Reimbursing Your Digital Twin: A New Era In Patient-Specific Surgery
Deploying AI-driven segmentation at an enterprise level goes beyond operational efficiency. It signals a commitment to pioneering the next era of precision healthcare.
Workload Up, Payment Down: The Growing Strain on Independent Practices
Physicians are facing rising workloads, shrinking support staff and declining reimbursement — resulting in a burnout crisis and threatening the sustainability of independent practices. Experts say urgent Medicare payment reforms are needed to prevent further consolidation, as well as preserve access to care.
The Power of One: Redefining Healthcare with an AI-Driven Unified Platform
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
Bipartisan Bill Seeks to Establish Parity Between MA & Traditional Medicare Payments
Two U.S. representatives have introduced the Prompt and Fair Pay Act, a bipartisan bill that would require Medicare Advantage plans to reimburse providers at least the same rates as traditional Medicare, as well as pay claims more promptly. Providers and industry groups have welcomed the proposal, citing mounting financial strain and growing concerns over care delays and denials.
Why Hospitals Are Losing the Financial Tug-of-War With Payers
Hospitals’ flat revenues are clashing with rising costs and excessive reimbursement denials from payers, said Rod Hanners, CEO of Keck Medicine of USC. He warned that policy efforts focused solely on limiting provider payments ignore the larger issue of unchecked profits among payers, drugmakers and other healthcare industry players.
New Legislation Seeks to Preserve Hospital-at-Home Reimbursement Until 2030
A bipartisan group of lawmakers introduced legislation this week to extend CMS’ hospital-at-home waiver for five more years, allowing hospitals to continue delivering acute care in patients’ homes with Medicare reimbursement. The move comes as research shows this model reduces mortality and healthcare costs.
Eko Health’s AI for Cardiac Diagnoses Earns CMS Reimbursement Rate
This week, CMS established a reimbursement code for Eko Health’s AI platform, which seeks to aid clinicians in the diagnosis of heart conditions. The goal behind the technology is to help catch heart disease earlier, when it’s easier to treat, and to make high quality diagnostic care more accessible.
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5 High-Impact Tax Strategies Every Physician Should Use in 2026 to Reduce Their Tax Bill
AI-native tax firm Gelt combines top human tax experts with AI to help physicians and healthcare practices use data-driven tax strategies to lower liabilities, improve profitability, and future-proof their finances.
INVEST Pitch Perfect Spotlight: How Pear Suite Makes Sure Community Health Workers Get Paid
Pear Suite recently won the payer/provider technology track of MedCity News’ INVEST Pitch Perfect contest. The startup provides a software platform for community health workers that helps them share data, submit claims and maintain compliance.
Labor Costs and Payer Rates Are Still Squeezing Providers’ Margins
New research found that most healthcare CFOs anticipate minimal financial gains this year due to high labor costs and insufficient payer rates. While providers are leveraging more data to improve financial planning, persistent challenges like wage pressures, recruiting difficulties and payers' increasing use of technology to deny claims continue to strain margins.
High Labor Costs Continue to Plague Providers, Data Shows
High labor costs remain an ongoing problem threatening providers’ bottom lines, according to new data from Kaufman Hall. The research revealed that medical groups’ median investment in each employed physician has reached more than $300,000 for the first time.
Increasing Efficiency and Reimbursements with Clearinghouses
Clearinghouses are just one great example of how the enhanced exchange of healthcare data can increase efficiency for healthcare providers and the greater healthcare community.
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Could QuantalX’s Device Make Managing Brain Health Easier?
CEO and neuroscientist Dr. Iftach Dolev on how the new device can bring a powerful tool to psychiatrists and neurologists alike.
Medicare Reimbursement for Doctors is in Critical Condition
Doctor’s offices are the front door of the American healthcare system. We owe it to them to support H.R. 2474 and put an end to annual Congressional stop-gap spending bills.
Why Digital Health Startups Should Start Thinking About Their Reimbursement Pathway Earlier
Some of the most difficult processes for digital health startups to navigate are those related to reimbursement and coding. Startups will often need to create entirely new codes for their products, so they should start thinking about this sooner rather than later, experts said at a recent conference.
Medicare Advantage Audit Ready with AI
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.
Digital Therapeutics Sector Sees Billing Codes as Key to Breaking Free of Reimbursement Rut
Medicare’s physician fee schedule includes billing codes for digital therapeutics for the first time. Stakeholders say these codes could help turn around reimbursement challenges weighing on the entire digital medicines sector.
Without the Right Policies, U.S. Risks Inhibiting its Momentum in Healthcare AI
As other industries confront what some see as a ‘wild west’ in terms of AI adoption, the healthcare industry is already using it, with guardrails in place to protect the patients and healthcare workers who are its customers. To maintain this momentum and not stymie it, policies must be in place that spur continued adoption of this technology.