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publication date

CFO
From One CFO to Another: Breaking the Medicare Advantage Bottleneck
Marie DeFreitas | August 07, 2025
See what the CFO of a health plan and the CFO of a health system think is the solution to...
Revenue Cycle
CMS Finalizes Payment Bump in 2026 IPPS Final Rule
Luke Gale | August 05, 2025
CMS has finalized a 2.6% payment increase for inpatient services, boosted DSH payments, established new interoperability rules for prior authorization,...
Payer
Work Requirements and Red Tape Ahead for Millions on Medicaid
KFF Health News | August 04, 2025
Georgia's system could signal that work mandates will lead to excessive red tape, improper denials, and lost coverage.
Innovation
Is Digital Therapeutics Finally Having Its Moment?
Eric Wicklund | August 01, 2025
CMS is proposing expanding coverage of digital health devices used in some behavioral health treatment programs and asking for comments...
Innovation
The 'Big Beautiful Bill' Was a Big Beautiful Bust for Telehealth, and Now the Clock Is Ticking
Eric Wicklund | July 25, 2025
While President Trump's reconciliation package did reinstate first-dollar coverage for HDHP-HSAs, a collection of waivers aimed at boosting coverage for...
Revenue Cycle
Infographic: A Quick Guide to the CY OPPS Proposed Rule
Luke Gale | July 24, 2025
The 2026 OPPS proposed rule offers a modest 2.4% payment update, along with some major policy shifts. CMS is pushing...
Revenue Cycle
CMS Proposes Modest Payment Bump, Major Policy Shifts in 2026 OPPS Proposed Rule
Luke Gale | July 18, 2025
CMS suggests a modest 2.4% payment update in the 2026 Hospital Outpatient Prospective Payment System proposed rule on top of...
CMO
RFK Jr. Wants to Revolutionize a Program that Supports Childhood Immunizations. The Results Could Be Catastrophic.
ProPublica | July 17, 2025
Dramatic changes to the Vaccine Injury Compensation Program risk driving drugmakers from the market, threatening access to shots.
CMO
CMS Releases Proposed Rule for 2026 Physician Fee Schedule
Christopher Cheney | July 16, 2025
The proposed rule would increase the conversion factor used to set physician payments by more than 3%.
Revenue Cycle
CMS to Test New Prior Authorization Requirements in Traditional Medicare
Luke Gale | July 08, 2025
A new CMS model will introduce new prior authorization requirements to traditional Medicare in six states, raising provider concerns about...
Payer
Analysis: To Cut Medicaid, the GOP's Following a Path Often Used to Expand Healthcare
KFF Health News | July 02, 2025
The budget reconciliation process is how nearly every major piece of health legislation has passed Congress since the 1980s.
Innovation
Defining the Benefits of the Hospital at Home Strategy
Eric Wicklund | June 27, 2025
In this week's The Winning Edge webinar, executives from three leading health systems discussed how the platform improves clinical outcomes,...
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