Reimbursement

PYA's Tynan Kugler, M.P.H., MBA, CVA, says supply shortages, employment shifts, reimbursement pressure and the productivity-versus-value debate are all pulling at once.

Independent primary care is wasting away due to a significant payment disparity. Here's how to fix it

Atlas MD co-founder Josh Umbehr, M.D., who has been in direct primary care practice since 2010, explains why he thinks the model is closer to mainstream than most physicians realize.

Health plans are investing heavily in artificial intelligence, but inaccurate provider data create reimbursement friction and avoidable strain on primary care practices

To maximize savings in value-based care, CMS should create payment models for physicians, not middlemen.

Prosper Beyond VBC's Doral Jacobsen on why most practices lose negotiations before they even get in the room, and what to do differently.

Armed with a new ruling, Democrats launch another effort to kill prior auth in WISeR payment model now running in six states.

Insurers and federal officials say prior authorization is moving into the digital age. Physicians are still waiting to see whether the burden actually drops.

Patients and policy makers should know a key part of the U.S. health care system is crumbling

AMA survey finds prior authorizations are killing physician trust in insurers, along with patient care.

A new American Medical Association survey ranks the country's largest commercial health insurers by the prior authorization burden they impose on physician practices.

A video explainer about why patients in direct primary care end up loving their doctors.

Orthopedic surgeon and author Erica Rowe Urquhart, M.D., Ph.D., MBA, joins Melissa Lucarelli, M.D., FAAFP, for a candid conversation about what's really working against physicians and their patients.

An analyst discusses lessons from the TRICARE health system and the case for cash-based care.

Arrow founder and CEO Roshan Patel explains why health care payment processing is a mess, and what practices can actually do about it.

How to take advantage of an underutilized revenue and care quality opportunity hiding in plain sight.

An explainer on the specialty gap, financial transparency and administrative friction in independent practices

Accountable care organizations want backup from the feds when they raise red flags about phony claims.

How one state aims to become the first to embrace a universal health care system.

TEAM request for information hints at willingness to relax restrictions on doctors owning hospitals and referring to them.

Elation Health’s inaugural Primary Care Pulse report finds independent primary care physicians are adopting new payment models, embracing AI and holding onto their patient relationships despite mounting financial pressure.

Health care groups back new legislation that could expand Medicare chronic care management.

Medicare extends application deadline to May 15 to expand participation for July start.

Claim denials are a huge problem for physicians and hospitals. The solution is found in rethinking data and workflow

MedPAC opens April meeting with deliberations on data that will be part of June report to Congress.