TEAM Model Poised to Reshape Post-Acute Care with Varying Provider Readiness

Skilled nursing and hospital readiness varies as the CMS-initiated TEAM bundled payment model launches in 2026, impacting post-acute care coordination, financial risk, and value-based contracting in U.S. healthcare.

IRS Filing Status Impacts Medicare Premiums, Not Eligibility

Understand how IRS tax filing status affects Medicare Part B and D premiums through IRMAA income thresholds, with tips on enrollment timing and employer coverage.

AI-Driven Prior Authorization Pilot Launches in Six States for Medicare

Beginning January 2026, six states will pilot an AI-driven prior authorization program in traditional Medicare to target fraud and waste, sparking industry concerns over increased claim denials and access delays.

CMS 2026 Medicare Outpatient Payments Rise 2.6%, Site-Neutral Cuts Take Effect

CMS finalizes 2026 Medicare outpatient payment rule with 2.6% increase, site-neutral payment cuts, and elimination of inpatient-only list impacting hospitals and ASCs.

Medicare Telehealth Use Substitutes Rather than Adds to Care, Analysis Finds

New analysis of 1.67M Medicare beneficiaries shows telehealth primarily substitutes in-person visits, stabilizing overall utilization. Key insights for policy and healthcare delivery.

Everything Senior Insurance Supports Utah Medicare Clients Through AEP 2025

Everything Senior Insurance provides Utah seniors with expert Medicare plan guidance and year-round support, highlighting key changes during the 2025 Medicare Annual Enrollment Period.

Medicare Open Enrollment: Weighing Original Medicare with Medigap vs. Medicare Advantage

Analyze the benefits and considerations of switching from Medicare Advantage to Original Medicare with Medigap during the 2026 open enrollment period for informed insurance decisions.

OIG Report Highlights Medicare Overpayments for Continuous Glucose Monitors

The HHS OIG report reveals Medicare Part B overpayments for continuous glucose monitors and supplies, recommending rate reductions to align with supplier costs and enhance program efficiency.

CMS Enhances Dialysis Facility Quality Transparency with DFCC Tool

CMS’s Dialysis Facility Care Compare on Medicare.gov offers star ratings and patient survey data to improve transparency and inform decisions on dialysis care quality. The new Provider Data Catalog enhances data access for stakeholders.

CMS to Revise Medicare Hospital Payment Weights Using Market-Based Data for FY2029

CMS plans to change Medicare hospital payment weights methodology using Medicare Advantage data starting FY2029, impacting hospital reimbursement and clinical documentation.