Is It Likely That the WISeR Model Will be Repealed?
Congressional Democrats are seeking to repeal the controversial WISeR model, but experts are unsure if their efforts will succeed.
Multicare CFO: Decades of CMS Underpayment is Creating an Unfair Two-Tiered System
MultiCare CFO James Lee said decades of government underpayment have pushed U.S. healthcare to a breaking point. He thinks the nation is headed toward a two-tier system — one for patients with commercial coverage, and another for those covered through CMS.
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Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
The 5 Areas Where Dr. Oz Says CMS Can Make Healthcare More Affordable
CMS Administrator Dr. Mehmet Oz outlined the agency's strategy for making healthcare more affordable during a Tuesday address at the HFMA Annual Conference, touching on everything from Medicare fraud to drug pricing to nutrition.
Expanding the Reach of Remote Patient Monitoring: The Real Signal Behind the 2026 RPM Changes
While the policy changes create new opportunities, they also introduce operational complexity. Here's some important things to know.
The 72-Hour Hurdle: Faster Prior Authorization is Exposing Healthcare’s Broken Billing Cycle
The healthcare ecosystem is fixing how quickly decisions get made, without fixing how quickly money actually moves. This isn’t a failure of reform. It’s evidence that reform is working — and revealing where modernization needs to continue.
What Data Delays Are Costing Healthcare — And Its Patients
Timely, usable data closes care gaps and improves operations, but healthcare organizations lack access.
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The Power of Real World Data to Study Women’s Health at Scale
Veradigm examines key clinical trends, comorbidity profiles, and treatment trends across adolescence, reproductive years, and peri-/post-menopause. Download it today!
CMS Finalizes Rule to Simplify Payer-Provider Disputes Under No Surprises Act
CMS finalized a new rule aimed at streamlining the No Surprises Act’s overwhelmed arbitration system. Provider groups largely welcomed the reforms — though some industry leaders said additional changes are still needed to address alleged misuse and improve transparency.
Medicare Patients Don’t Need More Information —They Need Someone to Act
The assumption is intuitive and well-intentioned: if patients simply understood the system better, they would use it more effectively. However, for most Medicare patients, that assumption is wrong. The barrier to care isn't knowledge, it's execution.
How AI & CMS are Solving the $4 Trillion Healthcare Crisis
The message to the industry is clear: If your business model is optimized only for FFS, you are the legacy. The future of healthcare belongs to those who can trade hours spent for improved patient lives.
CMS Halts New Medicare Enrollment for Hospice, Home Care Amid Fraud Crackdown
CMS imposed a six-month nationwide freeze on new Medicare enrollments for hospices and home health agencies as part of a broader crackdown on fraud in the sectors.
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The Healthcare Payments Industry Has a Perception Problem
Healthcare payments are no longer about transactions. It’s about controlling the revenue cycle. And increasingly, that control is not sitting with ISOs.
A Mandatory Shift: Why the CMS TEAM Model is an Important Opportunity for Health Systems
The most successful and high-performing health systems will approach TEAM not as a regulatory burden, but as a catalyst for transformation. They will use this moment to build the operating model, processes, workflows, and culture that position their health system for long-term success in value-based care.
Digitizing Medical Policy Alone Will Not Automate Prior Authorization at Scale
Many health plans are discovering that even after digitizing medical policies and implementing FHIR APIs, prior authorization turnaround times remain slow and provider frustration remains high. The reason is straightforward: digitization alone does not make medical‑necessity determinations executable by automated systems at scale.
The Quiet Revolution Comes Full Circle: How CMS ACCESS Validates Safety-Net Innovation
While other areas of healthcare have been star-struck by sophisticated AI and massive infrastructure investments, safety net entities have found that the answer is much simpler. Better managing chronic conditions across populations simply requires the right connection at the right time.
Trust, Technology and the Future of Interoperability: Solving Problems That Impact Real Lives
Healthcare interoperability isn’t an abstract concept; it’s about human connection, building trust and easing burden on patients and their care providers.
Policy Expert Believes CMS is Taking “Adversial Posture” to Medicare Advantage
A consultant who has analyzed healthcare policy over many decades declares that MA is in the middle of a fundamental reset both in terms of market headwinds and federal scrutiny.