Coverage, quality, and the economics of how care gets paid for.
Health secretary Robert F. Kennedy Jr.’s new autism panel is championing a controversial communication method popular among parents of severely autistic people. Critics warn of abuse — and fake “telepathy.”
Despite widespread support in polls for legalizing aid in dying, the number of people who go through with the practice remains very small.
Healthcare advocates warn that a new CMS rule on Medicaid work requirement exemptions could increase red tape and cause eligible people to lose coverage. The post Will CMS’ Last-Minute Medicaid Work Requirement Changes Cause More Harm? appeared first on MedCity News .
If hospitals are going to stay ahead, revenue cycle leaders must shift from reaction to strategy. Here are some key areas of focus. The post When AI Becomes a Payer Advantage, Hospitals Cannot Afford to Stay Reactive appeared first on MedCity News .
KFF Health News' editor-at-large for public health discussed Ebola, GLP-1 drugs, ultraprocessed food, and more in TV appearances this week.
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The healthcare ecosystem is fixing how quickly decisions get made, without fixing how quickly money actually moves. This isn’t a failure of reform. It’s evidence that reform is working — and revealing where modernization needs to continue. The post The 72-Hour Hurdle: Faster Prior Authorization is Exposing Healthcare’s Broken Billing Cycle appeared first on MedCity News .
Big cuts to healthcare programs in the 2025 GOP budget law are creating an affordability crunch for many Americans: Higher health insurance premiums. Confusion about who Medicaid will cover under the new rules. KFF Health News chief Washington correspondent Julie Rovner explains how the changes could leave nearly 2 million children uninsured.
Come January, pregnancy care physician billing codes will change from a bundled system to an à la carte one. Many obstetricians say this approach will better reflect the amount and type of care they provide. But it could incentivize providers to pile on visits and services.
Travel bans and conflict have disrupted supply chains in the Democratic Republic of Congo, leaving health workers without Ebola tests and protective gear needed to contain the outbreak.
MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, Managing Partner of Health Innovation Pitch, co-hosts of the Debunked Podcast, discussed the impact of Marty Makary’s resignation from the FDA, among other topics. The post Debunked Episode 27: The Impact of an FDA Commissioner’s Departure, Insider Trading, Microdosing GLP-1s and a Win for Lower Drug Prices appeared first on MedCity News .
A year after the measure’s passage, a state law is keeping immigrants and their children from accessing Medicaid even when they qualify.
To collect and scrutinize millions of Americans’ health data, U.S. health secretary Robert F. Kennedy Jr. aims to work with state organizations that help health systems share medical records. In Nebraska, millions in federal dollars has flowed into one nonprofit cooperating with Kennedy’s project.
This cross-sectional study identifies organizations engaged in lobbying related to the 340B Drug Pricing Program, estimates their lobbying expenditures, and characterizes their policy priorities.
Statement from the American Diabetes Association on the CMS’s Medicaid Work Requirements Interim Final Rule vcramer Wed, 06/03/2026 - 14:50 Official Statement Statement from the American Diabetes Association on the CMS’s Medicaid Work Requirements Interim Final Rule Arlington, Va. June 3, 2026 This week, the Centers for Medicare & Medicaid Services (CMS) released an interim final rule implementing the new community engagement requirements for Medicaid beneficiaries included in healthcare and tax legislation Congress passed last summer. Beginning January 1, 2027…
Artificial Intelligence (AI) is rapidly reshaping health plan operations. While some organizations are actively piloting or scaling AI solutions, others are still determining where to begin. Regardless of where your organization sits on the AI adoption curve, scaling AI responsibly, transparently and effectively is foundational. Across the industry, initial efforts have focused on defining governance […] The post Shape the Future of AI in Prior Authorization: Apply to Join NCQA’s Learning Collaborative appeared first on NCQA .
Statement attributable to: Jan K. Carney, MD, MPH, MACP President, American College of Physicians WASHINGTON, June 2, 2026—The American College of Physicians is strongly opposed to the community engagement requirements, or work requirements, in the Medicaid program, that would be implemented under the interim final rule published by the Centers for Medicare and Medicaid Services yesterday. Most adults covered by Medicaid are already working, caregiving, or would not be subject to this policy due to illness or disability; research shows us that instituting work requirements will not…
PURPOSE Medicare Annual Wellness Visits (AWVs) offer many potential benefits to older adults, but patients in racial and ethnic minority groups have lower rates of AWV completion. Our objective was to understand older minority patients’ attitudes and preferences related to preventive care and AWVs. METHODS From June 2024 through October 2024, we conducted 4 focus groups at 2 urban primary care settings (ie, an academic health system and a Federally Qualified Health Center) among Medicare enrollees aged 66 years or more with 1 or more primary care encounter at a participating organization…
Source: Centers for Medicare & Medicaid Services Related MedlinePlus Pages: Emergency Medical Services , Health Insurance
We are excited to announce that NCQA and our partners, eHealth Exchange, Cambia Health Solutions and MultiCare Health System, received a 2026 KLAS Points of Light Award for a Payer/Provider Initiative. Our work to advance digital quality measurement was a cross-sector collaboration that demonstrated how Bulk FHIR® transforms quality data exchange. The Problem: Fragmented, Manual […] The post NCQA Receives KLAS Points of Light Award for Demonstrating the Feasibility of Bulk FHIR Exchange appeared first on NCQA .
NCQA will join the vibrant community of researchers, policymakers and practitioners at the AcademyHealth Annual Research Meeting (ARM) in Seattle, WA, from May 30 to June 2. This year’s theme, “Rigor and Relevance Driving Action,” reflects the urgency of ensuring that research not only meets the highest standards but also informs decisions that improve health and healthcare […] The post NCQA President Will Participate in a “Great Debate” at the AcademyHealth Annual Research Meeting appeared first on NCQA .
PHILADELPHIA, May 18, 2026—The Centers for Medicare and Medicaid Services (CMS) should reform Medicare Advantage to protect patient health and realign the plan option with its original purpose, says the American College of Physicians (ACP). In a new paper, “ Protecting the Integrity and Quality of the Medicare Advantage Program: A Position Paper from the American College of Physicians ” published today in Annals of Internal Medicine , ACP examines the growth of the Medicare Advantage program and its implications for the delivery of fair, high-quality and fiscally responsible care to older…
The U.S. healthcare sector accounts for roughly 8.5% of total greenhouse gas (GHG) emissions, driven largely by energy use, supply chains, transportation and waste. While much of the conversation about healthcare decarbonization has focused on hospitals and clinical care, health plans play a powerful—and often overlooked—role in shaping how care is delivered and how resources […] The post New NCQA Research: What Health Plan Leaders Can Do to Reduce Climate Impact appeared first on NCQA .
On March 31, NCQA released the HEDIS® MY 2026 Volume 2: Technical Update (Technical Update), which provides comprehensive guidance for organizations reporting HEDIS. With this release, the HEDIS Volume 2: Technical Specifications are “frozen” for MY 2026. Why is the HEDIS Technical Update Important? HEDIS is a set of standardized performance measures that enable consumers, […] The post NCQA Releases HEDIS® MY 2026 Volume 2 Technical Update appeared first on NCQA .