Medicare & Medicaid

Greater availability of the blockbuster drugs does not mean every older patient should get them.

The draft 2027 Medicare Physician Fee Schedule opens five questions about the AMA's control of CPT codes, from licensing costs to who decides what a code is worth.

Physician lawmakers support primary care, inflation-indexed payments and new POINTS system for quality reporting.

CMS wants to cut the conversion factor, rewrite the G2211 add-on into a percentage modifier, halve payment for same-day procedures and put an expiration date on traditional MIPS.

Accountable care wins, but physicians and policy experts warn cuts are baked in

CMS chief Dr. Oz touts ‘some of the most significant Medicare reforms in recent years’

For better health at a cheaper cost, the nation needs more investment, access and doctors in primary care.

The top news stories in medicine this week.

Why did Medicare risk adjustment become little more than mining charts, checking boxes and gaming the system?

AMGA, lawmakers lead charge against beneficiary pay for chronic care management.

Insurers are seeking a median 14% increase for 2027, a jump that would leave typical marketplace premiums more than one-third higher in two years.

Answers on adapting to shifts in Medicare, with three strategies to implement right now.

New YouGov data rank what patients consider before agreeing to a treatment.

Two family doctors explain a new NASEM report recommending community-clinical partnerships

Lowering drug costs for older adults is a laudable goal, but don’t do it by blocking physician access to needed medicines.

The top news stories in medicine this week.

What primary care physicians should know about developing science that moves beyond skin substitutes.

Physicians are loading protected health information into consumer AI tools. Here’s how to avoid risk of HIPAA violations

Because compiling and feeding masses of data to Medicare takes time away from treating patients.

Primary care is a team sport, but some of the most important players are outside the physician’s office.

Andel is one of a growing number of companies selling brand-name drugs straight to employers, bypassing pharmacy benefit managers and insurers. Medical Economics sat down with founder and CEO Jay Bregman to understand the model and what physicians should keep in mind.

Two new federal programs are opening Medicare and Medicaid coverage for GLP-1 obesity drugs, and Tracy Zvenyach, Ph.D., M.S., RN, of the Obesity Action Coalition explains what it means for primary care physicians and their patients.

The top news stories in medicine this week.

Primary care is a team sport, but some of the most important players are outside the physician’s office.

Can independent practices turn Medicare into a strategic advantage? How to go from liability to leverage