MGMA members described capping Medicare Advantage contracts and favoring commercial patients, while one Texas practice leader reluctantly called Medicare her best payer.
News|Videos|January 15, 2025
Congress and health care in 2025: Disrupting the status quo, and vaccine skepticism
Author(s)Richard Payerchin
Rep. Greg Murphy, MD (R-North Carolina), discusses reforms he hopes Congress will consider this year.
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As the inauguration approaches in January 2025, President-elect Donald Trump has selected health care leaders who will bring needed disruption to improve the sector, said
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MGMA's government affairs staff walked through the fee schedule, value-based care, prior authorization, Medicaid and the year-end fight in Congress.
EBRI data show employer plans pay hospital outpatient departments about twice what physician offices receive for the same physician-administered drugs, and the commercial market has barely begun to address the gap.
The American Medical Association and five specialty societies say casting AI as smarter than physicians diminishes their expertise, a day after the health secretary praised AI second opinions.
At an MGMA Government Affairs town hall, attendees raised extrapolated audits, employer plans beyond state reach and denials with no reason codes.
A fallback version would make insurers prove upcoding, notify physicians and limit downcoding to 90 days.
Acting chief executive Akash Madiah credited practice leaders for outcomes patients never see, and the session's emcee offered a patient's account of two years of doctor visits.
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