Reimbursement

Armed with a new ruling, Democrats launch another effort to kill prior auth in WISeR payment model now running in six states.

Insurers and federal officials say prior authorization is moving into the digital age. Physicians are still waiting to see whether the burden actually drops.

Patients and policy makers should know a key part of the U.S. health care system is crumbling

AMA survey finds prior authorizations are killing physician trust in insurers, along with patient care.

A new American Medical Association survey ranks the country's largest commercial health insurers by the prior authorization burden they impose on physician practices.

An analyst discusses lessons from the TRICARE health system and the case for cash-based care.

How to take advantage of an underutilized revenue and care quality opportunity hiding in plain sight.

An explainer on the specialty gap, financial transparency and administrative friction in independent practices

Accountable care organizations want backup from the feds when they raise red flags about phony claims.

TEAM request for information hints at willingness to relax restrictions on doctors owning hospitals and referring to them.

Elation Health’s inaugural Primary Care Pulse report finds independent primary care physicians are adopting new payment models, embracing AI and holding onto their patient relationships despite mounting financial pressure.

Health care groups back new legislation that could expand Medicare chronic care management.

Medicare extends application deadline to May 15 to expand participation for July start.

Claim denials are a huge problem for physicians and hospitals. The solution is found in rethinking data and workflow

MedPAC opens April meeting with deliberations on data that will be part of June report to Congress.

Insurance expert discusses trends that could affect patients, and thus a practice’s bottom line.

Patients have the best chance of success — and physicians avoid exposure — when doctors and dentists pursue communication, clarity and collaboration

Physicians, lawmakers, policy advisers wrangle over legislation to adjust physician pay and upgrades to Medicare Advantage.

Understanding Medicare's strict physical presence requirements can save your practice from costly compliance violations

MIPS expert Holly Black explains the 2026 rule changes, the rise of MVPs and the practical steps small practices can take now to avoid Medicare penalties.

Could 2026 be a breakthrough year to even out Medicare payment to hospitals and physician practices?

Trump spotlights drug-price transparency and Most Favored Nation pricing —signaling changes to Obamacare subsidies and hospital insurer rules.

Medicare turns physicians into more productive data clerks, then pays them less. It’s a policy detached from reality.

Why recent policy shifts signal remote patient monitoring’s permanence in mainstream care

Milbank Memorial Fund leaders say investing more in primary care is a good deal for patients and the finances of the U.S. health care system.