Reimbursement

Insurer announces goals for 2026 as House of Representatives takes up review of PAs and other elements of Medicare Advantage.

Here are key provisions that physicians need to know about the proposed rule.

CMS could make changes in 2026 Hospital Outpatient Prospective Payment System.

AAFP, ACP respond with optimism and some critiques in the 2026 Medicare Physician Fee Schedule.

Key regulatory changes that could affect physician pay next year.

RFK Jr., Oz announce 60-day comment period for next year’s plan.

The number of primary care physicians employed by health insurance payers grew from 2016 to 2023, researchers say.

Details will emerge as $1 trillion health care cut becomes largest in nation’s history, policy analysts say.

How small practices can turn claim denials into faster payments, smarter workflows and long-term financial stability.

Here’s a summary about health care regulations and changes coming in the nation’s newest spending plan supported by congressional Republicans.

America’s Physician Groups publish 7 key reasons why the national spending plan is bad for health care.

New payment model looks to improve patient care by reducing unnecessary treatments.

A discussion with Plante Moran’s Tammy Schaeffer about why value-based care hasn’t been adopted more quickly

How finding the root cause of allergy symptoms can ease burdens on patients, clinicians and the health care system at large.

Primary care will be part of campaign to Make America Healthy Again, Health and Human Services leader says.

Survey data show that delays, denials and added steps tied to prior authorization are worsening patient outcomes and creating frustration — but AI may help streamline the process.

Pledge to streamline the process comes amid growing public and government pressure, but the previous industry promises in 2018 accomplished little.

HHS Secretary RFK Jr. announces changes to cut down on improper enrollments.

Trustees project Medicare hospital insurance trust fund will be depleted in 2033, three years earlier than expected.

Annual report puts depletion three years ahead of projected schedule in 2024 report.

AMGA survey finds member organizations anticipate major changes if Congress, President Trump slash Medicaid.

Senate Finance Committee publishes language that prompts new round of analysis, warnings for physicians, rural hospitals.

Reimbursement based on Medicare Economics Index will have a cost but ensure beneficiary access, commission says.

AI and data analytics will cut through administrative clutter and enable payers and providers to collaborate proactively, especially for “rising risk” patient groups

CMS Innovation Center leader outlines strategy for Making America Healthy Again.

A discussion with Duke University's Mark McClellan, M.D., Ph.D., about why value-based care hasn’t been adopted more quickly

Speculation mounts on potential changes and timing for federal spending plan already approved in House of Representatives.

MedPAC is a key adviser to Congress on Medicare pay for physicians.

Factors across U.S. health care pose a ‘dire threat’ to ‘severely destabilized’ independent private practice, threatening patient access.

Balancing the ledger and the mission with up-front payment solutions strengthens access and revenue.