CMS clarifies grandfathering rules for Medicaid payment caps, expanding eligibility and freezing approved payment amounts through 2028.

The Centers for Medicare & Medicaid Services Feb. 2 revised its approach to determining grandfathering eligibility by ...

Objective: To address concerns about payment adequacy in Medicare Advantage (MA) plans, a 2017 federal policy change increased risk scores and associated capitated payments for community-dwelling ...

We analyzed nearly 720 health insurance costs from eight insurers, reviewed complaints, customer satisfaction, metal tiers and the types of plans offered in the marketplace. See our top picks below to ...

The 2026 Medicare ACO landscape features expanded participation, new models like LEAD, and a focus on advanced payment tracks ...

Tuesday afternoon, the House of Representatives voted in favor of a spending bill that includes major pharmacy benefit manager (PBM) reforms aimed at increasing price transparency for consumers and ...

In 2026, investors may be more targeted in their investments. The state of Texas may also continue to evaluate the impact of ...

The Bundled Payments for Care Improvement Advanced Model (BPCI-A) aims to reduce hospital spending and generate savings for the Centers for Medicare and Medicaid Services (CMS). The design of BPCI-A ...

Accountable alternative payment models remained steady in 2024, according to a Feb. 2 survey by America’s Health Insurance Plans. In 2024, 44.9% of healthcare payments stemmed from alternative payment ...

When Noah Hulsman, who owns a skate shop in Louisville, Kentucky, learned he no longer qualified for federal subsidies to help him pay for his“ gold” Affordable Care Act health plan, the 37- year-old ...

It would boost funding for community health centers, extend several expiring programs such as special diabetes programs and teaching health centers’ graduate medical education programs, and ...

This week, federal agencies prepare for a partial government shutdown as the Senate advances an appropriations agreement that, if passed, will move ...