Reimbursement
Adjustments are estimated to total $196.5 million in 2026, CMS says.
Declining physician payments and rising operational costs place emergency medicine at financial risk, RAND finds.
This translates to $25 billion for MA insurers in 2026.
CMS declined to cover obesity drugs, as proposed under the Biden administration.
Cuts in Medicaid would likely mean that many beneficiaries would lose coverage, leading to more uncompensated care for hospitals.
Hospitals that are already struggling will lose funding, say the Democratic state treasurers of Republican-proposed cuts.
Members are frustrated by not finding accurate information online, by being unable to get a live agent or by lack of preventative care options, says Rita Sharma, chief product officer at Pager Health.
The PBM says the payment model more closely aligns with the costs pharmacies often face due to "manufacturer pricing actions."
The layoffs affect Johns Hopkins University and the nonprofit Jhpiego, which works closely with USAID.
Denials are the bane of patients and providers, but without them, healthcare costs would rise, says Christine Stetler, a registered nurse and AVP of Solution Engineering at MedeAnalytics.