If we focus only on placement, we will continue to see cycles of progress and regression. If we focus on stability — on what happens after the keys are handed over — we have an opportunity to change those trajectories more permanently. The post Medicaid’s Housing Problem Isn’t Placement — It’s What Happens Next appeared…
Despite the silk masks, oils, and sleepy girl mocktails swirling around social media, one of the greatest causes of non-restorative sleep is rarely mentioned by wellness influencers online: actual sleep disorders. The post The Sleep Crisis We May Be Missing: Why Millions of Americans Remain Undiagnosed appeared first on MedCity News.
Many health plans are discovering that even after digitizing medical policies and implementing FHIR APIs, prior authorization turnaround times remain slow and provider frustration remains high. The reason is straightforward: digitization alone does not make medical‑necessity determinations executable by automated systems at scale. The post Digitizing Medical Policy Alone Will Not Automate Prior Authorization at…
Fernando Viera Reyes necesitaba una biopsia por un posible cáncer de próstata cuando el gobierno de Trump lo envió a un centro de detención de inmigrantes en el desierto de Mojave, en California. Allí, esperó. Reyes, ahora de 51 años, solicitó reiteradas veces el procedimiento, según una demanda presentada en noviembre contra el gobierno federal,…
Republicans have hitched themselves to the “Make America Healthy Again” campaign, banking on its popularity to give them an electoral bounce. But the strategy carries risks. Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist who rails against Big Pharma and ultraprocessed food, is the leader of the movement. And Americans’…
This issue brief describes how Medicaid home care operates—including who is eligible and the systems in place to promote program integrity in its delivery—and the challenges of using new CMS data to identify unusual billing patterns or potential fraud in the program.
CMS will expand its ACCESS model starting in spring 2027 to cover heart failure, COPD, substance use disorders and tobacco cessation. The outcomes-based payment model, which launched in July with 160 participating providers, will now make roughly three in four Medicare beneficiaries eligible for at least one track. The post CMS Broadens ACCESS Model to…
The Peterson Health Technology Institute (PHTI) recently released a report titled: “Administrative AI: Current Use and Potential Impact.” The report was based on a workshop PHTI convened with senior leaders from health systems, health plans, technology developers, investment firms, and federal agencies in order to discuss how technology and policy can enable AI to reduce…
Senior care innovations offer a glimpse of what is to come while providing useful lessons for the broader healthcare sector. Successful AI-enabled technologies will improve outcomes, ease burdens, and increase autonomy. The post What Senior Care Can Teach Us About AI’s Future in Healthcare appeared first on MedCity News.
This policy watch examines monthly premiums for Medicare Part D stand-alone drug plans in 2025, as changes to the Part D benefit are being implemented in 2025, including a new $2,000 cap on out-of-pocket drug spending.