Coverage, quality, and the economics of how care gets paid for.
Myricx Bio brings to Novartis antibody drug conjugates with a novel cancer-killing payload called an NMT inhibitor. Novartis says Myricx’s drugs could have advantages over currently available ADCs as well as those still in clinical development. The post A $1B Acquisition Gives Novartis a Way to Stand Out in Crowded Area of Cancer appeared first on MedCity News .
The rule, released Thursday, builds on Trump administration priorities, including cutting Medicare reimbursement for drugs in the controversial 340B program and equalizing payment between sites of care.
California’s next governor will face tough decisions on a highly controversial piece of healthcare policy: what to do about health coverage for the more than 1.4 million low-income residents without legal status. Democrat Xavier Becerra and Republican Steve Hilton present starkly different choices as public opinion wavers.
A work requirement is coming to Medicaid. Sam Whitehead tells WAMU’s “Health Hub” how to keep your coverage — and who’s exempt from the new rule.
CMS published its proposed 2027 outpatient payment rule, including a 2.4% base rate increase alongside steep cuts to 340B drug payments and an expansion of site-neutral payment to off-campus imaging services. Provider groups warn that these changes would push many hospitals’ payments into negative territory. The post What to Know About CMS’ New Proposed Outpatient Payment Rule appeared first on MedCity News .
KFF estimates Medicare will spend $13.4 billion on the Medicare Advantage Quality Bonus Program in 2026 amid continued scrutiny of the program. The post Medicare to Spend $13B on MA Quality Bonus Program in 2026 appeared first on MedCity News .
States must rethink how program integrity is designed and delivered by focusing on four key priorities that enable oversight to scale alongside these programs. The post Modernizing Program Integrity in Medicaid Self-Directed Care appeared first on MedCity News .
Chair emeritus of the ACP Board of Regents, Dr. William Fox, said he is optimistic that Advanced Alternative Payment Models and other developments may provide a pathway for success for independent primary care practices.
KFF Health News journalists made the rounds on national and local media recently to discuss topical stories. Here’s a collection of their appearances.
One analyst called the insurer’s decision a “watershed moment” for liquid biopsy-based cancer screening and for the category of blood-based cancer testing.
When makers of infant formula hear that babies got sick or died while using their products, what happens next is left largely to the manufacturers. They decide whether to inform the FDA about possible harm, which could trigger steps to protect the public.
Join the conversation as the HealthQ team explores the messiness, humor, and satisfaction that comes with caregiving when you’re sandwiched between aging parents and growing kids.
From screwworm to flesh-eating bacteria, mounting public health risks are emerging in the wake of deep cuts to federal health agencies and programs.
The Centers for Medicare and Medicaid Services (CMS) issued the 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule on July 2, proposing a 2.4% increase to OPPS payment rates that reflects a market basket update of 3.2% reduced by a productivity adjustment of 0.8%.
Background Frailty is a common condition in older adults which becomes more prevalent and more severe with age. Health and care services designed to meet the needs of older adults living with frailty are expanding in number and scope, but information on the workforce needed to deliver services both now and in the future is lacking. Objectives To understand the service design and staffing configurations for frailty services through gathering data on the setting and purpose of services; target population; referral methods into the service; specific activities delivered; frailty assessment tools…
The Trump administration’s cuts to Medicaid and SNAP may complicate Republican Gov. Joe Lombardo’s reelection chances.
Gov. Gavin Newsom launched an ambitious initiative to make public schools the epicenter of mental health services for young people. Five years after he promised transformation, many schools have struggled to get the program up and running, and hundreds more have yet to try.
This cross-sectional study describes trends in physicians, advanced practice registered nurses, and physician associates providing home-based medical care for Medicaid beneficiaries between 2018 and 2022.
Zelis has introduced an AI solution to help health insurers streamline the No Surprises Act’s Independent Dispute Resolution process. The post Zelis Unveils Solution to Tackle Payer IDR Challenges appeared first on MedCity News .
[Sponsored] Zelis CEO Amanda Eisel discussed how AI can create value when it is applied to measurable outcomes: simplifying claims workflows, reducing administrative burden, strengthening payment integrity, improving the payments experience, and empowering members to navigate their healthcare financial journey with confidence. The post How Payers Can Use AI to Improve the Healthcare Financial Experience appeared first on MedCity News .
American hunters skew conservative, rural, and male — all associated with increased hesitancy about or resistance to vaccines. At the same time, hunters spend more time than most people outdoors and potentially exposed to Lyme disease. So how do they feel about a potential new vaccine against the tick-borne illness?
Trinity Moravian Church, a politically diverse congregation in Winston-Salem, North Carolina, has been raising money to retire medical debt in the surrounding community.
Starting in July, the government will cap what graduate students may borrow in federal loans, forcing many toward private lenders with higher interest rates. The borrowing limits will affect students pursuing healthcare degrees, and some clinicians and student loan experts worry they may impede efforts to diversify the healthcare workforce.
The July 1 changes are being framed as student loan policy. But they raise a larger question about what kind of labor, and whose labor, America is willing to invest in. The post Federal Loan Policy Is Pricing Women Out of Healthcare’s Most Critical Roles appeared first on MedCity News .