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The Billion-Dollar Question: Who Wins and Who Loses After CMS Halts EHO4All?

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The Medicare Advantage ecosystem spent two years preparing for one of the most consequential changes to Star Ratings: the Excellent Health Outcomes for All (EHO4All) health equity measure.Insurers upgraded data systems, redesigned care management, and built extensive operational frameworks to lift equity performance. Then CMS abruptly signaled that EHO4All may not move forward in 2027 […]

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When Oversight Fails: What OIG Enforcement Teaches Us About Documentation, Billing Integrity, and Organizational Risk

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A recent federal settlement involving Vohra Wound Physicians has once again placed a national spotlight on one of healthcare’s most persistent vulnerabilities: documentation and billing integrity.The case, which resulted in a forty-five million dollar settlement under the False Claims Act, is not an isolated event. It is part of a broader pattern of federal enforcement

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Why the White House and Tech Giants Are Racing to Block State AI Laws

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Artificial intelligence is rapidly reshaping healthcare, finance, national security, and the entire digital economy. But as AI accelerates faster than regulation, a new battle has emerged in Washington:Should states or the federal government set the rules for AI? Behind closed doors, the White House, major technology companies, and congressional leaders are moving quickly to stop

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Who Will Be Left to Care? Rebuilding America’s Primary Care Pipeline.

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Primary care is the backbone of America’s healthcare system — yet the foundation is cracking.While medical students enter the field with optimism and purpose, many are being pushed away by rising debt, stagnant pay, and policy neglect that make the dream of serving communities harder to sustain. The crisis in primary care is not new

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AI Won’t Fix Healthcare — But Augmented Intelligence Might.

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Artificial intelligence (AI) has dominated healthcare headlines — from predictive diagnostics to administrative automation. Yet as adoption accelerates, an important distinction is emerging: the future belongs not to artificial intelligence, but to augmented intelligence. Augmented intelligence enhances human judgment rather than replacing it. It is about machines amplifying human insight, not substituting for it —

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When AI Decides Who Gets Care: Why Medicare’s New WISeR Model Has Providers Alarmed.

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Artificial intelligence is about to enter one of the most controversial corners of American healthcare: Medicare prior authorization.The Wasteful and Inappropriate Service Reduction (WISeR) Model, scheduled to begin January 1, 2026, will introduce AI-driven prior authorizations for traditional Medicare beneficiaries — for the first time in history. While the Centers for Medicare & Medicaid Services

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The Cardiology Gold Rush: Why Private Equity Is Targeting the Heart of Healthcare

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In recent years, private equity has found a new frontier in healthcare — and this time, it is going straight for the heart. Across the United States, cardiology practices have become one of the fastest-growing targets for private equity investment, signaling a shift in where financial capital meets clinical opportunity.The attraction is clear: a fragmented

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Inside America’s Healthtech Hubs: Why Innovation Still Has a Zip Code

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In healthcare innovation, geography still matters. Despite a decade of digital transformation and promises of a borderless innovation economy, America’s healthcare startups continue to cluster in a handful of cities — where research institutions, investors, and health systems intersect. A new analysis by Healthworx, the innovation and investment arm of CareFirst BlueCross BlueShield, ranked the

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When Growth Meets Gravity: Why CVS Is Closing 16 Oak Street Health Centers

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In healthcare, scale often promises stability — but the latest move by CVS Health to close 16 Oak Street Health centers reveals the growing tension between ambition and affordability in the primary care landscape. The decision, announced as part of CVS Health’s $2 billion cost-cutting plan, underscores how even well-capitalized organizations are struggling to reconcile

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CMS Just Raised Physician Pay — But Who Actually Wins?

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The Centers for Medicare and Medicaid Services (CMS) has finalized its 2026 Medicare Physician Fee Schedule, delivering a modest 2.5% reimbursement increase for physicians who treat Medicare beneficiaries.At first glance, it looks like long-awaited good news after years of stagnant or declining rates. But beneath the surface, the regulation signals a structural reshaping of how—and

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