KFF analysis of 2022 Medicare Advantage data shows 17% had diagnosis additions increasing CMS payments, with minimal diagnosis deletions impacting risk adjustments.
Explore challenges healthcare providers face with payer denials and audits and how solutions like PayerWatch's platform improve revenue protection and utilization management.
Key deadlines and options for Medicare Annual Enrollment and Advantage Plan changes, including plan discontinuations and open enrollment periods for 2025-2026.
CMS introduces the ACCESS Model, a voluntary Medicare Part B demonstration offering Outcome-Aligned Payments for technology-enhanced chronic care. The model supports providers managing chronic conditions like diabetes and hypertension, emphasizing care coordination and outcome-based reimbursement.
CMS proposes 2027 Medicare Advantage star ratings changes, removing Health Equity Index, adding depression screening measure, and refining enrollment policies to enhance care quality and plan comparisons.
Medicare beneficiaries face higher Part B premiums and fewer prescription drug plan options in 2026. Explore key changes for Medicare and advice for enrollment.
Alabama’s education funding faces significant challenges as rising health insurance costs and new private school funding policies pressure the state budget. PEEHIP requests a 33% funding increase for 2027 amid stable revenues.
Rising Medicare Advantage enrollment among dialysis patients following the 21st Century Cures Act presents new challenges in care coordination, provider access, and regulatory oversight, impacting insurers and policymakers.
Home health providers face challenges shifting from fee-for-service to value-based care due to payer demands and regulatory pressures. Innovative payment models and care delivery adaptations are key to success.
Medicare Part B premiums increase 9.2% for 2026 as ACA subsidy expiration looms, impacting 22 million enrollees. CMS proposes cost-sharing reductions and new tools on Medicare.gov to manage rising healthcare costs.
