Medicare's 2025 payment updates introduce advanced primary care and behavioral health codes poised to reshape reimbursement landscapes, addressing primary care financial challenges and influencing specialist payment cuts.
A study on Medicare billing code G2211 highlights its impact on primary care reimbursement and specialists' engagement in comprehensive care.
Internal Humana data revealed higher hospitalization rates in their Medicare Advantage clinics than publicly reported, raising questions on integrated care outcomes and investor transparency.
The ACO Assignment Improvement Act proposes Medicare policy changes to include nurse practitioners and physician assistants in ACO patient assignments, expanding access to coordinated care and supporting Medicare savings and quality improvements.
Explore key 2026 Medicare Physician Fee Schedule updates, including efficiency adjustments, practice expense reforms, and impacts on primary care and subspecialties under CMS policies.
Insights from the 2025 Payer + Provider Summit on AI-driven care, value-based models, community partnerships, and the need for stable federal policies to advance primary and preventive care.
MaineHealth's Trellis Health introduces a membership-based primary care system aiming to enhance access, reduce specialist visits, and improve provider work-life balance through direct payment models. This innovative approach may influence broader primary care payment reforms.
CMS's 2026 Medicare payment proposals aim to rebalance reimbursements in favor of primary care and outpatient clinics, reduce hospital-owned clinic premiums, and introduce site-neutral payments to improve Medicare value and primary care sustainability.
Analysis shows rising exits of primary care physicians from Medicare fee-for-service, highlighting access challenges for older adults and shifts to Medicare Advantage and direct primary care models.
Study reveals rising physician exit rates from Medicare fee-for-service, with primary care facing notable impact amid payment and administrative challenges.
