Payer Systems

How Will CMS Updates Boost IPF Payments for FY 2026?
Management & Administration How Will CMS Updates Boost IPF Payments for FY 2026?

In a significant move for mental health care providers, the Centers for Medicare and Medicaid Services (CMS) has rolled out a series of updates to the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS) for fiscal year 2026. These changes, detailed in a recent final rule,

Why Is CareOregon Limiting Out-of-Network Mental Health Care?
Management & Administration Why Is CareOregon Limiting Out-of-Network Mental Health Care?

In a healthcare landscape increasingly defined by rising costs and funding uncertainties, a significant policy shift by CareOregon, a Portland, Oregon-based nonprofit managed care organization, has sparked attention and concern among its members and industry observers. This nonprofit, the largest

CMS Partners with Tech Firms for New Health Data Ecosystem
Management & Administration CMS Partners with Tech Firms for New Health Data Ecosystem

In a landmark effort to transform the landscape of healthcare data management, the U.S. Centers for Medicare & Medicaid Services (CMS) has launched an innovative federal Health Technology Ecosystem, as announced by President Donald Trump at the White House. This bold initiative seeks to overhaul

How Are Employers Tackling Rising Specialty Drug Costs?
Management & Administration How Are Employers Tackling Rising Specialty Drug Costs?

The escalating expense of specialty drugs, critical for treating complex conditions such as cancer and rare diseases, has emerged as a pressing issue for employers and health plans across the healthcare landscape, demanding urgent and innovative solutions. With these medications accounting for a

Are Single-Payer Systems Failing Rare Disease Patients?
Management & Administration Are Single-Payer Systems Failing Rare Disease Patients?

The challenges of providing breakthrough therapies for rare diseases within single-payer healthcare systems are becoming increasingly evident. These systems, which aim to offer universal healthcare, often face dilemmas when funding high-cost treatments for low-population diseases. In contrast,

Are Single-Payer Systems Failing Cancer Patients With Delays and Limits?
Management & Administration Are Single-Payer Systems Failing Cancer Patients With Delays and Limits?

The ongoing debate over the effectiveness of single-payer healthcare systems has significant implications for cancer patients, who uniquely depend on timely and advanced medical interventions. As this article delves into the critical challenges faced under such systems, it becomes apparent that

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