New & Notable
Physician pay cuts loom as CMS unveils major Medicare reforms
The 2027 Medicare Physician Fee Schedule rule would cut conversion factors, sunset traditional MIPS and overhaul the Medicare Shared Savings Program despite provider pushback on costs.
Care continues shift to outpatient as hospital margins dip
Outpatient revenue jumped 8% YTD while operating margins fell to 2.7% in May, prompting strategic changes, Kaufman Hall reports.
REACH ACOs save $2.5B as model prepares for LEAD shift
REACH ACOs achieved $2.5B in gross savings with a 6.7% rate in 2024, as 96 of 115 ACOs earn net savings as the model prepares to transition to LEAD in 2027.
CMS proposes expanded authority to revoke Medicare privileges
CMS proposes expanding its authority to revoke Medicare providers in fraud crackdown, while updating home health payments with a 2.4% increase and continued PDGM adjustments.
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Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
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Latest News
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Physician pay cuts loom as CMS unveils major Medicare reforms
The 2027 Medicare Physician Fee Schedule rule would cut conversion factors, sunset traditional MIPS and overhaul the Medicare Shared Savings Program despite provider pushback on costs.
-
Care continues shift to outpatient as hospital margins dip
Outpatient revenue jumped 8% YTD while operating margins fell to 2.7% in May, prompting strategic changes, Kaufman Hall reports.
-
REACH ACOs save $2.5B as model prepares for LEAD shift
REACH ACOs achieved $2.5B in gross savings with a 6.7% rate in 2024, as 96 of 115 ACOs earn net savings as the model prepares to transition to LEAD in 2027.
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CMS proposes expanded authority to revoke Medicare privileges
CMS proposes expanding its authority to revoke Medicare providers in fraud crackdown, while updating home health payments with a 2.4% increase and continued PDGM adjustments.
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CMS takes aim at 340B, site-neural payments in OPPS proposal
The proposed Hospital Outpatient Prospective Payment System rule also includes a 2.4% rate boost, prior authorization for Botox injections and a more aggressive 340B remedy plan.
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Elevance: No Surprises Act IDR awards hit 'extreme' levels for OR
Providers are winning 90% of payment disputes for planned procedures with awards up to 119 times typical rates, raising questions about the No Surprises Act's impact.
Features
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Amid staffing shortages, AI becomes medical coding's backup hire
Even competitive providers like UC Davis Health now use AI to support thinning medical coding teams, creating more tech-driven workflows and a fundamental shift in the workforce.
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New No Surprises Act rules won't fix $51M crisis, TX group says
Radiology Associates of North Texas expects to pay millions to participate in the No Surprises Act's IDR process even as CMS tries to alleviate major pain points for providers.
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The U.S. finally bent the healthcare cost curve, one economist says
Health economist David Cutler's new analysis shows a deceleration in U.S. healthcare spending as technology advancements make care cheaper.
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How AI scribes are shifting coding intensity, reimbursement
The proliferation of AI scribes for clinical documentation has started a shift in coding intensity, raising concerns about reimbursement and affordability.