US halts over $1 billion in Medicaid funds to California and Minnesota due to medicare fraud concerns and payment claims issues.
Scaling value based care requires key capabilities and a solid data foundation for success in healthcare payments.
A federal judge halts Trump administration rules cutting ACA market protections, preserving coverage access and subsidy eligibility for enrollees.
Congress targets doctor pay and pricing with new Medicare reform bills that impact doctor reimbursement and patient care costs.
Medicare prior-authorization pilot survives Senate Republican vote, keeping AI-driven checks in six states as Democrats fail to end the program.
Medicare pay cuts loom for doctors in 2027 under new reimbursement rules, affecting all physicians with conversion factor cuts, which will lower…
HCA Healthcare lowers its 2026 profit outlook due to $400M in insurance losses from ACA coverage drops, reshaping hospital revenue.
New data shows ACO REACH savings hit $2.5 billion in 2024 as the value-based care pilot nears its 2026 expiration, with $988…
Ascension acquires Williamson Health in a $1B deal, expanding its Tennessee portfolio with the regional health system based in Franklin.
Medicare bonuses to hit $13 billion in quality bonus payments to Medicare Advantage plans this year, a significant increase from last year's…