Practice Finance

Medicare rates, prior authorization, telehealth and Medicaid coverage all change between Sept. 14, 2026, and Jan. 1, 2028.

Dan D'Orazio of Sage Growth Partners says there are just too many obstacles for the American health system to fully embrace value-based care

Another conversion factor cut is on the table for 2027, and MGMA's Anders Gilberg breaks down why budget neutrality keeps forcing cuts in one specialty to pay for another and what the end of MIPS means for physicians.

Why value-based care requires AI that tells clinicians not just who is at risk, but which interventions are most likely to change outcomes.

Overhead swallows roughly 60% of the typical practice's revenue, and most of it sits in a few line items. These nine moves pull real money off that number without touching the exam room — and the biggest lever is the one most owners are slowest to open.

Health care economist Wayne Winegarden, Ph.D., makes the case that fixing Medicare payment, not restricting MSOs, is the way to keep independent practices open.

The 2026 Medicare Advantage raise is a pause, not a trend. When rates tighten in 2027, these basics will separate a shared savings check from a shortfall.

Most physicians know the direct primary care pitch; whether the economics hold up once you're in it is the more difficult question to answer.

Health policy veteran and "Zen Lobbyist" author Gary Jacobs argues that the payment system, not the insurers, is behind a second straight year of double-digit ACA premium increases, and that primary care-led risk is the only durable fix.

A reimbursement gap of five to 12 times for the same procedure is letting hospitals outbid private practices for their own physicians. Three U.S. Women's Health Alliance advocates explain what it costs patients and what they are asking Congress to do about it.

Fax machines are gone from billing. Prior authorization and clinical communication are still stuck in 1985.

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

Aligning access, revenue cycles and digital engagement can reduce friction, improve transparency and accelerate collections

Physicians in eight specialties now clear $500,000 a year, and the distance between the top earners and primary care keeps growing.

Independent medical practices face a hard question as consolidation accelerates: keep going it alone, or find a partner. Ziegler's Andy Colbert breaks down what a practice is really worth and how physicians should weigh their options.

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

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.

PYA's Tynan Kugler breaks down the four forces pulling physician pay in competing directions, and why getting the underlying compensation model wrong can be expensive and legally complicated to undo.

Most practices collect less than half of what patients owe. Here's how to change that — in any month of the year.

Where you set up shop can quietly cost you thousands. These are the states that take the biggest share of residents' income in state and local taxes.

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

Percentage of collections is the least informative number