CMS’s newly finalized TEAM payment model holds hospitals accountable for entire surgical episodes
Editor's Note As part of the Centers for Medicare and Medicaid Services (CMS) newly issued 2026 Final Rule, the Transforming Episode Accountability Model (TEAM) will hold hospitals and health systems accountable for the entire episode of care for major surgeries, from admission through 30 days post-discharge. HIT Consultant reported the…
CMS payment overhaul could cut specialist pay
Editor's Note A “quiet transformation” in how Medicare pays doctors could reduce payments for specialty care, including rates for billing codes associated with surgery, diagnostic imaging, outpatient care, pain management, and orthopedics, Modern Healthcare July 22 reports. According to the article, The Centers for Medicare and Medicaid Services (CMS) 2026…
Providers call for deeper reform despite CMS proposing payment hikes in 2026
Editor's Note CMS is boosting 2026 Medicare outpatient payments by 2.4%, but provider groups warn the increase barely scratches the surface of mounting financial strain. Alongside the payment bump, the agency is proposing a two-track physician reimbursement model that ties rates to value-based care participation. While some see these moves…
Bad debt climbs as patient defaults, denials impact hospital revenue growth
Editor's Note Bad debt—payments hospitals expected to collect but ultimately had to write off—is increasing across hospitals as patients struggle to pay their share of healthcare costs and insurers raise the rate of claim denials, Modern Healthcare reported June 19. Citing a Kaufman Hall analysis of data from about 700…
ASCA 2025: Leading lawmaker reflects on surgery center priorities
Editor's Note At the 2025 Ambulatory Surgery Center Association (ASCA) conference, discussion of legislative priorities extended beyond educational sessions. Thanks to a visit from the ranking lawmaker of the congressional subcommittee responsible for most healthcare policymaking, attendees also got first-hand insight into the latest negotiations on Capitol Hill. US Representative…
Legislation proposes to halt Medicare physician payment cuts
Editor's Note A January 31 statement from the American Medical Association (AMA) announces the organization’s support for bipartisan legislation aiming to reverse steep Medicare reimbursement reductions threatening physician practices and patient care access. Introduced by a coalition of 10 House members, the "Medicare Patient Access and Practice Stabilization Act" would…
Commentary: Studies show how surgeon decisions follow the money
Editor's Note Financial incentives can shape surgeons’ decision-making, but their effectiveness depends on the structure of the payment model. This is the central message of a January 26 article in Forbes reporting on two studies: one linking a sharp increase in hernia cases to a simple Medicare coding change, and…
Study: Demand for anesthesiologists rises sharply, driven by job market, regional variations
Editor's Note A recent study by RIVANNA® Medical, a leader in medical imaging technology, highlights a rising interest in anesthesiologist careers across the US, showing a 46% increase in online job search activity from August 2020 to August 2024, Rivanna Medical reported in October 2024. The study analyzed search trends…
2025 Medicare reimbursement cuts spark concern among physicians
Editor's Note Doctors facing inflationary and operational cost increases are decrying recently finalized 2025 Medicare reimbursement rates, according to a November 4 report in Healthcare Dive. The 2025 rates reduce physician payments by 2.9% while increasing rates for hospital outpatient departments and ambulatory surgery centers (ASCs) by 2.9%, the outlet…
Vertical integration reshaping US healthcare: Impact on cost, access
Editor's Note A growing trend toward vertical integration in US healthcare is leading to significant changes in how care is delivered and billed, according to a new study by Brown University researchers published on September 16. Vertical integration refers to the consolidation of physician-owned practices into larger health systems, a…
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