Policy

A new University of Michigan poll finds most older adults barely review their coverage at open enrollment, and the fallout lands in the exam room and the billing office.

What happens to kidney care when Medicare’s CKCC model sunsets and LEAD begins?

In 590,282 California heart attack hospitalizations, a new PCI-capable facility within a 30-minute drive lowered 30-day mortality 20% in communities without prior access but did not change survival where the procedure was already available.

MedPAC commissioners pile on Medicare’s Merit-based Incentive Payment System, a program they love to hate

The proposal from Rep. Frank Pallone Jr. would end independent dispute resolution for care delivered starting in 2028.

Lower pay for telehealth, direct billing for NPs and PAs come up for discussion.

A NAACOS and Innovaccer survey of 116 leaders also found only 21% are tracking which of their patients have enrolled in the new chronic care model.

Are directory errors and omissions creating barriers to care for patients?

The CMS-0057 rule regulates health plans. The question that matters is: Which of your payers will be live in your EHR on Jan. 1?

The top news stories in medicine this week.

CMS' proposed cuts to physician fees focus on the operating room. For the primary care physicians managing recovery after surgery, the real gap is much larger.

Health care was the only one of five sectors to cut spending commitments this spring, falling 2.8% as hospitals faced rising supply costs and physicians awaited the final 2027 Medicare fee schedule, Coupa's Business Spend Index found.

Urban Institute analysis finds 26% of insured adults owe medical debt, with hospitals the largest source

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.

Nolla Health claims it has the nation’s first approval for artificial intelligence to issue initial prescriptions. Physician review comes later.

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.

HHS finalizes price transparency updates as employers push insurance vendors to open the books.

Medicine has never moved this fast. How much of the next decade has already been decided, and what’s still open?

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.

The American Medical Association and five specialty societies say casting AI as smarter than physicians diminishes their expertise, a day after the health secretary praised AI second opinions.

Nearly 54 percent lower costs for adults with chronic disease. Four experts on why primary care still gets under 5% of health care spending.

MGMA members described capping Medicare Advantage contracts and favoring commercial patients, while one Texas practice leader reluctantly called Medicare her best payer.

At an MGMA Government Affairs town hall, attendees raised extrapolated audits, employer plans beyond state reach and denials with no reason codes.