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Public Health & Policy >

Medicare

A computer rendering of a mans hand adjusting the RISK level with a large knob.

A Tale of Two Accountable Care Organizations

There is still hope for the future of value-based care

A computer rendered info graphic describing sepsis.

CMS Sepsis Measurement Under Fire

Measure doesn't work and its re-endorsement process was flawed, critics say

CMS Revamps Direct Contracting Model

Participants in current GPDC Direct Contracting must meet new equity and governance requirements

A photo of a motion-blurred ambulance rushing to an emergency.

Costs Soaring for Ground Ambulance Transport

Surprise billing law doesn't apply to ambulance rides

A photo of the exterior of a Walmart store.

Large Employers Are Suiting Up to Fix Healthcare

Do they have a shot?

A photo of a sad woman sitting on the floor in her house, head in hands.

Mental Health Crisis Demands Better Coverage, Worker Pay, Experts Tell House

Advocates argue for workforce incentives, peer involvement, and closing Medicare coverage gaps

A box of BinaxNOW rapid tests next to other products in a medicine cabinet in a home.

Medicare Patients Can't Get Their At-Home COVID Test Kits Covered -- Yet

But CMS says it's working to provide that coverage

A portrait of a male physician covering his mouth.

Why Are Physicians Silent About Outrageous Drug Prices?

Milton Packer wonders why physicians are struggling to get their priorities straight

The packaging and vial of Aduhelm over a close up of a Medicare card

Medicare Plans to Restrict Coverage of New Alzheimer's Drug

Proposal would cover aducanumab (Aduhelm) in patients on qualifying clinical trials

A red X and green check mark over the covers of three USMLE Step 1 study guides.

Was This Really Our Best Attempt at Step 1 Exam Reform?

Shifting to a pass/fail system has unintended consequences

AMA over a photo of Chicago, IL.

AMA Delegates Spar Over Medicare Drug Price Negotiation

Some worry this could lead to price controls for physician services

AMA over a photo of Chicago, IL.

Young Physicians Need Support From Organized Medicine, Says AMA President

"The fear and weariness ... I'd call it battle fatigue"

Metal letters spelling OUTPATIENT on the roof of a hospital.

Should Medicare Pay the Same Amount Regardless of Where a Service Is Provided?

MedPAC members like the idea -- with a few caveats

A pair of scissors cut through a U.S. $100 bill.

Final Physician Fee Schedule Rule Includes a Nearly 4% Payment Cut

Will leave practices in "financial peril," says AMA president

President Joe Biden promotes his Build Back Better infrastructure plan

Biden Announces Deal With Congress on Infrastructure Bill

Medicare hearing benefits make the cut, but dental, vision, drug-pricing provisions are left out

A Black woman wearing a protective mask which reads: Patients First and holding a National Nurses United flag.

National Nurses Union Wants to Fight Back

Resolutions call for consistent PPE and staffing levels, better organization and Medicare for All

Six U.S. $100 bills and a stethoscope protrude from the breast pocket of a doctor’s coat.

Medicaid Will Be a Bigger Target for Alternative Payment Models, CMS Official Says

Health equity also will be a focus, says CMMI official Ellen Lukens

A female physician discusses a hip replacement with her senior female patient.

Medicare Is Sticking With Mandatory Demonstration Models for Now

But "we need to move away from having a model for every episode," says CMMI head Elizabeth Fowler

A car accident victim is loaded into a helicopter on a highway in Ohio.

Air Ambulance Costs Are Soaring

And surprise bills often come along for the ride

A mature man with a cataract in his right eye.

When Prior Authorization Practices Go Too Far

Congress can reverse a troubling trend that creates patient care disruptions

A prescription medication bottle lying on its side filled with $100 bills.

PhRMA Warns of Dire Consequences if Medicare Allowed to Negotiate Drug Prices

"We know how the story ends" when the government sets prices, group says

INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Pharmacist Charged for Vax Card Sales; Moderna Recipe Fight; Drug Waste Report COIs

This past week in healthcare investigations

HIMSS over a conceptual image of a physician accessing data via a tablet.

Notice Any Rule Changes in Washington? You Can Thank COVID

"It's opened a Pandora's box, which is not going back"

A photo of radiotherapy equipment

Medicare's Radiation Oncology Payment Model Vexes Oncology Community

Participation required for certain radiation oncology practices starting next January

A young female nurse writes notes during a home visit to her mature male patient, both are wearing protective masks.

Bring House Calls Into the 21st Century

The pandemic highlighted the benefits of home health services for a range of patient populations

The YouTube video thumbnail with Dr. Zubin Damania and Vinay Prasad, MD, MPH, and the words IVERMECTIN& Aducanumab?

Ivermectin and Aducanumab: Do They Work?

ZDoggMD and Vinay Prasad, MD, MPH, analyze the evidence

Several packets of Suboxone sublingual film

As Overdoses Rise, Opioid Treatment Providers Struggle to Get Paid

Providers of medication assisted treatment say they're bleeding cash, and unable to keep staff

AMA over a grid of doctors faces of various genders and ethnicities.

AMA Delegates Tussle Over Lowering Medicare Eligibility Age to 60

Resolution asks association to urge Congress to take action

A photo of Donald Berwick, MD

Want Healthcare for All? Ditch Fee-for-Service, Says Former CMS Chief

"We should move to global budgets as soon as possible," says Donald Berwick

An advertisement for Alexander Baldonado’s business over a photo of blue rubber gloved hands counting $100 bills.

Federal COVID Fraud Charges Include Doc's Testing Scheme

Physician used COVID-19 testing event for more profitable purposes, says DOJ

A mature Black male physician shows info on a tablet to his mature Asian female patient who is wearing a headwrap

Op-Ed: A Door Opens to Transform Cancer Care

Incoming CMS Administrator Chiquita Brooks-LaSure brings hope to the cancer community

A collection of various copay assistance cards on a tabletop

CMS Rules for Insurers Punt on Drug Copay Relief

"Really disappointing" that payment notice didn't even mention these cards, coupons

SCAI over several views of left and right coronary angiography

Shifting PCI Procedures to Outpatient Centers: Safety First?

Do benefits in efficiency, cost reduction outweigh risks?

A mature businessman rests his chin on his handcuffed hands

Four Sentenced in Mental Health Center Scam

Heads of a Houston healthcare chain will go to prison for kickbacks, mental healthcare fraud

A computer rendering of a highway with years printed on it stretching out to the horizon beginning with 2021

On the Road to High-Value Healthcare in the U.S.: Are We There Yet?

CMS needs to keep the value-based payment models that work, and ditch the others

A female dermatologist examines the scalp of a senior woman with a magnifying lens.

Op-Ed: Dermatology Needs Lower Costs and Better Care

A proposal for value-based care

A checkmark and X in circles over an x-ray image of spinal fusion.

Doc Groups Object to New Prior Authorization Rules in Medicare

Requirements for two spinal procedures set to take effect July 1

A close up of a sleeping man wearing a sleep apnea mask

AHRQ: Studies Fail to Show Long-Term Benefit for CPAP

Sleep apnea specialists dumbfounded at critique of "gold standard" treatment

A disgruntled mans face on a ping pong ball on an orange paddle held by a doctor

Op-Ed: Primary Care and Specialty Ping Pong

Let's put an end to bureaucratic medicine and treat the patient in front of us

ISC over a computer rendering of a male figure with the front of his brain highlighted by a flash of light

Multi-City Study Bolsters Case for Mobile Stroke Units

But reimbursement woes, balkanized EMS agencies block path to broader use

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