Reimbursement

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.

MGMA, Accountable for Health offer analyses of 2026 Medicare Physician Fee Schedule.

Comments published about next year’s Medicare Physician Fee Schedule.

Costs change based on site of care, and physicians’ hospital affiliation or independent practice, according to new research.

New analysis argues that Medicare’s payment system undervalues cognitive effort in primary care, contributing to physician shortages and reduced patient access.

Clean claims that drive quick payments require foundational workflows, configuring systems properly from the start, and regularly revisiting how you measure success.

Health insurance companies pledge prior authorization reform, yet providers face ongoing delays and distrust, highlighting the gap between promises and reality.

More developments and data around the finances and patient outcomes of traditional Medicare and Medicare Advantage.

New platform aims to speed approvals, cut denials and ease physician workload.

Analyst J.D. Power releases 2025 Medicare Advantage report.

Medallion says $43 million will go for development to streamline process.

Potential changes for remote physiologic monitoring and remote therapeutic monitoring in the 2026 Medicare Physician Fee Schedule.