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.
From a same-day payment cut to AI-run prior authorization in traditional Medicare, MGMA's government affairs team laid out what Washington has in store for physicians next year.
Current quality programs measure organizations and claims after the fact, but the next generation of measurement focuses on the everyday clinical decisions that drive unnecessary spending.