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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.

A simple break-even calculation turns a reimbursement advantage into staff minutes, showing practices when prior authorization, denials and uncollected patient balances wipe out a better rate.

Coding scrutiny, payment gaps and a push for price caps show up across Trilliant Health's annual look at where U.S. health care is headed.

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.
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