On January 1, 2026, the Center for Medicare & Medicaid Innovation (CMMI) launched the Wasteful and Inappropriate Service Reduction (WISeR) Model that establishes new prior authorization requirements in traditional Medicare. This analysis explores the potential impact of the WISeR model by examining recent spending and utilization trends in traditional Medicare for services selected for prior…
An analysis by Axene Health Partners revealed that Imagine360 delivered 19% in annual savings—equating to $7.7 million—compared to traditional health plans for Rollins, a pest control company. The post How Imagine360 Saved this Employer 19% Compared to Traditional Health Plans appeared first on MedCity News.
In mid-May, Mandi Rokx had a 3-month-old baby and a letter from a Florida agency warning that they both would be cut from Medicaid, the health insurance program for people with low incomes or disabilities. Under a Florida law passed in 2021, Rokx was supposed to receive 12 months of continuous coverage after giving birth….
KFF Health News chief Washington correspondent Julie Rovner appeared on CNN’s “Quest Means Business” to discuss the Affordable Care Act subsidies at the core of the government shutdown on Oct. 2. Rovner also appeared on NPR’s “Morning Edition” to discuss the subsidies on Oct. 7. Click here to watch Rovner on “Quest Means Business.” Click…
At the Behavioral Health Tech conference, panelists said employers often rush to adopt digital mental health tools without tailoring them to employee needs or effectively promoting their use. The post What Are the Biggest Mistakes Employers Make When Introducing Digital Mental Health Solutions? appeared first on MedCity News.
This issue brief provides an update on the latest trends in kindergarten children’s routine vaccination and exemption rates. Over three-quarters (39) of states had measles, mumps, rubella (MMR)vaccination rates below the “target” rate of 95% for the 2024-2025 school year.
AI-generated clinic notes from ambient outpatient visits assist clinicians in numerous ways
Navina closed a $55 million Series C funding round led by Goldman Sachs. The company, based in Israel and New York, uses AI to help primary care physicians thrive in value-based care models. The post Navina Snags $55M for Its Value-Based Care AI Copilot appeared first on MedCity News.
As Congressional Republicans and President Trump search for trillions of dollars in cuts to mandatory federal spending that could help offset the cost of extending expiring tax cuts, this brief analyzes current support from the federal government for health programs and services, including both spending and tax subsidies as context for those federal budget discussions.
“An Arm and a Leg” senior producer Emily Pisacreta recently lost a job that provided her with health insurance. So now, for the first time, she will be signing up for Obamacare. Her search is off to a rocky start. Pisacreta gives listeners a sobering look at how the high price of health insurance plans…