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Accounting & Financial Management / Payer
List shows all Medicare Advantage plans' overall star ratings for 2026
Susan Morse
October 10, 2025
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Accounting & Financial Management / Payer
House vote expected today on bill that would reopen the government
The CR would extend Medicare telehealth flexibilities, including acute hospital care at home and allow for retroactive payments.
Susan Morse
November 12, 2025
Artificial Intelligence / Payer
Star ratings stabilizing, but health plans should be ready for changes
Expected drop in next year's star ratings will be due to the health equity index that includes social risk factors in CMS calculations.
Jeff Lagasse
November 12, 2025
Artificial Intelligence / Payer
Democrats introduce legislation to block WISEeR prior authorization model
Susan Morse
November 11, 2025
Texas sues drugmakers over acetaminophen-autism claims
Cigna teaming with Magic Johnson on music initiative
CMMI announces pilot to lower drug prices in Medicaid
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Ambulatory Care / Payer
UnitedHealth set to acquire medical group in Massachusetts
Susan Morse
October 10, 2025
Medicare & Medicaid / Payer
CMMI announces pilot to lower drug prices in Medicaid
Susan Morse
November 10, 2025
Compliance & Legal / Payer
Senate proposes ending shutdown as House calls for extending subsidies
Jeff Lagasse
November 10, 2025
Artificial Intelligence / Payer
DRH Health expanding AI technology into clinical documentation
Jeff Lagasse
November 09, 2025
Accounting & Financial Management / Payer
Hospitals face documentation and financial burden from new telehealth mandate
Susan Morse
November 07, 2025
Medicare & Medicaid / Payer
Democrats press CMS on 'rushing' Medicare provider directory
The lawmakers say the tool used by CMS is riddled with errors, while beneficiaries have not been notified.
Jeff Lagasse
November 07, 2025
AHA, AMA, other providers urge Congress to prevent 15% payment cut to labs
NYU Langone extends physician presence into nursing homes
KEY PAYER TOPICS
MEDICARE & MEDICAID / Payer
Star ratings stabilizing, but health plans should be ready for changes
Expected drop in next year's star ratings will be due to the health equity index that includes social risk factors in CMS calculations.
Jeff Lagasse
November 12, 2025
Democrats introduce legislation to block WISEeR prior authorization model
CMMI announces pilot to lower drug prices in Medicaid
Hospitals face documentation and financial burden from new telehealth mandate
Democrats press CMS on 'rushing' Medicare provider directory
ANALYTICS / Payer
Humana, Providence team on data exchange initiative
The collaboration establishes a scalable ecosystem for secure and standardized data sharing.
Jeff Lagasse
October 23, 2025
AI allows for faster, more accurate 'decision science'
PBGH aiming for accurate pricing for employers with data project
AI as the enabler, not just technology 'running amok'
Interacting with FDA's generative AI platform Elsa
REVENUE CYCLE MANAGEMENT / Payer
Hospital expense growth is outpacing revenue
Profitability has decreased while bad debt and charity care continue to rise, says Kaufman Hall report.
Susan Morse
September 09, 2025
Athenahealth is piloting AI model for clinical decision-making
AI makes a difference in revenue cycle collection
Cedar announces agentic AI for healthcare billing
Cleveland Clinic to debut AI tools for revenue cycle