Reimbursement

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.

With denials cutting deeper into practice revenue, physicians are turning to AI-driven tools to catch errors before submission, automate appeals and reduce administrative burnout.

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

With denials cutting deeper into practice revenue, physicians are turning to AI-driven tools to catch errors before submission, automate appeals and reduce administrative burnout.

With denials cutting deeper into practice revenue, physicians are turning to AI-driven tools to catch errors before submission, automate appeals and reduce administrative burnout.

With denials cutting deeper into practice revenue, physicians are turning to AI-driven tools to catch errors before submission, automate appeals and reduce administrative burnout.

HHS Office of Inspector General is tracking the huge increase in spending, with a call to action for possible payment reform.

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.

AI offers much potential, but do physicians trust it to solve the prior authorization problem?

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.

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.

As spending climbs and value plummets, Trilliant Health proposes hard questions to buck negative trends.

A policy expert of the American Telemedicine Association reacts to the suspension of flexibilities for telehealth care in traditional Medicare.

A policy expert of the American Telemedicine Association reacts to the suspension of flexibilities for telehealth care in traditional Medicare.

A policy expert of the American Telemedicine Association reacts to the suspension of flexibilities for telehealth care in traditional Medicare.

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

How to partner to drive better patient outcomes and control costs

A study of more than 3 million Medicare Advantage beneficiaries shows patients in value-based, senior-focused primary care organizations see their physicians more often and with greater continuity than those in fee-for-service settings.

A JAMA viewpoint argues new reimbursement policies may deliver long-sought revenue to primary care, though uptake, staffing and fee cuts elsewhere cloud the outlook.