Reimbursement

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.

Actions this week involve three major health care policy bills

The draft 2027 Medicare Physician Fee Schedule opens five questions about the AMA's control of CPT codes, from licensing costs to who decides what a code is worth.

Physician lawmakers support primary care, inflation-indexed payments and new POINTS system for quality reporting.

Accountable care wins, but physicians and policy experts warn cuts are baked in

Two physicians and two health system executives got candid with Chief Healthcare Executive about denials, administrative burden and what AI is actually delivering.

CMS chief Dr. Oz touts ‘some of the most significant Medicare reforms in recent years’

AMGA, lawmakers lead charge against beneficiary pay for chronic care management.

Physicians are loading protected health information into consumer AI tools. Here’s how to avoid risk of HIPAA violations