Healthcare IT Today

NOVEMBER 26, 2024

The following is a guest article by Andrew Mignatti, Co-Founder and CEO at careviso As Medicare annual open enrollment is underway, healthcare providers soon face the overwhelming task of verifying benefits for millions of patients.

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Medicare Interoperability Patient Experience healthcare technology 54

BHM Healthcare Solutions

JULY 15, 2025

The Centers for Medicare & Medicaid Services (CMS) has unveiled a proposed physician payment rule aimed at significantly reducing wasteful spending while enhancing quality measures for Medicare beneficiaries.

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Medicare 97

Health Populi

JUNE 25, 2025

GDP, based on the latest national health expenditure projections developed by researchers from the Centers for Medicare and Medicaid Services (CMS). By 2033, national health spending will comprise 20.3% of the U.S. This growth will be happening as CMS projects coverage of insured people to decline over the period.

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Health Populi

DECEMBER 18, 2024

But today we report out the latest data from the Centers for Medicare and Medicaid Services (CMS) that national health spending in America reached $4.9 The rate of spending among the three other payer types – Medicare, Medicaid, and consumers’ out-of-pocket costs — grew more modestly, at 8.1%, 7.9%, and 7.2%

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Aging in Place Technology Watch

JANUARY 15, 2025

The 2024 Medicare Physician Fee Schedule introduces new billing codes for caregiver training services , allowing eligible practitioners to bill Medicare for providing training and education to caregivers of patients with chronic illnesses or disabilities. To date, Louisiana, Delaware, and Nevada have completed both processes.

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Healthcare IT Today

JANUARY 23, 2025

Shah, Co-Founder and CEO at Dina Payers Lean on Technology to Coordinate New Innovative Supplemental Benefits to Improve Quality, Outcomes, and Costs for Seniors Non-medical supplemental benefits like in-home support services, meal delivery, home modifications, and transportation have skyrocketed with Medicare Advantage (MA) plans.

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BHM Healthcare Solutions

JUNE 24, 2025

Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced a new industry-wide initiative to streamline prior authorization processes. In June 2025, the U.S. Led by HHS Secretary Robert F. Kennedy, Jr.

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Interoperability Medicare 98

Health Populi

OCTOBER 30, 2024

Bravo to Essence Healthcare, a Medicare Advantage plan, for offering Oura rings in 2025 to members who want to engage with self-tracking, sharing data, and acting on advice to benefit their health as they age.

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Healthcare IT Today

JANUARY 8, 2025

Margins are tight, IT teams are being asked to rationalize and evaluate their budgets, and the new administration will emphasize accountability in programs like Medicare.

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Health IT RCM Patient Experience Life Science 87

Healthcare IT Today

JUNE 13, 2025

Industry experts warn: Organizations have months, not years, to prepare for unprecedented audit expansion The Medicare Advantage industry faces its most significant regulatory disruption in decades. The New Reality: From Selective to Universal Coverage The scale of this change cannot be overstated.

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Healthcare IT Today

JUNE 14, 2025

Colin and John debated what CMS is asking for, whether the right stakeholders will chime in, and how Medicare can make technology easier for beneficiaries to use. All Medicare Advantage plans are now subject to annual RADV audits , in an effort to reduce $40 billion in excess payments to MA plans.

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Life Science Healthcare IT Medicare Nursing 84

Electronic Health Reporter

JUNE 26, 2025

Federal audits targeting Centers for Medicare & Medicaid Services (CMS) reimbursements are intensifying, and rehab therapists are already feeling the impact. This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. By John Wallace, PT, MS, FAPTA, chief compliance officer, WebPT.

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Medicare 91

FierceHealthIT

JUNE 16, 2025

Democrats in the House and Senate have introduced a new bill that would establish a new "Part E" for Medicare that will allow people to opt into the program.

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Medicare 101

Mobi Health News

JULY 3, 2025

It has 600,000 members across Medicare Advantage, Medicaid and commercial lines of business. Astrana Health has more than 20,000 providers and more than 1.6 million patients via its affiliated provider networks, management services and integrated care delivery clinics, which include primary, specialty, ancillary and 24/7 virtual care.

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Healthcare IT News - Telehealth

JUNE 3, 2025

"State medical boards, the Centers for Medicare & Medicaid Services, and commercial payers all are stepping up enforcement around where and how care is delivered.

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Telemedicine Medicare Telehealth Healthcare IT 160

Healthcare IT Today

DECEMBER 22, 2024

Access to home health for Medicare beneficiaries is decreasing , according to a recent report from Trella Health, with the number of home health visits per day down more than 17% between 2017 and 2023. That said, rejection rates hit a trough in 2018 and have increased 16% since then.

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Healthcare IT Today

JUNE 11, 2025

On June 3, Dr. Mehmet Oz, the Centers for Medicare and Medicaid Services (CMS) Administrator, at a meeting with health technology stakeholders in Washington, DC, announced that CMS plans to help fix these problems by building a national healthcare directory, starting with provider information. billion on annual maintenance.

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Healthcare IT Today

JANUARY 14, 2025

Medicare Advantage (MA) will likely see expanded backing, further solidifying its role as a cornerstone of value-based care. Dana McCalley, VP of Value-Based Care at Navina In 2025, we can expect sustained momentum for value-based care, driven by advocacy groups pushing for a full transition and strengthened by bipartisan support.

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Health IT Primary Care Mental health Patient Experience 79

Digital Health Wire

APRIL 21, 2025

The Peterson Center on Healthcare is back with another report that doesnt mince words when it comes to remote patient monitoring: RPM reimbursement in Medicare is misaligned with the clinical value of these tools. Although only ~1% of Medicare patients are in RPM programs, utilization has grown exponentially since the start of the pandemic.

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Healthcare IT News - Telehealth

APRIL 14, 2025

For Medicare, telemedicine reimbursement and regulation has been about kicking the can down the road – more temporary extensions of COVID-era flexibilities. Anything that will increase healthcare spending or Medicare spending is seen as difficult. The current ones run out on September 30. That's where we stand right now.

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GlobalMed

DECEMBER 16, 2024

These provisions allowed for Medicare coverage of telehealth visits regardless of geographic location and eliminated in-person visit requirements for certain services. Telehealth at a Crossroads: The Impact of Expiring Waiver During the public health emergency (PHE), telehealth benefited from temporary regulatory flexibilities.

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Healthcare IT Today

OCTOBER 25, 2024

taxpayer dollars, such as Medicaid and Medicare, if the requisite cybersecurity baseline is not met. As these pieces of legislation suggest, the mandatory implementation of technical controls is crucial to improving cybersecurity for the healthcare industry and, in turn, protecting patient data and wellbeing.

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Healthcare Cybersecurity Medicare Healthcare IT Leadership 117

Health Populi

MARCH 3, 2025

We must accept uncertainties in our forecasting and planning for coverage of Medicaid and Medicare, as well as VA health care, in the current environment — because we don’t know what we don’t know about plans for each of these programs through the Federal lens. health care.

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Digital Health Medical Billing Primary Care Interoperability 177

Healthcare IT Today

DECEMBER 30, 2024

Allison Combs, Head of Product, Payer, Clinical Effectiveness at Wolters Kluwer Health In 2024, Medicare Advantage faced decreasing reimbursement rates alongside surging enrollment, and both trends are likely to continue into and beyond 2025. Government-funded capitation has to ensure care is adequate.

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Healthcare IT Today

JUNE 2, 2025

Improving the Healthcare Experience with Value-Based Care and Payer-Provider Collaboration The Centers for Medicare & Medicaid Services aims to have all Medicare fee-for-service beneficiaries and the vast majority of Medicaid beneficiaries in value-based care relationships by 2030.

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EHR Medicare Primary Care Patient Experience 101

FierceHealthIT

MAY 22, 2025

is cracking down on Medicare Advantage in the latest effort to root out waste, fraud and abuse. Mehmet Oz, M.D.,

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Medicare 87

Healthcare IT Today

JUNE 9, 2025

We kick this episode off by sharing our thoughts on CMS’s ask for input on technology for Medicare beneficiaries. Lastly, we conclude this episode with a discussion on some of the things Medicare could do with technology to improve it for patients. Are they asking the right stakeholders, and will they get stakeholder involvement?

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Healthcare IT Medicare Leadership Health IT 106

AMC Health

DECEMBER 18, 2024

CMS recently published its 2025 Medicare Advantage and Part D Star Ratings fact sheet. Medicare Advantage Plans Are Under-Performing CMS most recent findings echo trends weve seen for quite some time. Here, we explore some of our key takeaways, how they will impact your plan, plus, how you can boost your Star ratings in 2026.

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Medicare 52

Healthcare IT Today

OCTOBER 26, 2024

Read more… It’s Time to Combat “Instafraud” in Medicare Advantage. If 65% of patients use a mobile device when interacting with their care provider , then it’s time for organizations to shift away from prioritizing web-based and portal offerings, said Lee Jones at Gozio Health.

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Electronic Health Reporter

DECEMBER 18, 2024

By Don Rucker, MD, chief strategy officer, 1up Health Medicare Advantage is a capitated health plan and the government, which pays for the plan, needs massive amounts of performance data to ensure that plans do […] The article How is Medicare Advantage Policy Forcing Changes in Payer Tech Stacks? Illegal copying is prohibited.

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Medicare 91

Health Populi

DECEMBER 30, 2024

Health Populi’s Hot Points: I leave time in my frenetic schedule at CES for serendipity to kick in.

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Digital Health Health Policy Mental health Medicare 156

Connected Health Initiative

JULY 17, 2025

CHI letter to CMS-CMMI re Wearables (17 July 2025) The post CHI Letter regarding The Center for Medicare and Medicaid Services Action Needed to Provide Every American with Access to Wearables within Four Years first appeared on Connected Health Initiative.

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Healthcare IT Today

MARCH 14, 2025

Between 2019 and 2022, hospital expenses surged by 17.5% , while Medicare reimbursement rose just 7.5%. The following is a guest article by Russell Graney, Founder and CEO at Aidin Hospitals are at a breaking point. Margins are razor-thin, costs are skyrocketing, and staff burnout is at an all-time high.

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Health Populi

OCTOBER 22, 2024

Finally, check out this persona that PwC developed from this year’s health consumer research; this group of people are characterized as tech-resistant with health at-risk — likely a Medicare-covered population, at high-risk for not exercising or engaging in wellness activities — while having low digital adoption compared with five (..)

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Digital Health Mental health Telehealth Medicare 156

Healthcare IT Today

JUNE 6, 2025

Medicare does not require a concurrent authorization, making it an often overlooked space. The Role of AI The role of AI in determining outpatient medical necessity and prior authorization has received the majority of the media focus. Less attention has been paid to inpatient medical necessity and concurrent authorization.

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FierceHealthIT

MAY 15, 2025

The CMS, within the HHS, wants feedback on how it can develop better digital health tools for Medicare beneficiaries and drive adoption.

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Medicare Digital Health 61

Healthcare IT Today

JUNE 13, 2025

It could be lead screening for a child in one location, an eye exam for a patient with diabetes in another, and a comprehensive assessment with care planning through a hybrid visit with a nurse practitioner for a Medicare Advantage member in the afternoon.

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