In October 2024, the Centers for Medicare and Medicaid Services (CMS) approved the first ever Section 1115 waiver demonstration amendments that would allow Medicaid and CHIP coverage of traditional health care practices for American Indian or Alaska Native (AIAN) people in Arizona, California, New Mexico, and Oregon. This Waiver Watch reviews disparities in health and…
When Lawrence and Penny Higgins of Fairfield, Maine, first learned in 2020 that high levels of toxic chemicals called PFAS taint their home’s well water, they wondered how their health might suffer. They had consumed the water for decades, given it to their pets and farm animals, and used it to irrigate their vegetable garden…
This brief estimates the number of current Marketplace enrollees with a mental health diagnosis to understand what changes in enrollment may mean for access to services. Among the 24.3 million Marketplace enrollees in 2025, over 4.4 million individuals are estimated to have at least one mental health diagnosis on a health care claim.
Millenium Physician Group’s Tesha Simpson and Cone Health’s John Supra discuss how AI could change clinician and patient experiences
High-performing groups treat utilization with the same rigor they apply to coding and quality. Here are four key principles we’ve seen successful organizations adopt. The post Utilization: The Hidden Revenue Leak in VBC appeared first on MedCity News.
As Congress weighs spending cuts and other changes to Medicaid, more than half (54%) of the public say they are worried significant reductions in federal Medicaid spending would negatively affect their family’s ability to obtain and afford health care, a new KFF Health Tracking Poll finds. This includes about three in 10 (29%) who say…More
Pharma leaders must take a “construction crew” mindset and start treating workforce development in the same manner as they do critical infrastructure. The post The Real Bottleneck in U.S. Pharma Reshoring Isn’t Factories – It’s Talent appeared first on MedCity News.
This report provides an analysis of donor government funding to address family planning in low- and middle-income countries in 2023, which totaled US$1.47 billion, and was an increase of 7% (US$101 million) compared to the 2022 amount (US$1.37 billion); although, it was still below the peak level reached in 2019 (US$1.58 billion). The overall increase…
An Urban Institute report finds that the One Big Beautiful Bill Act could cause 5–10 million people to lose Medicaid coverage by 2028, with outcomes heavily dependent on how states implement work requirements and eligibility rules. The post State Mitigation Strategies Could Blunt Medicaid Coverage Losses appeared first on MedCity News.
CMS sets timeline for Medicaid SDP payment reductions and compliance