CMS
publication date
Revenue Cycle
Prior Authorization Delays Are Driving Patients Away From Providers
Almost 80% of physicians surveyed by the AMA say patients are skipping care because of delays in prior authorizations.
Innovation
CMS Advances Virtual Care, Digital Health Coverage in Proposed 2025 PFS
The proposed Physician Fee Schedule includes, among other things, Medicare coverage for care management using telehealth and digital health tools,...
Payer
What Medicaid MCO Alliance Health's Partnership with Cityblock Means For Innovation
The risk-based contract marks meaningful expansion for both companies in a state that is growing its Medicaid rolls to include...
Payer
CBO: Uninsured Rates Projected to Rise Through 2034
After years of coverage growth, the very factors that are protecting more Americans could reverse progress.
CFO
The 3-Pronged Battle: How CFOs Are Staying Afloat Amongst Inflation, Labor Cost, and Inadequate Payment Rates
CMS' OPPS proposed rule checks some boxes for hospitals, but misses the mark for others.
CMO
CMO: Medicare's Proposed Physician Payment Cut 'Absolutely the Wrong Direction'
Physician reimbursement from Medicare decreased 29% from 2001 to 2024, according to the American Medical Association.
What the Chevron Case Means for Rev Cycle Executives
One health system has already filed a lawsuit, could it happen to you?
Payer
23 Million Unenrolled: 11 Insights from the Medicaid Unwinding
New Kaiser Family Foundation research reports state challenges and some successes despite mass disenrollment.
Revenue Cycle
3 Rev Cycle News Stories You May Have Missed
Providers affected by the Change ransomware attack were tossed a lifeline and CMS tackles suspicious billing.
Revenue Cycle
Proposed Rule Targets 'Highly Suspect' Billing in Shared Savings Program
The rule is part of larger plan to address anomalous spending in the program.
Payer
Socially Determined and Mathematica Partner to Target Social Risk for Government Organizations
The partnership seeks to highlight the impact of social determinants of health on costs and outcomes.
Innovation
5 Recommendations to Improve RPM Adoption
A report issued earlier this year by the Bipartisan Policy Center offers a blueprint for expanding remote patient monitoring opportunities...