The Achieving Healthcare Efficiency through Accountable Design, or AHEAD, model launched in 2023 to put states on the hook ...

The WISeR Model will test innovative tools, including artificial intelligence, to streamline prior authorization for certain items and services identified as prone to fraud, waste, abuse, and ...

Health plans and employers view gene therapy affordability as a significant challenge, as CMS rolls out a sickle cell model to improve cost outcomes.

The Centers for Medicare & Medicaid Services (CMS) announced a new experimental model late last week to streamline some prior authorizations under the traditional Medicare program, but some ...

Maryland is doubling down on all-payer hospital payment, and CMS is hoping other states might follow suit despite major challenges to its success. Since the advent of Medicare and Medicaid, states and ...