Addressing Payer Denials and Utilization Challenges in US Healthcare
Explore challenges healthcare providers face with payer denials and audits and how solutions like PayerWatch's platform improve revenue protection and utilization management.
Medicare Annual Enrollment Deadline and Plan Changes Explained
Key deadlines and options for Medicare Annual Enrollment and Advantage Plan changes, including plan discontinuations and open enrollment periods for 2025-2026.
CMS Launches ACCESS Model for Technology-Supported Chronic Care Management
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 Medicare Advantage Star Ratings Changes for 2027
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 2026: Rising Costs and Reduced Plan Options Challenge Beneficiaries
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 Faces Education Funding Challenges Amid Rising Health Insurance Costs
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.
Medicare Advantage Growth in Dialysis Patients Raises Care and Policy Challenges
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 Navigate Challenges in Shifting to Value-Based Reimbursement
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 Rise 9.2% Amid ACA Subsidy Uncertainty
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.
Georgia Man Sentenced for Illegal Medicare Genetic Testing Kickback Scheme
Georgia man sentenced to 46 months and $7.2M restitution for illegal Medicare kickbacks tied to unnecessary genetic tests, reflecting enforcement on healthcare fraud.