Reimbursement

Dan D'Orazio of Sage Growth Partners says there are just too many obstacles for the American health system to fully embrace value-based care

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.

What primary care physicians should know about developing science that moves beyond skin substitutes.

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

Primary care is a team sport, but some of the most important players are outside the physician’s office.

Can independent practices turn Medicare into a strategic advantage? How to go from liability to leverage

The latest HHS-OIG findings spur audits in real time around vascular procedures — and primary care could be involved.

Here’s how to get paid more for managing patient complex conditions over time.

A new survey of physicians, nurses and health care leaders points to burnout, reimbursement uncertainty and the pace of AI adoption as the top threats to the system, even as national data show physician burnout easing.

For value-based care, the future is in building collaboration between primary and specialty care.

Medicare’s G2211 code has a critical design flaw by applying a primary care fix to specialty care

Medicare spends $1.1 trillion a year — or misspends it, depending on this analysis of incentives and outcomes.

Medicare Payment Advisory Commission publishes June report to Congress

Learn more about the goals, procedures and billing of the new 10-year ACCESS payment model.