New & Notable
Democrats introduce bill to repeal Medicare prior authorization pilot
The lawmakers argue the CMS innovation center model, which will implement AI-backed prior authorization for some services in six states, will add red tape and limit access to care.
— Healthcare Dive
Survey: Most providers not ready for TEAM bundled payments
Despite new requirements coming in January, 77% of providers don't feel prepared for new TEAM bundled payments as they continue to suffer from data challenges.
Physician Fee Schedule final rule brings key changes for ACOs
The final rule for the 2026 Medicare Physician Fee Schedule includes major programmatic and quality reporting changes for the Medicare Shared Savings Program.
CMS finalizes CY 2026 Medicare Physician Fee Schedule
CMS finalized a modest bump in Medicare Physician Fee Schedule rates next year alongside new policies to promote the prevention of chronic diseases and restructure efficiency 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.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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Survey: Most providers not ready for TEAM bundled payments
Despite new requirements coming in January, 77% of providers don't feel prepared for new TEAM bundled payments as they continue to suffer from data challenges.
-
Physician Fee Schedule final rule brings key changes for ACOs
The final rule for the 2026 Medicare Physician Fee Schedule includes major programmatic and quality reporting changes for the Medicare Shared Savings Program.
-
CMS finalizes CY 2026 Medicare Physician Fee Schedule
CMS finalized a modest bump in Medicare Physician Fee Schedule rates next year alongside new policies to promote the prevention of chronic diseases and restructure efficiency adjustments.
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Insurers point to provider misuse of surprise billing arbitration
A new report from AHIP and BCBSA shows providers submitting high volumes of ineligible claims, as payers and providers continue to place blame for federal IDR hiccups.
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R1 launches a revenue 'operating system' for end-to-end coverage
R1 announced the launch of the Phare Operating System, which utilizes AI agents to orchestrate automated revenue cycle management, spanning from patient access to denials management.
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Study examines surgical price tags, finds massive markups
A new study shows significant hospital pricing markups, with the high-cost hospitals for elective surgical care also experiencing more adverse care outcomes.
Features
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ACA enhanced tax credit fight exposes healthcare's funding crisis
Enhanced premium tax credits are at the center of the latest government shutdown, creating concerns for providers and exposing a history of patchwork solutions for a cracked system.
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Provider pay caught in the middle during government shutdown
The ongoing government shutdown will impact Medicare reimbursement, particularly for telehealth services, putting revenue cycle teams in a tight spot.
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Athenahealth revamps revenue cycle management in the era of AI
Athenahealth is adding AI features to its practice and revenue cycle management capabilities, at no additional cost, as the health IT company leans toward becoming AI native.
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Innovation interrupted: How reimbursement is stalling health AI
The current reimbursement system wasn't made to pay for health AI, but that will need to change as healthcare providers rapidly adopt AI medical services to improve clinical outcomes.