Reimbursement

Thirty-four MA plans earned 5 stars in 2026 star ratings.

The AI-native model yields revenue cycle results that were unimaginable only a year ago, says athenahealth.

Hospitals increasingly see ASCs not only as a budget item but as a central element of strategy, report says.

HRSA is scheduled to issue approvals to drugmakers by Oct. 15 for implementation of the pilot on Jan. 1, 2026.

Medicare and Medicaid reimbursement will continue, but Medicaid payments are dependent on federal appropriation.

That includes a $7.7 billion increase in demand for uncompensated care, numbers showed.

The legislation is endorsed by numerous healthcare groups, including the American Hospital Association.

The new model is intended to provide pharmacies with better financial means to stock more medicines, which is expected to alleviate drug shortages.

Hospitals should know the cost of providing care so that if they’re losing money on a specific service they can go to payers and renegotiate, says Kelly Arduino, Healthcare Industry Leader at advisory firm Wipfli.

The physician does the prescription in the background, Surescripts asks the PBM for prior auth approval and the information is pulled from the EHR, all within 30 seconds, says Matt Koehler, VP of product innovation at Surescripts.