2027 Medicare primary care payment changes target longstanding undervaluation
Medicare payment for primary care is set to undergo noteworthy changes in 2027, with bigger updates looming. The proposed rule for Medicare’s Physician Fee Schedule (PFS) includes provisions to address what CMS recognizes as a long-running undervaluation of primary care, according to an agency leader. “We’re embarking on a two-year strategy to change that,” Jake…
MedPAC examines Medicare spending shifts and hospital payment pressures
Depletion looms in as few as seven years for Medicare’s Hospital Insurance Trust Fund even amid long-term drops in Part A spending per beneficiary, according to insights from a meeting of the Medicare Payment Advisory Commission (MedPAC). The Congressional Budget Office (CBO) has put the depletion date at 14 years out, or seven years later…
Cost saving strategies, a more modern patient experience and more
Nick Hut discusses the Medicare OPPS Proposed Rule with Kathy Stull. Erika Grotto talks with Michael Driscoll of Fidelity Investments about cost saving strategies for employers and with Tracy Monson from Onbe about modernizing the patient financial experience.
Costs loom amid evolving trans care policies
Hospitals urged CMS to withdraw proposed rules aimed at barring “sex-rejecting procedures” on children, while others warned of costs. Several hospital groups raised objections to two proposed rules from CMS that would: A violation of the CoPs can result in monetary sanctions, exclusion from Medicare and Medicaid and, potentially, False Claims Act violations, noted a…
Breaking down key 2026 regulations for hospitals and physicians
HFMA policy director Katie Gilfillan joins Nick Hut and Shawn Stack as they discuss the Medicare physician fee schedule for 2026. Also in this episode, Nick and Shawn analyze the hospital OPPS Medicare payment update for 2026.
Humata Health prepares providers for Medicare’s WISeR model launch
The CEO of one of the six vendors implementing Medicare’s new prior authorization (PA) program recently addressed provider concerns on its payment model, uncertainty of the approach of the AI used and challenges in submitting data. The six-state CMS Wasteful and Inappropriate Service Reduction (WISeR) model, which launches Jan. 1, will require either PA or…
Hospitals urge ways to cut $1 trillion administrative cost
The American Hospital Association has submitted 100 regulatory changes to the Trump administration to reduce the estimated $1 trillion annual cost of health administrative requirements, including deregulating quality measures, billing and payment, and telehealth.