At MedCity News’ inaugural Bullseye conference in Chicago, Debunked Podcast co-hosts Arundhati Parmar and Samir Batra discussed recent CMS actions and Mayo Clinic’s former research director, who has filed a complaint against the medical center over how it’s deploying AI. The post Debunked Episode 29: CMS GLP-1 Drug Pilot Program, RPM Strategy Raise Questions appeared first on MedCity News .
Conservatives who have long pushed for Medicaid work requirements often said vulnerable people would get a pass. But the federal government’s list of exemptions left off homeless people.
Sen. Andy Kim of New Jersey wants to offer universal healthcare until age 26. He sat down with KFF Health News’ Julie Rovner to answer the question: “How Would You Fix It?”
The Centers for Medicare and Medicaid Services (CMS) released the 2027 Inpatient Prospective Payment System (IPPS) final rule on July 31. The rule includes a net increase to inpatient hospital payment of 2.3%, reflecting a 3.2% increase in the hospital market basket reduced 0.9% by the productivity adjustment.
NCQA is ready to roll out the person-centered outcome (PCO) measures in HEDIS® MY 2027 for Dual-Eligible Special Needs Plans (D-SNP) and Chronic Condition Special Needs Plans (C-SNP). Unlike traditional care process measures, the PCO measures incorporate the person’s voice into the care plan and quality measurement. “We have an enormous opportunity to continue to […] The post Person-Centered Outcome Measures Are Approved for HEDIS MY 2027 appeared first on NCQA .
Cardiac intensive care unit (CICU)-focused clinicians reported high job satisfaction, yet one in three also reported burnout, according to the first study to investigate burnout in this population, published March 25 in JACC: Advances.
Objectives Out-of-pocket payments remain a major source of healthcare financing in Kenya, yet it is unclear whether health insurance coverage is associated with lower out-of-pocket spending due to non-random enrolment. This study uses coarsened exact matching (CEM) to compare out-of-pocket costs (OOPCs) between insured and uninsured individuals. Design, setting and participants This study used cross-sectional data from the 2022 Kenya Demographic and Health Survey which covered 80 780 household members. Participants with missing or incomplete information on health insurance status and OOPC were…
Lisata is laying off 72% of its workforce, including its chief medical officer, as the solid tumor biotech tries to navigate a new future after a planned merger with cancer imaging company Kuva Labs fell apart.
Ahead of Medicaid work requirements, a health plan in California hopes to stanch the number of people losing coverage by using an AI program to schedule appointments and remind enrollees to fill out paperwork. The plan says it can do the work of 40 employees at a fraction of the cost.
Yes, they’ve heard all the poop jokes. Public health staffers are painstakingly tracing the sources of this massive outbreak, combing through fast-food orders and lettuce purchases as they listen to people’s lengthy, messy stories about their illness.
M&A activity is going beyond big pharma acquisitions with Supernus Pharmaceuticals and Indivior Pharmaceuticals reaching a stock deal that the companies call a merger of equals. The combined company’s portfolio will have 11 commercialized products in addiction, attention-deficit hyperactivity disorder, depression, and Parkinson’s disease. The post Supernus and Indivior to Merge, Forming a New CNS-Focused Pharma Company appeared first on MedCity News .
Regulators also finalized the first nationwide, mandatory payment model to reduce the cost of joint replacements starting in 2028. Hospitals said the pay raise was inadequate, and chafed at the mandatory nature of the new model.
The Healthcare Effectiveness Data and Information Set (HEDIS®) is continuously evolving to reflect clinical best practices and to support the needs of organizations that deliver and coordinate care. For HEDIS Measurement Year (MY) 2027, NCQA introduced several updates: Added 6 new measures. Updated 3 existing measures. Transitioned 1 measure to Electronic Clinical Data Systems (ECDS) […] The post HEDIS® MY 2027: What’s New, What’s Changed, What’s Retired appeared first on NCQA .
The Healthcare Effectiveness Data and Information Set (HEDIS®) is continuously evolving to reflect clinical best practices for organizations delivering long-term services and supports (LTSS). The HEDIS MY 2027 Technical Specifications for Long-Term Services and Supports Measures is a set of HEDIS measures designed to assess whether LTSS organizations are delivering high-quality, person-centered care. The specifications include […] The post HEDIS® MY 2027 Volume 2 Release for Long-Term Services and Supports appeared first on NCQA .
A century-old rural Michigan hospital converted to a stripped-down model Congress created to help keep small facilities afloat, then it closed. The emergency hospital model, created a few years ago, is stabilizing some hospitals, arrived too late for others, and now faces major challenges under the One Big Beautiful Bill Act.
Rising premiums forced many people in Affordable Care Act plans to give up their coverage. But the Trump administration claims a huge drop in enrollment is almost entirely due to its fraud crackdown.
The Department of Justice in June issued a legal opinion saying states aren’t required to provide services that help people with disabilities remain in their homes. The new position has added momentum to states’ existing legal challenges to the requirement and triggered worries among people who rely on these services.
Sentara Health notified Anthem that it will let its commercial, Medicare and Medicaid contracts expire at year’s end unless the two sides reach a new rate agreement. The dispute puts coverage for an estimated 380,000 Virginians at risk. The post ‘We’re Not Going to Be Bullied’: Sentara Digs in on Anthem Contract Fight appeared first on MedCity News .
This cross-sectional study examines the variation in changes in inpatient rehabilitation facility use per traditional Medicare beneficiary and inpatient rehabilitation facility supply at the state level between 2019 and 2024.
New Study: 500,000 Americans with Diabetes Projected to Lose Medicaid Coverage by 2034 mcarmody Fri, 07/31/2026 - 17:57 Press release New Study: 500,000 Americans with Diabetes Projected to Lose Medicaid Coverage by 2034 ARLINGTON, Va. August 3, 2026 A new study released by the American Diabetes Association ® (ADA) today estimates that, absent policy change, nearly 500,000 Medicaid beneficiaries with diabetes will lose healthcare coverage by 2034. According to the research—commissioned by the ADA from Health Management Associates—coverage losses will disproportionately affect Americans who…
North Carolina's Robeson County, where most of the tribe’s citizens live, ranks as one of the worst counties in the U.S. for health disparities. After securing federal recognition, Lumbee tribal leaders will have to decide how to address them.
They’re known for touting pandemic precautions, Affordable Care Act plans, and testing for lead in schools. This year, some former public health officials are touting themselves — for governor or senator.