New & Notable
Hospital price transparency compliance improves, but lags at 49%
Experts say clearer communication from CMS and stronger enforcement actions have led to improvements in hospital price transparency compliance.
New 2027 CPT codes released as AMA faces mounting criticism
The 2027 CPT code set features new AI service codes and a maternity care framework, as the AMA defends its coding system against copyright lawsuits.
Medical supply companies banned in $3.4B fraud takedown
Eleven medical supply companies will not receive Parts C or D payments following a CMS crackdown on potential fraudulent, wasteful and abusive billing.
Study: Emergency care costs fall up to 52% after No Surprises Act
A new analysis from HaloMD provides evidence that the No Surprises Act is working to cut costs, with data indicating about $1B in savings from out-of-network emergency care.
Medicaid losses leave more patients paying cash, Epic finds
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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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Hospital price transparency compliance improves, but lags at 49%
Experts say clearer communication from CMS and stronger enforcement actions have led to improvements in hospital price transparency compliance.
-
New 2027 CPT codes released as AMA faces mounting criticism
The 2027 CPT code set features new AI service codes and a maternity care framework, as the AMA defends its coding system against copyright lawsuits.
-
Medical supply companies banned in $3.4B fraud takedown
Eleven medical supply companies will not receive Parts C or D payments following a CMS crackdown on potential fraudulent, wasteful and abusive billing.
-
Study: Emergency care costs fall up to 52% after No Surprises Act
A new analysis from HaloMD provides evidence that the No Surprises Act is working to cut costs, with data indicating about $1B in savings from out-of-network emergency care.
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Providers warn of another decade of 340B payment problems
Leading provider associations are urging the CMS to reconsider severe cuts to 340B reimbursements to hospitals, warning of another decades-long payment battle.
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$15.6B provider payouts fuel surge in No Surprises Act costs
Arbitrators awarded providers $15.6B from 2023-2025 under the No Surprises Act, with median payments at 445% of the QPA, which researchers say could drive up premiums.
Features
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Payers say AI doesn't deny care. The truth is more complex.
Payers say AI is not clicking the deny button on prior authorizations and provider claims, but the technology does play a key role in deciding which requests need further review.
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How providers can weather Medicaid cuts when many won't
Federal Medicaid reform will affect providers differently, with some more at risk of closing while others can innovate their way out of severe revenue losses.
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Prior authorization automation hinges on human connection
Healthcare is rapidly automating the prior authorization process, but Ochsner Health has found that a new initiative connecting payers and providers is making progress tangible.
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What providers really need to streamline prior authorizations
Providers have yet to see much progress on a pledge last year to streamline prior authorizations, signaling misalignment between payer promises and meaningful change for providers.