For providers, the rules mean more control over monitoring and the chance to keep a larger share of reimbursement. For device companies, they create a chance to show measurable value and guide clinicians through a system that is shifting quickly.
Further change in the Star Ratings program is inevitable, but one thing won’t change: plans that make targeted investments in improving the member experience and clinical outcomes, driven by data, are the most likely to succeed and achieve a higher overall rating.
How can AI benefit and improve patient outcome in the emergency department? Watch the latest episode to find out.
The challenge for policymakers is balance: encouraging rigor without unintentionally weakening a program that now serves the majority of Medicare beneficiaries. Thoughtful rate calibration can determine whether this transition strengthens the program or strains it unnecessarily.
We cannot wait for CMS to hand us perfect blueprints for rehab. The time is now for rehab leaders to define what optimized care looks like, build these pathways using evidence and outcomes data, and then aggressively demonstrate that our services are the most effective way to align with the new strategic direction of healthcare.
The 15 drugs selected for the Centers for Medicare and Medicaid Services drug price negotiation program accounted for about $27 billion in total prescription spending under Medicare Parts B and D. But this revenue from Medicare makes up a small percentage of each drug manufacturer’s total sales.
A unified workflow for all referrals, resulting in fewer clicks and less confusion, means provider matching can be conducted based on specialty, location, insurance, and real-time availability, for an easier track to the right provider, not just any provider.
At the ViVE conference in LA, Smarter Technologies Chief Medical Officer Ruben Amarasingham MD talked with Katie Adams about the company's larger goals for AI: to improve the accuracy of data and make healthcare less burdensome for physicians and clinicians.
The DEA’s anticipated extension of telehealth prescribing flexibility once again averts an immediate disruption in care, but it leaves providers and patients in the same cycle of uncertainty that has persisted for years.
The decision to eliminate nursing and PA degrees from ‘professional degree’ status isn’t just a financial policy choice; it’s a workforce policy choice. And, unfortunately, it’s moving in the wrong direction at the worst possible time.
Using Section 232 national-security tariffs on imported medical equipment risks repeating the same mistakes that have long plagued U.S. health policy: relying on blunt instruments for complex problems.
The Trump administration can immediately take these two price transparency administrative actions to reduce costs and improve affordability.
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
Americans largely trust their doctors but are skeptical of payers, drugmakers and hospital leadership — a divide fueled by rising costs and a complex, opaque healthcare system. Kristin Wikelius of United States of Care said restoring confidence will require more transparency, simpler navigation and policies that prioritize preventive care.
Clinging to our old models is equivalent to waiting for failure. We need to embrace the tools, team structures, and delivery models that this ongoing crisis demands.
Newly launched Pfizer drugs will be priced at parity to prices in comparable developed nations, according to the most-favored nation pricing agreement. But industry observers note that big pharma companies are also raising some prices overseas as part of a strategy to protect U.S. revenue.
There are aspects of the plan worth praising, but these benefits are overshadowed by three key concerns that will disproportionately impact vulnerable populations if the plan is implemented as written.
FDA Commissioner Marty Makary said publishing complete response letters recognizes public interest in the transparency and credibility of agency decision-making about drugs. He also said the move complies with an executive order that covers the communication of scientific data.