer plans pay hospital outpatient departments about twice what physician offices receive for the same physician-administered drugs, and the commercial market has barely begun to address the gap.
Trilliant Health's annual trends report traces primary care shortages, payment gaps and looming price caps to incentives no single stakeholder has reason to fix.
Medical Economics spoke with MGMA's Madison Hynes about the association's draft bill to ban automatic downcoding, the Patients First Act and AI-run prior authorization in traditional Medicare.
CMS' proposed cuts to physician fees focus on the operating room. For the primary care physicians managing recovery after surgery, the real gap is much larger.