Medicare & Medicaid

CMS administrator outlines payment changes, Medicaid reforms, fraud efforts and a plan to overhaul prior authorization during his speech at the AMA Interim Meeting of the House of Delegates.

Money for doctors, quick turnaround, policy changes — and even excitement?

Top CMS policymakers outline benefits to primary care for Medicare spending next year.

A decade of federal initiatives strengthened care coordination, engagement and clinical quality in primary care, but fee-for-service incentives kept spending high.

GLP-1 drugs Wegovy, Zepbound will have lower prices and be covered by Medicare.

Consolidation boosts continuity of care but deepens disparities in follow-up and preventive services, researchers report.

Advocacy groups issue praise, some questions for next year’s physician payment rule.

Organizations react to CMS’ plan for physician payment next year.

CMS announces changes to ‘deliver better outcomes for patients’ while safeguarding funds.

To sustain Medicare Advantage, payers and providers must rebuild collaboration through transparency and standardization.

Strategies for organizations to navigate CMS's decision to fast-track risk adjustment audits.

A new analysis of 11.6 billion Medicare claims from 2013-2023 shows physician participation rose modestly over the past decade, but exits surged — especially among older physicians, women and those in rural and shortage areas.

Jason Jobes of Norwood outlines why taking the right amount of financial risk — and investing in infrastructure — is essential for practices transitioning to VBC.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A revised CMS notice late on Oct. 15 said claims for Physician Fee Schedule and other payment programs will be processed and paid in a timely manner. The exceptions are claims for programs that have expired, such as telehealth flexibilities.

Jason Jobes of Norwood explains why the move toward value-based care is both necessary and challenging — and what physician practices can do to prepare.

Researchers examine trends for EDs, intensive care units over 10-year span.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

Ohio State researchers say the billionaire entrepreneur’s Cost Plus Drug Company exposes how insurance premiums and middlemen drive up the true cost of neurologic medications.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

Feds highlight huge growth in spending on wound care and why it could be problematic in health care.