Reimbursement

Quality, revenue, utilization, documentation and savings are not all the same thing

As more payors adopt automatic E/M downcoding policies, practices that skip payment validation risk leaving significant revenue on the table.

There a six recurring errors that leave independent practices financing equipment on terms mismatched to how they actually get paid.

Despite major problems across U.S. health care, evidence shows what primary care is getting right.

An HHS video sent patients to a Medicare comment docket that has already drawn more than 19,000 submissions.

Peterson Health Technology Institute's Caroline Pearson explains why payment models — not the technology itself — will decide whether AI lowers costs for physicians and patients.

Payment models should reflect not just the theoretical value of services rendered, but the practical realities of how healthcare is financed and paid for today.

Big groups clean up in independent dispute resolution, but little, if any, goes to primary care.

The top news stories in medicine this week.

Retrospective data are not irrelevant, but primary care needs AI and advanced analytics to treat real-world patients in real time.

Meanwhile, patients will pay because employers expect health insurance premiums to rise 10% in 2027.

CEO Casey Pittock says CMS's proposed CY2027 Physician Fee Schedule could bar third-party clinical staff from billing for remote monitoring services.

Physicians have questions about capitation. Here's what it means for your practice.

A 2024 policy shift is forcing practices to wait on claims adjudication before billing — and the delay is eroding collections and straining independent practices

With small cuts, targeted gains and revision of the G2211 code, here’s what CMS' proposed 2027 PFS means for your bottom line

A physician's FAQ guide to Medicare's visit-complexity add-on code

Structural financial incentives explain why value-based care has stalled — even as new data and payer-provider strategies show where the model is already working.

Medicare is requesting information, including physician commentary, on primary care and MAHA.

The top news stories in medicine this week.

2027 Medicare Physician Fee Schedule at heart of Primary Care Collaborative discussion

The top news stories in medicine this week.

RFK Jr. says California and Minnesota have to prove the legitimacy of claims before the money flows.

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.

Access, AI and accountable care are part of now and the future, CMS leaders say.

The top news stories in medicine this week.