THE BILL On May 12, the Congressional Research Service released its first formal overview of a Medicare experiment that has been quietly underway since New Year’s Day. It is called the Wasteful and Inappropriate Service Reduction Model, or WISeR for short, and it represents the largest expansion of prior...
Value-based purchasing (VBP) is a payment approach that ties reimbursement to the quality of care delivered rather than simply the volume of services provided. Think about how the traditional fee-for-service model works. A provider gets paid for every test, procedure, and visit, regardless of whether the patient got better,...
For five years, enhanced premium tax credits made Affordable Care Act marketplace plans far cheaper for tens of millions of Americans. First passed in the 2021 American Rescue Plan Act and extended through the Inflation Reduction Act, those subsidies expired at the end of 2025 after Congress declined to...
For years, the bottleneck for AI in healthcare has not been the technology. It has been the billing code. Original Medicare pays for visits, procedures, and a defined set of activities — none of which describe what an autonomous system actually does when it manages a patient’s blood pressure...