Journey of Care Launches Colorado-Based Value-Focused Palliative Care Provider

Colorado's Journey of Care introduces a dedicated value-based palliative care model targeting Medicare Advantage and special needs plans with interdisciplinary services and telehealth support.

HHS OIG Identifies $17 Billion in Potential Savings in Healthcare Programs

The HHS Office of Inspector General identifies $17 billion in potential cost savings by improving program efficiency and compliance in healthcare programs.

SMART Health Care Act Targets Medicare Abuse & Hospital Overbilling

Rep. Spartz introduces the SMART Health Care Act to reduce Medicare and Medicaid waste, address hospital overbilling, enhance rural healthcare access, and reform the 340B drug program.

CMS GUIDE Model Transforms Medicare Dementia Care with Home-Based Focus

CMS's GUIDE Model is reshaping Medicare dementia care with home-based solutions, virtual nursing, and new respite care reimbursements to improve patient outcomes and reduce costs.

Humana's Prior Authorization Process for Medical Services and Medications

Explore Humana's detailed prior authorization requirements for medical services and medications, including timelines, appeal rights, and Medicare member guidance for coverage approvals.

Medicare Caps Oral Cancer Drug Costs and Expands Payment Options in 2025

New Medicare Part D rules in 2025 cap oral cancer drug costs at $2,000 annually and introduce a voluntary monthly payment plan to improve affordability for patients.

U.S. Healthcare Budget Reconciliation Delayed Amid Medicaid, Medicare, and HHS Oversight Developments

Updates on U.S. healthcare budget reconciliation delays, Medicaid policy debates, Medicare Advantage lawsuits, HHS budget for FY 2026, and new NIH research initiatives shaping insurance and healthcare regulation.

Rural Hospitals Face Financial Pressures Amid Changing Medicare Reimbursement

Ozarks Community Hospital highlights financial challenges in rural healthcare due to lower Medicare Advantage reimbursements and the value of nonprofit status in accessing grants.

Medicare Cuts Fund Medicaid Expansion Under ACA, Impacting Hospital Finances

Summary of Medicare payment reductions used to fund Medicaid expansion under ACA, highlighting impact on hospital financial stability and Medicare's long-term obligations.

Impact of Proposed Federal Medicaid Cuts on Washington State Healthcare and Economy

Explore the potential impacts of proposed federal Medicaid cuts on Washington state's healthcare system, rural hospitals, Medicaid beneficiaries, and state economy.