According to the National Community Pharmacists Association, 60.4% of independent pharmacists are weighing not stocking one or more of the first 10 drugs in the Medicare Drug Price Negotiation program. Another 32.8% have already decided not to stock one or more of the drugs.
Reporting quality on all beneficiaries marks a major shift, requiring thoughtful preparation and strategic planning. If your Accountable Care Organization (ACO) hasn’t started yet, don’t worry — there’s still time to get on track.
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
While many view Dr. Mehmet Oz's nomination to lead the Centers for Medicare and Medicaid Services (CMS) with skepticism, there's a compelling case that his unconventional background could catalyze long-overdue support for family caregivers.
Updated schema requirements are easy to mix up — here are a few simple solutions
President-Elect Donald Trump nominated celebrity physician Dr. Mehmet Oz to lead CMS. Healthcare leaders have mixed feelings on the news — for instance, one CEO pointed out that Dr. Oz could advance the food-as-medicine movement, and others noted that his appointment may decrease pharmaceutical innovation and access to certain medications.
Now is the time for health plans to step up and embrace the tools and strategies that will not only meet regulatory demands, but also drive innovation in care delivery.
When it comes to managing inbound phone calls, underperformance has devastating cost implications.
Reimbursement models that align primary care with behavioral health offer low-income provider organizations serving rural Americans and other vulnerable populations an opportunity to enhance coordination and improve outcomes while generating sorely needed revenue.
For those who rely on these treatments, affordable medication access is a matter of health, freedom, and dignity, and their mechanisms and outcomes are non-partisan.
For 2025, the average star rating for Medicare Advantage Prescription Drug contracts was 3.92, compared to 4.07 for 2024, 4.14 for 2023 and 4.37 for 2022.
CMS recently finalized the Patient Safety Structural Measure, which sets forth a broad roadmap for the implementation of a culture of safety, learning, transparency and accountability within hospitals and health systems nationwide — enabling and encouraging significant progress towards safer care and improved support for healthcare workers.
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.
The reintroduction of the "Improving Seniors' Timely Access to Care Act" marks a critical step toward modernizing the prior authorization process within Medicare Advantage plans. So, what does this mean for patients and providers moving forward?
Integrating comprehensive risk assessment tools that identify fall risks early can enable healthcare providers to implement personalized preventive measures, such as tailored exercise and physical therapy programs that strengthen mobility and balance among at-risk individuals.
Adding generative AI and other AI tools to coding and chart review practices streamlines a complex process and better positions plans for risk adjustment audits.
Healthcare organizations tend to view issues in pockets – how they are impacting their specific organization and region – but patient safety is a collective mission. No matter what hospital or health system they are in, or which care model they belong to, patients everywhere deserve safer care.
If enacted, the codes will represent the first major step toward broad-based reimbursement for digital therapeutics, and acknowledgement that CMS recognizes the substantial role new digital solutions can provide.