CMS's Medicare Advantage proposal reintroduces the reward factor, affecting insurer payments by $13B, and phases out the inpatient-only list, impacting outpatient care and rural health strategies.
A national study reveals significant racial disparities in physician payments for outpatient care, driven largely by Medicaid reimbursement differences, highlighting systemic inequities in US healthcare.
Federal budget and policy changes in Washington will force many New Yorkers off the Essential Plan, causing significant premium hikes and coverage losses, threatening progress in the state's health insurance landscape.
Texas HHSC to transition from Dual Demonstration Program to Integrated Dual-Eligible Special Needs Plan (D-SNP) model in 2026, enhancing Medicare and Medicaid integration for dual eligibles in STAR+PLUS.
The expiration of enhanced ACA health insurance subsidies could double premiums, reduce coverage for millions, and strain state budgets, with significant economic and healthcare impacts nationwide.
Health First Urgent Care agrees to $2.8 million settlement for Medicare and Medicaid overbilling linked to improper diagnostic test billing practices in Washington State.
CMS unveils the GENERous Medicaid payment model introducing MFN drug pricing, alongside expanded Trump administration drug pricing agreements and key regulatory updates for 2026.
Banner Health's insurance plan integrates health system data and AI technology to improve care coordination, compliance, and member experience in Medicare and Medicaid markets.
Explore how rural hospitals are adapting to Medicaid cuts and workforce challenges through innovation and targeted strategies to maintain healthcare access in rural America.
Novo Nordisk and Eli Lilly agree to lower GLP-1 drug prices in exchange for expanded Medicare and Medicaid coverage, marking a major shift in U.S. drug pricing and access.
