While other areas of healthcare have been star-struck by sophisticated AI and massive infrastructure investments, safety net entities have found that the answer is much simpler. Better managing chronic conditions across populations simply requires the right connection at the right time. 

The post The Quiet Revolution Comes Full Circle: How CMS ACCESS Validates Safety-Net Innovation appeared first on MedCity News.

OSHA and NIOSH recommend that all hospitals develop comprehensive violence prevention programs. Here are some action items that provide a framework for building a legally defensible program.

The post OSHA’s Evolving Approach to Workplace Violence Prevention in Healthcare appeared first on MedCity News.

Over the past 15 years, financial and administrative barriers – most notably step therapy mandates and prior authorization requirements – have repeatedly forced patients through suboptimal or ineffective treatments before they can try another therapy, have tied the hands of healthcare professionals and patients alike. Now there’s a possible solution.

The post Join the Fight Against Chronic Pain: It’s Time for Breakthrough Legislation in Congress appeared first on MedCity News.

Generic medicines face no tariffs, though the Trump administration reserves the right to revisit that in the future. Some branded drugmakers face a reduced tariff rate, but that could change if they don’t reach a so-called most-favored nation drug price deal.

The post The Drug Companies Avoiding Trump’s Tariffs — For Now appeared first on MedCity News.

Leaders must resist the urge to replicate urban models that do not translate well to rural contexts. Instead, they should design solutions that are built for rural communities, grounded in local insight and enabled by scalable capabilities.

The post A Once in a Generation Opportunity to Reimagine Rural Health appeared first on MedCity News.

For providers, the rules mean more control over monitoring and the chance to keep a larger share of reimbursement. For device companies, they create a chance to show measurable value and guide clinicians through a system that is shifting quickly.

The post How New Medicare Rules Will Reshape Cardiac Monitoring and Remote Patient Care appeared first on MedCity News.

Further change in the Star Ratings program is inevitable, but one thing won’t change: plans that make targeted investments in improving the member experience and clinical outcomes, driven by data, are the most likely to succeed and achieve a higher overall rating.

The post 2026 Star Ratings Shift: 4 Strategies for MA Plans appeared first on MedCity News.

The challenge for policymakers is balance: encouraging rigor without unintentionally weakening a program that now serves the majority of Medicare beneficiaries. Thoughtful rate calibration can determine whether this transition strengthens the program or strains it unnecessarily.

The post Medicare Advantage’s Discipline Era — and Why the Final Rate Notice Matters More Than It Appears appeared first on MedCity News.

We cannot wait for CMS to hand us perfect blueprints for rehab. The time is now for rehab leaders to define what optimized care looks like, build these pathways using evidence and outcomes data, and then aggressively demonstrate that our services are the most effective way to align with the new strategic direction of healthcare.

The post Optimizing Care Pathways: The Next Frontier in Rehab Performance appeared first on MedCity News.

The 15 drugs selected for the Centers for Medicare and Medicaid Services drug price negotiation program accounted for about $27 billion in total prescription spending under Medicare Parts B and D. But this revenue from Medicare makes up a small percentage of each drug manufacturer’s total sales.

The post With CMS’s New List of Meds for Drug Price Negotiation, Analyst Sees Small Financial Hit to Pharmas appeared first on MedCity News.

A unified workflow for all referrals, resulting in fewer clicks and less confusion, means provider matching can be conducted based on specialty, location, insurance, and real-time availability, for an easier track to the right provider, not just any provider.

The post TEAM Success Depends on How Well a Hospital Ensures Medicare Patients Get the 30-Day Episode of Care They Need appeared first on MedCity News.

The DEA’s anticipated extension of telehealth prescribing flexibility once again averts an immediate disruption in care, but it leaves providers and patients in the same cycle of uncertainty that has persisted for years.

The post Another Extension Expected for Virtual Prescribing, Same Uncertainty appeared first on MedCity News.

The decision to eliminate nursing and PA degrees from ‘professional degree’ status isn’t just a financial policy choice; it’s a workforce policy choice. And, unfortunately, it’s moving in the wrong direction at the worst possible time.

The post Reclassifying Nursing Degrees Puts Us All At Risk appeared first on MedCity News.

Using Section 232 national-security tariffs on imported medical equipment risks repeating the same mistakes that have long plagued U.S. health policy: relying on blunt instruments for complex problems.

The post Trade Restrictions on Medical Equipment? Proceed With Caution appeared first on MedCity News.

The Trump administration can immediately take these two price transparency administrative actions to reduce costs and improve affordability.

The post President Trump Can Act Now To Make Healthcare Affordable appeared first on MedCity News.

Americans largely trust their doctors but are skeptical of payers, drugmakers and hospital leadership — a divide fueled by rising costs and a complex, opaque healthcare system. Kristin Wikelius of United States of Care said restoring confidence will require more transparency, simpler navigation and policies that prioritize preventive care.

The post What Is Needed to Rebuild Trust in U.S. Healthcare? appeared first on MedCity News.

Clinging to our old models is equivalent to waiting for failure. We need to embrace the tools, team structures, and delivery models that this ongoing crisis demands.

The post Stress Test: OBBBA, Rural Fragility, and Innovation appeared first on MedCity News.

Newly launched Pfizer drugs will be priced at parity to prices in comparable developed nations, according to the most-favored nation pricing agreement. But industry observers note that big pharma companies are also raising some prices overseas as part of a strategy to protect U.S. revenue.

The post Pfizer Reaches Deal on Most-Favored Nation Drug Pricing; Other Pharmas Expected to Follow appeared first on MedCity News.

There are aspects of the plan worth praising, but these benefits are overshadowed by three key concerns that will disproportionately impact vulnerable populations if the plan is implemented as written.

The post Where The AI Action Plan Falls Short On Healthcare Trust appeared first on MedCity News.

FDA Commissioner Marty Makary said publishing complete response letters recognizes public interest in the transparency and credibility of agency decision-making about drugs. He also said the move complies with an executive order that covers the communication of scientific data.

The post Embracing Transparency, FDA Will Make All Future Drug Rejection Letters Public appeared first on MedCity News.

The Trump administration’s Make America Healthy Again nutrition policies and Medicare Advantage plan ethics were prominent themes on the latest episode of the Debunked Podcast with MedCity News Editor-in-Chief Arundhati Parmar and guest co-host Paul Markovich, CEO of Blue Shield of California parent company Ascendiun.

The post Debunked Episode 18: Unpacking MAHA, Nutrition on a Regional and Global Scale appeared first on MedCity News.

Here’s a roadmap that brings together a wide range of existing and new initiatives under four key goals that enable community-based organizations to take stock of their existing capabilities and coordinate across them effectively.

The post Protecting Members’ Medicaid Coverage Must Start Now appeared first on MedCity News.

At the heart of this fight are the patients whose lives quite literally depend on Medicaid. But we are also fighting for the caregivers who show up every day, the children who rely on stability, the families who rally around their loved ones, and all those whose lives are shaped by access to care.

The post Medicaid Helps Families — Like Mine — Live the Promise of “Life, Liberty, and the Pursuit of Happiness” appeared first on MedCity News.

Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers.

The post CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation appeared first on MedCity News.

The One Big Beautiful Bill Act has drawn criticism from healthcare groups for slashing Medicaid and ACA subsidies, but it contains a few provisions that could drive progress.

The post Are There Any Healthcare Wins Hidden Inside the One Big Beautiful Bill Act? Yes, a Few… appeared first on MedCity News.

For hospitals and health systems, the challenge is steep, but so is the opportunity. TEAM offers a framework to deliver more coordinated, cost-effective, and patient-focused care. Those who prepare now will be far better positioned to thrive in a value-based future.

The post Mandatory by 2026: 5 Ways to Prepare for CMS’ TEAM Payment Model appeared first on MedCity News.

Inaccuracies don’t just erode trust — they lead directly to surprise billing events, missed appointments, care delays, and in some cases, enforcement action.

The post Beyond Broken Links: The High Stakes of Provider Directory Accuracy in the No Surprises Era appeared first on MedCity News.

A delayed diagnosis can cause a progression in severity (from mild to moderate to severe), increased suffering for the entire family, as well as enhance the risk of long-term neurological damage and the time it takes for them to heal.  

The post The Hidden Autoimmune Disorder Affecting Our Kids: Understanding PANS and PANDAS appeared first on MedCity News.

Through the convergence of proactive policy, advanced technology and strategic public-private partnerships, we can achieve this “no wrong door” vision and deliver a connected, streamlined social safety net that’s more efficient, economical, and effective. Here’s how.

The post No Wrong Door: How Policy, Technology & Partnerships Can Power a Connected Social Safety Net appeared first on MedCity News.

Public debate is growing, but the real path forward lies in defining autism’s biology — and for the first time, we can.

The post The Administration’s Autism Plan Is Controversial – But It Also Presents a Vital Opportunity appeared first on MedCity News.