Coding scrutiny, payment gaps and a push for price caps show up across Trilliant Health's annual look at where U.S. health care is headed.
News|Videos|June 21, 2024
Congressional perspectives: Repealing Obamacare?
Author(s)Richard Payerchin
Repealing won’t happen, but reforms could.
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Rep. Buddy Carter (R-Georgia) said he still supports repealing the Affordable Care Act, known as Obamacare, but it won’t happen with the current Congress. Even so, competition in health care is necessary to bring down prices for patients.
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Trilliant Health's annual trends report traces primary care shortages, payment gaps and looming price caps to incentives no single stakeholder has reason to fix.
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.
From a same-day payment cut to AI-run prior authorization in traditional Medicare, MGMA's government affairs team laid out what Washington has in store for physicians next year.
MGMA members described capping Medicare Advantage contracts and favoring commercial patients, while one Texas practice leader reluctantly called Medicare her best payer.
Recent CMS rule changes reinforce that operational discipline is increasingly shaping reimbursement
Medical Economics spoke with Monique Delgado, former CEO of Integrated Medical Services, about where salary-only pay falls short, which metrics to tie incentives to and how to change physician pay without eroding trust.
From AI scribes and coding habits to the claims payers quietly cut, these are the lessons physicians can take from four days of sessions and interviews at the Medical Group Management Association's centennial meeting.
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