A podcast on the key issues in healthcare, featuring innovators from across the industry.
We power our members by building our community and fostering connections through executive peer learning. We support professional growth through talent and development. We accelerate understanding by delivering timely and actionable data and insights on key challenges. And we catalyze transformation by building alliances in areas where the power of the collective is greater than the power of one.
CMS released the calendar year 2025 proposed rules for the physician fee schedule (PFS) and outpatient prospective payment system (OPPS).
Supreme Court ends Chevron deference, impacting agency interpretation of statutes.
EvidenceCare published a video and supporting article on how to advance IT initiatives in a lean environment featuring Lifepoint Health's CIO, Al Smith, and EvidenceCare's CEO, Bo Barthlomew.
In June, 11 health system members provided feedback to CMS regarding quality program modifications and health equity-related initiatives
In mid-August, CMS announced that it has negotiated lower Medicare prices for ten widely used drugs, taking advantage of new authorities legislated by Congress in 2022.
The FTC is preparing a lawsuit against the three largest PBMs—OptumRx, Express Scripts, and CVS Caremark—over allegations that they steered patients to more expensive drugs in exchange for manufacturer rebates.
Headwinds from MA utilization and Medicaid disenrollment are continuing to put a drag on payer profits, and policymakers are increasingly focused on prior authorization.
CMS confirmed it will rework this year’s Medicare Advantage star ratings after facing a string of legal losses in cases brought by payers disputing recent methodological changes.
On April 1, CMS released its final rate announcement for MA in CY2024, choosing to make no significant changes to the proposal in January that cut payers’ benchmark rate.
A bipartisan bill to reform prior authorization in Medicare Advantage has been introduced in Congress with 130 representatives and 42 senators as sponsors, a signal of broad support.
Our featured numbers in the news this week, including the uninsured rate, GLP-1 poisonings, and PE deals.
In the first quarter of 2024, hospital and health system M&A activity spiked with 20 deals reported, the highest since 2020 but still ~30% below pre-pandemic levels.
In early May, the Department of Justice announced the creation of a new task force focused on healthcare monopolies and collusion.
Our favorite reads from the past week, including STAT's coverage of the AI "Pepsi challenge" and a Wall Street Journal investigation into home visits in MA.