Earlier this year the Centers for Medicare and Medicaid Services introduced the "Wasteful and Inappropriate Service Reduction" model, a series of prior authorization requirements designed to ensure timely and appropriate Medicare payment for select items and services in six states (New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington) that take effect Jan. 1.
As part of the “WISeR” requirements, CMS selected tech vendors to implement enhanced technological models to
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Technology
Cornell Survey: Experts Warn HSA Conversion and Small Premiums Threaten ACA Affordability
What You Should Know:
- A new survey from the Cornell Health Policy Center reveals that 70% of health policy scholars believe converting ACA subsidies into Health Savings Accounts (HSAs) would worsen affordability for enrollees.
- Additionally, 81% of experts agree that ending automatic renewals—a policy slated for 2028 under the "One Big Beautiful Bill Act"—will substantially reduce Marketplace enrollment. These findings come as policymakers scramble to find alternatives to enhanced
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Why Rural Health Transformation Must Include Maternal Health
Congress’ most recent budget reconciliation bill included controversial cuts to Medicaid spending. The legislation slashed hundreds of billions of dollars from the program over the next decade, a move that is likely to disproportionately affect rural hospitals and safety-net providers.
To offset the cuts, lawmakers introduced the $50 billion Rural Health Transformation Program (RHTP), a five-year initiative (2026-30) meant to
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Expert Insight on Silicone Products for C-Section Scar Support
C-section recovery brings a mix of physical changes and new routines, and many parents look for simple ways to support their scar as it heals. Silicone products offer gentle comfort while helping the area feel protected during movement. They rest softly on the skin and fit easily into everyday postpartum habits. This guide explains what experts say about silicone for C-section scars and how it supports smoother healing.
Many new mothers begin with silicone strips for scar reduction once the
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Prenatal Compliance: Solving SDOH Needs Builds Trust with Moms
Pregnancy is one of the most-expensive episodes for insurers, averaging about $19,000 for pregnancy, vaginal delivery and postpartum care, and $26,000 for cesarean births. Compared with other industrialized nations, costs in the U.S. are nearly eight times higher.
And what do mothers in the U.S. get in return for this high-priced care? They get the highest death rate per 100,000 live births in the developed world, with 18.6 deaths recorded in 2022, compared with 5.5 deaths per 100,000 in the
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Auxira Health Raises $7.8M to Solve the Cardiology Shortage with Virtual Clinical Pods
What You Should Know:
- Auxira Health, a virtual cardiology company co-developed by MedStar Health, has secured $7.8M in seed funding to address the growing cardiologist shortage and clinician burnout crisis.
- Unlike standard telehealth platforms, Auxira embeds dedicated "clinical pods" of nurses and advanced practitioners directly into existing practice workflows, training them on-site to ensure seamless integration.
- The funding will fuel the company's expansion,
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The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags
What You Should Know:
- A new report from Sage Growth Partners reveals a striking disconnect in the healthcare industry: while only 20% of C-suite leaders believe progress has been made in value-based care (VBC) recently, 77% plan to increase their participation in these models over the next two years.
- The "plot twist" indicates that despite operational hurdles and low revenue exposure today, hospital executives view VBC as essential for long-term financial survival. The data
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Healthcare Costs vs. Wages: Why Premiums Are Absorbing Your Annual Raise
Healthcare costs are consuming an increasingly large share of household budgets. A RAND study found that payments to finance healthcare averaged $9,393 per person, or nearly 19% of average household income. For many families, that means more than a line item on a paycheck. It shapes the way people decide when to see a doctor, whether to fill a prescription, and how secure they feel in their jobs. A benefit once seen as a cornerstone of compensation is now a source of financial stress. For
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The $4,000 Deductible Era: Why Employer-Sponsored Insurance is Breaking the American Worker
What You Should Know:
- A new 50-state analysis reveals that over half (51.7%) of U.S. private-sector workers are now enrolled in high-deductible health plans (HDHPs) as employers struggle to manage rising costs. The report shows that annual family premiums jumped to $24,540 in 2024, outpacing inflation, while average family deductibles surpassed $4,000 for the first time.
- The trend exposes millions of Americans to greater financial risk in medical emergencies, signaling a
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ACOG Declares Telehealth an “Ethical Imperative” for Obstetric Care
The maternal healthcare industry has been divided over the use of telehealth since the early days of its use for obstetrics.
Concerns about losing the personal connection of the physician-provider relationship, compromising the quality of care, and adding more work to a strained labor force initially complicated the adoption of telehealth. However, a growing body of research and on-the-ground experience slowly dispelled those concerns, and the COVID pandemic accelerated an emerging clinical
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