From pay cuts to workforce evolutions, 2024 was a tumultuous year for physicians. Here are five pieces of good and bad news each for physicians: The bad news CMS cuts pay again Amid rising industry concern about physician reimbursement declines, CMS finalized a 2.83% physician pay cut Nov. 1. The 2025 Medicare Hospital Outpatient Prospective…

Primary care practices are facing a significant shift as the Centers for Medicare & Medicaid Services (CMS) continues to push toward its goal that all Medicare beneficiaries be under a value-based contract by 2030. Moreover, providers are faced with constant challenges in maintaining sustainable practices with ever-increasing administrative burdens, staff shortages and increasing operational costs….

The Center for Medicare and Medicaid Innovation (CMMI) within CMS is tasked with fostering “healthcare transformation by finding new ways to pay for and deliver care that can lower costs and improve care.” An important component of CMMI’s agenda is the accountable care organization (ACO) model in fee-for-service (FFS) traditional Medicare (TM). CMS defines ACOs…

As we move through the second half of 2024, managed care organizations must prioritize member engagement, especially for individuals with chronic conditions. This period presents an opportunity to embrace strategies that encourage essential healthcare visits, such as annual wellness and primary care appointments. Read on for member engagement tactics that focus on precise member identification,…

The healthcare industry has been buffeted by a growing number of challenges over the past few years. This turbulence struck provider organizations in 2022, while payers were initially sheltered from the storm (Exhibit 1). But conditions became more difficult for payers in 2023, which has continued into this year, and there’s limited respite on the…